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

We offer home and birth center birth. Home birth since April 2001 and birth center birth since October of 2012. We are happy to attend birth in either setting. It’s up to you!

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. We are fully accredited with the CABC, the Commission for the Accreditation of Birth Centers. 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. 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. Your midwife will do a thorough review of prior medical records, especially prior births, to help her 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.

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, full newborn resuscitation 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.

Is water birth available at your Center?

Yes! We love water labor and birth. The pain relief experienced by a laboring woman during submersion in warm water is well documented. Each of our birth suites offers a large tub for women to labor in and to birth in if it feels right for them!

**Clients choosing home birth must make their own tub arrangements.

http://www.waterbirth.org

 

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!

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
  4. who have not already had a vaginal birth after their cesarean birth

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 midwife review. 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 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 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

How are the care providers different from those in the hospital?

The care team @ Healing Passages are considered community experts in the physiological birth process and experts in birth outside the hospital. We have been providing out-of-hospital 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 are the Birth Package offerings?

The Birth Center Blossom Package & the Home Birth Root Package are ALL INCLUSIVE and include the following:

• Free orientation to our care model and sustainable Center

• Complimentary foundational wellness class

• Care by a Certified Nurse-Midwife and dedicated team in our community based setting

• Direct access to your care team via text, email and phone

• A wellness approach to your health, your pregnancy, your care

• Personalized, family-centered care that empowers you, where children are welcome!

• Extended appointment times build trust

• The same care team follows you beginning to end

• We make decisions with you, not for you

• The only place where the woman has complete autonomy over her care and baby’s

• Extensive evidence based education & support, ensuring you are fully informed

• Access to your electronic health record via our system, Maternity Neighborhood

• Immediate access to a wellness community in & beyond our walls ~19 years strong

• Specialized prenatal & postpartum group care

• Discussion of newborn care, testing & medications prior to birth

• More time with your provider during your labor and birth

• A care team fully experienced in physiological, instinctive birth

• Skin to skin care in the newborn transition

• MotherBaby care means caring for you & baby for six weeks post birth

• Dedicated breastfeeding team of experts available to our community

• Prenatal and breastfeeding classes on site, included in your package

• Exclusive membership to our client only groups

• All in a one-of-a-kind building made from clay, metal, stone, water & wood

• A space for healing and health and that makes you go “Ahhh”

• Find yourself at Healing Passages

 

 

Are your BIRTH services covered by insurance?

Yes! But each client’s coverage is different. It is important to understand your out-of-network policy. Our birth package fees are currently out-of-network with major insurance companies. Clients pay in full by 34 weeks gestation and are then provided a receipt for care following their birth to self-submit to their insurance company for reimbursement.

 

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, can I participate in your community programming?

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 MotherBaby Cafe or take our breastfeeding class by freshMums. 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 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 on the website found on the home page or go into theVillage tab and click on the class you are interested in taking. Simply follow the link from there! You can always call the office to reserve a spot!

Well-woman Care

Can I come to your Center for my annual well-woman exam?

YES! We love to do annual well-woman exams. And we 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, hormone balancing, perimenopausal guidance 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!