Frequently Asked Questions

We have provided answers to the most frequently asked questions we receive. Please feel free to contact us if you do not find the information you are looking for.

Birth Services

In what settings do you provide birth services?

HOME, BIRTH CENTER & HOSPITAL

The Willowsong Midwives are have been doing homebirth since April 2001; Birth Center birth at Healing Passages Birth & Wellness Center since October 2012 and hospital birth at Broadlawns Medical Center with admitting privileges since September 2014.

What is a free-standing birth center?

A Birth Center is a homelike facility, existing within a health care system with a program of care designed in the wellness model of pregnancy and birth. Birth centers are guided by principles of prevention, sensitivity, safety, appropriate medical intervention, and cost effectiveness. Birth centers provide family-centered personalized care for healthy women before, during and after normal pregnancy, labor and birth. (www.birthcenters.org)

Why choose a birth center, you ask? Well, as midwives we often say, “Welcome to OUR home”. The birth center provides a way for us to support women and families in a facility that is created for the purpose of holding the space for birth. It is in such a ‘home’ that women do the hard work of labor without unnecessary intervention, in a comfortable, sacred space made for birthing; making it safe for mother and child. The birth center allows us to reach more women who may never consider a homebirth, but want a similar experience within a facility.

Our birth center is called Healing Passages Birth & Wellness Center and is the only independently owned birth center in Des Moines. Our location brings women close to the major hospitals of the Des Moines Metro area in the event the laboring woman/new baby needs to transport or risk status changes. Iowa Methodist Medical Center, a level 1 trauma center, is a convenient 5 minutes away. Mercy Medical Center, a level II trauma center is also less than 10 min from our center. Broadlawns Medical Center, a Level III trauma center and our hospital of choice for most transports, is just down the street. Ultimately, the birth center is more cost effective than the hospital for healthy women and newborns; making it affordable for families and thus more sustainable for our community.

Who is appropriate for out-of-hospital birth?

We believe that pregnancy is normal and that your body knows how to give birth. Your age and number of prior pregnancies do not matter to us, as long as you are healthy—physically, emotionally and mentally. In order to birth outside the hospital, your pregnancy must be at least 37 weeks gestation (3 weeks before your due date). We follow international standard of care for out-of-hospital birth appropriate clients. The midwives will do a thorough review of prior medical records, especially prior births, to help them decide if you are a good candidate. Women are taken on a case-by-case basis, depending on their unique stories. Risk is evaluated all the way through your pregnancy, on a day by day, moment to moment basis.

The midwives work closely with the greater healthcare community collaborating, consulting, and referring as needed with local perinatologists, OB/GYNs, chiropractors, acupuncturists, massage therapists, energy healers and counselors. We need a healthy mom and a healthy baby at the end to proceed with the out-of-hispital birth. Although the majority of women will qualify, there are high-risk situations that are not appropriate for out-of-hospital birth. We cannot accept clients with twins. We do not do a planned breech. Other examples of high-risk situations that are not suitable for an out-of-hospital birth include chronic high blood pressure, diabetes requiring insulin, placenta previa (the placenta is over the cervix), pregnancy induced hypertension requiring medication or preeclampsia, or a medical problem with the baby (heart defect, etc) that will require special care.

During your pregnancy and prenatal care there is much that can be done to prevent many complications. If you were considered high risk during a previous pregnancy we would be happy to review your chart with you and determine if you remain in a higher risk category or not. If you have a question about your “risk status” feel free to call and speak with a midwife about your personal concerns.

What emergency equipment or medicine do you provide?

Whether we are doing a home birth or in our birth suite, we have supplies and medications equivalent to a Level I labor and delivery room in a hospital. This would be similar to many of our rural hospitals in Iowa. We have at every birth, all of the equipment necessary for fetal monitoring in labor, newborn resuscitation (meconium aspirators, resuscitators, oxygen tanks & masks, Laryngoscopes, etc.) and postpartum hemorrhage (includes IV fluids and medications), among many other things. Because our supply list is so extensive, we answer any specific questions you have at your consultation upon request.

Birth centers are not mini-hospitals — your labor will never be induced or stimulated with oxytocin (Pitocin) or herbs; and C-sections, instrumental deliveries and continuous monitoring with electronic fetal monitors are NOT done at birth centers.

We are fully equipped to stabilize and transport. We are diligent to follow the international standards of out-of-hospital birth, which includes not being further than 30 minutes from our Level I Trauma Center in the metro area or any of the Level II hospitals here locally.

Do you do waterbirth?

Yes! We love water labor and birth. We currently offer water birth at home or in the Birth Center. We cannot do waterbirth at the hospital at this time. The pain relief experienced by a laboring woman during submersion in warm water is well documented. Clients can 1) birth in their own home tubs or 2) rent or buy their own tub and manage the set-up and clean-up themselves or 3) rent through a tub service in the area that takes care of it all! Large heated birthing tubs with pain relieving jets are available to women for an additional fee through our preferred, all-inclusive, independently owned tub business: www.tubworksiowa.com

http://www.waterbirth.org

 

How many families do you accept per month into your care?

Because some women go early, some go late, and some right on time, we currently help approximately 8-10 women with their babies per month. We are a two midwife practice, growing into a three midwife practice. We believe very much in a work/life/family balance for our team. Due to the extensive postpartum follow-up we do, we have found that 4-5 births/midwife each month is perfect. The ratio is slightly higher for hospital based doctors and midwives. Months can easily fill up, so we encourage prospective clients to call today to schedule to come to an orientation run by one of our midwives. It is a great opportunity to see our space and how different it is from a traditional medical clinic, tour our birth suite and here about our services. The best time to research this is before you become pregnant!

Can I have pain medications or an epidural at a birth center?

No. An epidural requires an anesthesiologist and the birth center does not have one on staff. Epidurals and pain medications used during labor and delivery increase risk to both mother and baby, and that increased risk is better managed within a hospital setting.

Midwives are well acquainted with a wide array of techniques to manage pain in labor. Your midwives and birth team will help you discover effective pain-relief without the use of drugs. Freedom of movement, eating and drinking in labor, hands-on support, use of water, and the presence of a skilled professional well-acquainted with normal birth all enhance women’s ability to cope in labor without the risks associated with medical pain relief.

Who may I have with me at the birth?

You may have anyone you like at your birth and who is supportive and inspiring to your choices. We strongly urge our clients to surround themselves with positive, helpful people. We will help maintain your vision of birth. Please remember that this time is all about you and your family. When choosing who to have present, please consider “How will this person aid in this process?”, “Do they provide loving energy?”, “Can they help with my children or prepare food?”. Remember, you need to be able to let go during birth, with absolutely no inhibitions. During your prenatal visits we discuss what to expect at the birth and what should be expected of everyone: A prepared birth team and family with love and support make for a wonderful birth! We encourage you to bring friends or family members that you plan to have at your birth in for a tour if they have additional questions or concerns. And of course, they are always welcome at your prenatal visits!

What if I have to transfer to a hospital?

Willowsong Nurse-Midwives now have admitting privileges at Broadlawns Medical Center and began offering planned hospital birth to women in September 2014. Women needing to or choosing to transfer for non-emergent reasons to Broadlawns can now stay in the care of the Willowsong Team!

Hospital transfers do happen, sometimes by choice, and sometimes by need. The birth center is located close to many wonderful hospitals. In the case of a non-emergent transfer you can choose the hospital of your choice. In the rare case of an emergency you will be transferred to either Iowa Methodist Medical Center or Mercy Medical Center, located only 5 minutes away. The majority of transfers occur in your family’s car. Some though, will need an ambulance to transport us to our hospital of choice. We love working with the local EMS crews if needed and are skilled at making any transfer smooth and quick.

For homebirth, it is the same. Our midwives only attend women at home who live within a thirty minute transfer time to a Level II hospital or Level I Trauma Center. This transfer time is standard of care for any provider on call for birth—whether that provider is transferring you into the hospital OR meeting you at the hospital.

Willowsong Midwifery Care has been operating in Des Moines since April 2001! Over the years we have established good relationships with many obstetrical physicians and the hospitals in which they work. This makes our transfers smooth and easy. The Willowsong birth team will never abandon you at the hospital door. We stay with our clients once they are in the hospital, transfer care to the team awaiting us with your full medical record and then provide support for you and your family until the end of your birth experience.

Numerous studies have shown that a planned birth center or home birth is as safe as a hospital birth for low-risk women. Women giving birth in these settings experience lower rates of intervention in birth, including lower usage of drugs for pain relief, fewer pitocin inductions and lower rates of induction overall, lower rates of episiotomy, fewer operative births, and lower cesarean section rates without compromising the safety of their births.

Do you accept women who have had a prior Cesarean birth?

Healing Passages Birth & Wellness Center is currently considering women for a Trial of Labor (TOL) to birth at our Birth Center. Our VBAC policies are dictated by our current malpractice contract and standards set forth by the American Association of Birth Centers for all Accredited Centers.

We are NOT accepting women for a TOL:

  1. who desire to birth at home or
  2. who have had two prior cesarean births or
  3. whose uterus was repaired with a single layer instead of a double layer

All women coming into care are assessed for risk status and appropriateness for midwifery care based on their personal medical history and prior labor and birth records. Women desiring TOL must get their labor records (intrapartum nursing notes) and their surgical report for the midwives to review. Both midwives must agree to take on a client. Candidates are assessed based on the likelihood of having a successful VBAC. We talk through all the available options and challenges with attempting TOL at Healing Passages and in the Des Moines area.

For women who are determined to not be good candidates for our Birth Center (due to prior labor history or they have criteria #2 or #3 above), we currently have the ability to co-manage with physicians in Nebraska and with the midwives in Iowa City—in a relationship known as shared care. This is perfect for women wanting the Willowsong Model of Care. We do the prenatal and post birth care and clients birth with the providers in Omaha or Iowa City.

Nurse-Midwifery Care

What is a Certified Nurse-Midwife?

Certified nurse-midwives are registered nurses who have graduated from a nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME) and have passed a national certification examination to receive the professional designation of certified nurse-midwife. Nurse-midwives have been practicing in the United States since the 1920s—ACNM (www.midwife.org)

As midwives:

  • We honor the normalcy of women’s lifecycle events
  • We believe in:
    • Watchful waiting and non-intervention in normal processes
    • Appropriate use of interventions and technology for current or potential health problems
    • Consultation, collaboration and referral with other members of the health care team as needed to provide optimal health care—ACNM

 Why choose a midwife?

The World Health Organization says: “Midwives are the most appropriate primary health care provider to be assigned to the care of normal birth. Midwives are experts in normal pregnancy, birth and post birth care, and offer personalized care based in the belief that pregnancy and childbirth are normal, healthy aspects of life. Your midwife strives to help you and your family learn to trust and believe in pregnancy and the birth process.”

What is a CNM’s scope of practice?

Midwifery as practiced by certified nurse-midwives (CNMs®) and certified midwives (CMs®) encompasses a full range of primary health care services for women from adolescence to beyond menopause. These services include primary care, gynecologic and family planning services, preconception care, care during pregnancy, childbirth and the postpartum period, care of the normal newborn during the first 28 days of life, and treatment of male partners for sexually transmitted infections.—ACNM

What is a Willowsong Midwife?

Willowsong Midwives are all Advanced Registered Nurse Practitioners/Certified Nurse-Midwives (ARNPs/CNMs). A CNM in the state of Iowa is a nurse-practitioner and has an independent license and full prescriptive authority (can write prescriptions for medicine). They are NOT by license, dependent on physicians. Willowsong midwives are considered community experts in the physiological birth process and experts in birth outside the hospital. We have been providing home birth and well-woman care since 2001 to women like YOU who are searching for something different in the care you receive. Whether it is for your well-woman exam, your pregnancy and birth, or for your newborn; if you are searching for more sensitive, individualized, more holistic care; you have found your team! WELCOME to our growing community. Here you will find some of the most educated and empowered families, dedicated to changing the way we, as a community, as a culture, think about CARE and BIRTH.

Payments & Costs for Midwifery Birth Services

What is healthcare sharing and is it an option for my family?

Many of our clients have used a cost-sharing arrangement to cover all or part of their prenatal care fees. Organizations like Samaritan Ministries and Christian Healthcare Ministries provide networks of members who help defer each other’s healthcare expenses, but do maintain certain requirements for participation (members may need to prove adherence to a Christian faith and lifestyle, or sign up in advance of conception, for example). This might be a good option for you if paying for birth care out-of-pocket or through traditional insurance is not feasible. For more information, please visit the following websites:

http://www.chministries.org

http://samaritanministries.org

 

 

 

What services are included in the Conscious Birth package?

  • Routine prenatal visits, (once a month until 28 weeks, every other week until 36 weeks, weekly until delivery) including a comprehensive initial prenatal and physical exam and pap smear
  • Availability of an on call Midwife 24 hours a day during your entire pregnancy and postpartum
  • Group Prenatal classes peppered in with one-on-one visits with our midwives
  • Access to our Client Connections Secret Facebook page
  • Access to our exclusive Birth Circle evening group
  • Free entry into our Prenatal Breastfeeding Class by freshMums
  • Labor support
  • Birth services
  • Use of the water birth tub is included in the birth center fee. Home birth clients typically contract with TubWorks for their tub or they use their own
  • Postpartum care (the initial three-four hours post birth, a 24 hour visit, a day two breastfeeding visit, a visit between day 3-5, a visit between weeks 2-3 and one six week group visit with mothers and babies back at the office.
  • Immediate newborn physical exam at the time of birth
  • Newborn assessment at all of the included postpartum visits
  • Filing of your baby’s birth certificate & social security card
  • Personalized pregnancy paperwork and folder
  • Access to our wonderful lending library
  • Breastfeeding support and counseling
  • Nutritional counseling
  • Complimentary billing to your insurance company

What are the costs of the Conscious Birth Package?

When a woman decides that Willowsong is right for her, she is choosing a model of care that is unique in our community. We feel that the quality of personal attention and care we provide is worth investing in. Birth centers and home birth practices enjoy better health outcomes for mothers and babies than standard hospital care for comparable childbearing populations.

The professional Care of the Mother fee for both home birth and birth center birth is $5400. There are additional fees for newborn care and for birth center facility use; please call our office to inquire about details.

Planned hospital birth is $5200 for individualized care and $4800 for group care (this does not include hospital facility fees).

A portion of fees are paid in full by 34 weeks gestation. Please contact our office for additional details.

Our fees are billed to your insurance as out-of-network. We are NOT currently in-network for any birth package.  As a courtesy to the client, our fees include billing services to help you receive a refund from your insurance company.

The facility fees for both home birth and birth center birth and the professional fee for the Willowsong Midwifery Service for you and your baby cost substantially less than a normal, vaginal hospital birth. With hospital birth, you are responsible for both the hospital facility fee and the professional fee for your prenatal, labor and birth care and postpartum, as well as baby care. These fees can range anywhere from $10,000-$20,000; higher if you have a cesarean birth or any intervention during the process.

 

Are your birth services covered by insurance?

Our birth package fees are currently out-of-network with major insurance companies. Clients pay in full by 34 weeks gestation and we bill your insurance company for you, as a courtesy following the birth. It is not that we do not want to be in-network, it is that traditionally, insurance companies are not willing to reimburse our fees in full, nor recognize that our care is substantially different from the current community model of pregnancy care. This is similar to the lack of reimbursement for most preventative, holistic care, such as: acupuncture, chiropractic, massage, energy healing work & herbal medicine.

We are currently working with a national billing company to negotiate, not only our facility fee for birth at Healing Passages Birth & Wellness Center, but Willowsong’s professional midwifery fee, as well, for both home, birth center birth & hospital birth.

It is really important that you fully understand how your out-of-network coverage works. Your insurance company is yours, not ours. You chose them to cater to your health needs. You play an important role in advocating that insurance companies reimburse nurse-midwives in the out-of-hospital setting. The global fee for all prenatal care, birth, and postpartum services is significantly less than area hospital delivery charges, which makes your out-of-pocket costs comparable to, if not less than, a normal vaginal delivery at the hospital.

Imagine at 3 months postpartum you are getting a refund check instead of a bill from your insurance, for services not covered for your hospital birth!

What if my insurance plan does not cover childbirth unless attended by a physician?

For insurance companies it comes down to cost. Since a birth center birth and homebirth costs 30-50% less than a normal hospital birth, we believe that it is good health care policy to provide maternity coverage for healthy women experiencing normal pregnancies who desire the out-of-hospital experience. Nurse-Midwives in Iowa are Advanced Registered Nurse Practitioners (ARNPs/CNMs) & are experts in healthy pregnancy, labor and birth. They are licensed by the State of Iowa to attend births in a variety of settings without the supervision of a physician. We encourage consumers to inform their insurance providers directly about their support for midwifery care and the birth center/homebirth option.

Also talk with your employer about changing the benefits summary for the plans that are offered to advocate for midwifery care and coverage!

Why pay for a birth experience with our Willowsong Team when my insurance would fully cover the current standard of care in a hospital?

Are you willing to pay more for an exceptional product/experience or pay minimal for status quo? We make these choices on a daily basis in all aspects of our lives. For the Willowsong team, the experience is everything, the relationships are everything, the connections are everything and simply cannot be found anywhere else!

The comprehensive maternity care and newborn care offered by the Willowsong Nurse-Midwives is exceptional. Our model of care with true informed consent and partnership in care, low intervention in healthy pregnancies, experts in physiological birth & the mother-baby connection, and community building through theVillage, is unparalleled in our community. Office visits last 1/2 hour or longer as needed, allowing you to develop an authentic relationship with your midwife and allowing her to fully explore your state of health and educate you on how to best prepare for a healthy childbirth.

Even more than that, when you enter into Willowsong’s care, you are embraced by a community. A community of women and men on the same journey as yourself—educated, passionate, determined. No where else will you find such support and connection. BIRTH has the ability to transform you for a lifetime. Instead of letting FEAR get in the way, believe that you can do it, and embrace the experience. The process along the way is everything.

Birth centers and homebirth practices have much better health outcomes than hospitals for healthy women experiencing normal pregnancies. Hospital cesarean birth rates and intervention rates in healthy labor & birth in our area and throughout the nation have been rising steadily over the past several years. The national c-section rate has been over 27%! In contrast, the average rate among birth center clients was only 4%. Cesarean section is major abdominal surgery, with significant long-term health consequences. It also provides a significant barrier to breastfeeding success, which also has a major impact on the long-term health of mother and baby.

Invest in your pregnancy care and help us advocate for this model to be available to everyone! Call your insurance company and be a part of a team of consumers that are helping to educate for better reimbursement for midwives and out-of-hospital birth!

Do you offer financing terms?

Midwifery fees are paid monthly and are due in full by 34 weeks in pregnancy. Payments are agreed upon at your first prenatal appointment. Our team is very flexible with each family and their unique financial situation. Every client has a different plan that works for them. We accept cash, check and major credit cards. Many clients pay out of their health savings account.

At your initial prenatal appointment, you will meet with our Client Care Coordinator to make all financial arrangements. All billing and insurance questions are directed to our account manager with Midwife’s Billing Service. We strongly encourage each client to work closely with billing to get a prompt and substantial return on their investment.

What is your financial policy?

We accept cash, checks and all major credit cards. Comprehensive maternity care fees are paid monthly and are due in full by 34 weeks in pregnancy. Payment plans are agreed upon at your first prenatal appointment. Don’t forget about your HSA or Health Savings Account. Money can be withdrawn from that to pay our services & then you have the added benefit of receiving tax benefits on your investment.

Most traditional indemnity health insurance companies, and several local HMOs that offer point-of-service (POS) plans, will cover our care based on your out-of-network coverage. We will work with you to determine if your insurance company covers our services.

Village Learning Center

If I have never been a client of Willowsong, can I come to theVillage?

YES! The foundation of theVillage is a community hub for women to gather for support and nourishment. We believe women are full of wisdom to share with each other, whether they choose to have children or not. Although some of our groups are closed to our clients only, many are open to the public. Go to theVillage tab and find ‘public groups and classes’ on our Village page.

If you are interested in our birth services, come to a free orientation. If you are a new mama looking for a supportive place to breastfeed, meet other breastfeeding women, or to get advice from our breastfeeding experts; come to our freshMums support group. For women who have experienced a tough birth journey or a loss in pregnancy or shortly after, you may find our Mother’s Tears Support Group the place for you. The community can get nutrition advice, learn about cloth diapering and baby wearing, attend a baby sign language class or an Attachment Parenting group! We also have a mother/baby postpartum support group, called MamaToto for anyone who wants to meet other cool mamas!

The best part is most of these offerings are FREE! Sign up today!

How do I register for a class or event?

Go to our Village calendar and click on the class you are interested in taking. Simply follow the link from there!

Well-woman Care

Can I see your midwives for my annual pap, well-woman exam?

YES! Our midwives love to do annual well-woman exams. And they are in-network with major insurance companies for these services! In a relaxing, home-like environment, come get your physical exam, pap/pelvic, clinical breast exam, annual blood work done, depletion evaluation, preconceptual counseling, birth control, sexually transmitted infection screening and talk with your midwife about setting your health goals for the year!

Go to theCare tab and check out our Empowered Well-Woman Care to learn more!