If you are considering an Out-0f-Hospital birth for the very first time as a result of the Pandemic PLEASE read all of the following information PRIOR to contacting our office

Thank you for your interest in out-of-hospital birth. We are receiving a very  large influx of phone calls and requests of women wanting to transfer from a planned hospital birth to an out-of-hospital birth.  Some of the inquiries are from couples who would have NEVER considered an alternative-style birth but are now exploring due to the severe restrictions of in-hospital births.  Others possibly considered out-of-hospital birth originally and are now revisiting that option.  We understand that this is a difficult time for birthing couples and hope that we can help you as you navigate your options.  In order to answer some general questions and concerns, we've put together this section.

Precautions


All of us at APM are following the guidelines and precautions to help ensure that the birth center, our clients and our staff have minimal exposure and maximum protections from Corona virus and other illnesses.  We have always prided ourselves on the cleanliness and attention to details and we have only increased our diligence during the pandemic.   Everything that we are doing falls in line with our philosophy  that the more things we can do preventively in pregnancy means the more freedom mothers have  and the less restrictions we need to implement during birth.  


Ancient Paths Midwifery is considered a Wellness Center and has a long-standing policy of only healthy, asymptomatic clients, staff and guests are allowed inside.  Staff has been tested for COVID antibodies (all negative) and continue being tested for active illness every 3 weeks.  Staff and clients are all screened upon entrance with temperature and verbal screening of symptoms.  We are following social distancing with clients waiting to come inside once the previous client has departed & the exam room, office and restroom completely sanitized.  We have put up a sneeze guard at the desk so you can come sit and schedule your next visit, make a payment and sign any papers while being protected. Staff are wearing protective clothing and equipment and following rigorous hand-washing requirements. Many midwives in CA have stopped attending water births due to the possible exposure of maternal feces in the water.  We have ALWAYS worn the shoulder-length gloves to eliminate contact with the birth water and continue to do so, eliminating this risk.  We also don aprons & face protection during the birth.  


Regardless of how you feel about this virus (we know the pendulum swings wide on both sides), you can rest assured that we are doing everything possible to remain compliant, protect the people we come in contact with,  and work towards the goal of having the sweetest pandemic birth possible!     

Considering Becoming a Client?  Please make sure you meet the criteria for low-risk, normal pregnancy and birth.

In addition to the normal Medical Board of California Guidelines for Client Selection we are outlining the following to help you decide if you meet the low risk criteria for out-of-hospital birth. If you have anything you're unsure of, please email our office.  


  • Mother pregnant with 1 baby, head down at time of delivery, at least .
  • Pregnancy must be free of complications such as High Blood Pressure, no placenta previa, abnormal fetal anomalies, etc. 
  • No history of IVF, previous significant birth complications such as forceps delivery, chorioamnitis, retained placenta or uncontrolled hemorrhage.
  • Women with Gestional Diabetes must be well controlled by diet (No insulin or RX medications to control)
  • Women with a history of previous cesarean section must have also had a successful VBAC (vaginal birth after cesarean).  A birth summary of all previous deliveries is required prior to acceptance in to care including a delivery summary showing the successful VBAC. 
  • First time mothers will be considered based on their history and birth preparation. 
  • Must have began prenatal care with the current pregnancy by 14 weeks, have a Dating Ultrasound in first trimester and full OB/Anatomy US in second trimester.  Ultrasounds must be normal; no low-lying placenta, Bicornate uterus, abnormal fetal anatomy, etc.   
  • If transferring care at 29+ weeks, must have had valid gestational diabetes screening with either the 1 hour screening followed by a negative 3 hours GTT if 1 hour was positive, OR a negative 2 hour GTT.  All testing must have been done using Glucola (no jelly bean tests, or self home monitoring of glucose levels), Must also have CBC and RPR done after 26 weeks.
  • If transferring after 36 weeks must have a GBS culture; negative result and baby in head-down position
  • Must have completed all late transfer practice requirements by the onset of labor to deliver at the birth center
  • MUST have current pregnancy records including all laboratory, ultrasound and physician notes as well as a labor and delivery summary of each prior birth.
  • Any pertinent missing labs to be drawn by APM, must receive results PRIOR to onset of labor
  • As always, clients must be alcohol, drug and tobacco free. 











Special Considerations When Considering Out-Of-Hospital Birth

If you met the criteria listed above for transferring to our practice there are some additional things you need to be aware of PRIOR to requesting a consultation.  

  • At this time we are only doing births at the Birth Center.  Those desiring a homebirth are considered and will be accommodated as the pandemic situation allows.  
  • Prenatal Visits are done by a combination of both Telehealth appointment and Office Visits. Telehealth visits are done between 9-Noon and in-person office visits will follow between 1-4 pm, on the same day.
  • Only the pregnant woman is allowed to be present at the in-office appointments and everyone in her household must be symptom/illness free
  • Woman in labor must be at least 37.0 weeks pregnant and not more than 41.6 weeks pregnant or she will be required to give birth in hospital
  • At the time of labor, you will be admitted to birth center once you are at least 5 cm.  
  • Only the Spouse/Partner is allowed to be present at the labor/delivery/postpartum, no guests at the birth center.  A professional Doula is also welcome but it must be a Professional/Certified Doula and also have COVID-19 negative testing.  
  • The birthing couple must shower and put on clean clothing within 1 hour prior of being admitted to the birth center and must be symptom free.  
  • There is NO epidural or pharmaceutical pain relief available at the birth center, this is NATURAL birth only
  • Waterbirth is and will continue to be an option for labor and birthing
  • Mothers who are Rh NEGATIVE will have babies cord blood tested at delivery and if baby is Rh POSITIVE, the mother will receive Rhogam injection prior to discharge
  • Babies are given a thimerosal-free, preservative-free dose of Vitamin K prior to discharge.  
  • Babies receive prophylactic eye treatment unless parents decline
  • Midwives are unable to administer the newborn Hepatitis vaccine, this will be done with pediatrician at a later date
  • All clients will be discharged to home at 2-3 hours after birth
  • There can be NO guests at your home until the Mother and Baby have completed their postpartum visit which will occur between 24-48 hours after birth.
  • If a transfer to the hospital become necessary, the midwives are not currently allowed to accompany you.  They will call the back-up obstetrician and give him report, fax the records to labor and delivery and you will be sent to either Montclair Community, San Dimas Community or Kaiser Ontario for admission. 


COSTS and FEES

The cost of our care is the same regardless of when in your pregnancy you begin care.  The birth package is $5700 and includes any/all in-person and telehealth prenatal care, the facility and staff for birth, in person postpartum visit at 24-28 hours if delivered at the birth center and telehealth postpartum care for 6 weeks after delivery.  It does not include the cost for lab work, ultrasound or any costs incurred if transfer to hospital becomes necessary.


IF YOU ARE BEGINNING CARE AT THE ONSET OF YOUR PREGNANCY OR TRANSFERRING AT 29 WEEKS OR LESS: we will collect a non-refundable deposit and then you will make monthly payments until you are considered due: end of 36th week. 


IF YOU ARE TRANSFERRING CARE IN YOUR THIRD TRIMESTER:

Payments for confirming your spot in our practice, review of medical records, prenatal Care including telehealth and in-person visits is $2300 to be paid in the following manner:

  • At the time of Registering there is an $800 non-refundable deposit
  • At 30 weeks a non-refundable $ 500.00 Payment is required
  • At 34 weeks a non-refundable $ 500.00 Payment is required
  • At 36 weeks a non-refundable $ 500.00 Payment is required
  • These payments may be made by cash, check, MasterCard, Visa or a Flex-Spending or Health Savings Account cards  
  • If you transfer out of care for any reason prior to 37 weeks there are no refunds on any payments made.


Payment for Birth and Postpartum Care including facility, staff, in-person and Telehealth visits is $3400 to be paid at 37 weeks or upon admission

  • The Final Payment can be made by Cash, MasterCard or Visa on the day the mother turns 37 weeks OR at time of labor you will be required to bring a $3400 CASH payment that will be received immediately upon admission. 
  • If paying by cash in labor, it must be in $100 denominations and paid immediately upon arrival and prior to the laboring woman being admitted to the birthing suite.
  • Once the woman has been admitted in to the birthing suite, there are no refunds if a transfer of care occurs.

NOTE:  

If the pregnant/laboring woman or anyone that she has had close contact with, lives with or is caring for her children has in the prior 14 days had any symptoms that may be a COVID-19 infection or contact in the last 14 days with anyone with a known COVID-19 infection she will not be able to have an in person appointment. If this is true at the time of labor, you will have to have a hospital birth.


INSURANCE:

If you have an HMO or Kaiser insurance your birth package costs will be entirely “out of pocket”. If you have a PPO, your charges can be submitted for possible reimbursement and there is a fee for this service.  See Insurance Billing pages on this website.


During the time of pandemic those with PPO insurance may be able to get a GAP exception for out-of-hospital birth where they will reimburse at the In-Network rates. 

Ancient Paths Midwifery is NOT a MediCal provider; we do not accept IEHP, LA Care, or any of the Covered California plans

Still Interested?

If you've been able to get through all the things we have had to do to remain compliant and are still interested in Midwifery Care, natural birth and learning more, we encourage you to visit the About Us, Services, Birth Center and Getting Started pages.  Once you've had a chance to do that, give us a call or email!