These questions are an important part of choosing care that feels safe, respectful, and aligned. This list is a starting place for meaningful conversation as you explore midwifery care.

1. What training, certification, and licensure do you hold?
   (Are you a CPM, CNM, or LM, and are you licensed in this state?)

2. How long have you been practicing, and how many births have you attended?

3. What is your approach or philosophy of pregnancy and birth?

4. How do you support informed consent and shared decision-making?

5. What does prenatal care with you look like?
   (Visit length, frequency, education, labs, and screenings.)

6. Who is a good candidate for homebirth in your practice?

7. What situations would make someone ineligible or require transfer of care?

8. How do you handle transfers to the hospital if needed?
   (Which hospitals, how often transfers occur, and whether you stay.)

9. What support do you provide during labor and birth?
   (Comfort measures, positioning, presence, and clinical care.)

10. What equipment and emergency supplies do you bring to a homebirth?

11. How long do you stay after the birth, and what postpartum care is included?

12. What newborn care do you provide in the first days and weeks?

13. What is the total cost of care, and what does it include?

14. Do you offer payment plans, superbills, or work with insurance or health sharing ministries?

15. What do you value most in the midwife–client relationship?

Is homebirth safe?
Safety in homebirth depends on appropriate candidate selection, skilled midwifery care, and clear plans for hospital transfer if needed. Studies of planned homebirths with trained attendants and established transport systems show that many families experience normal labor and birth with low intervention and favorable newborn outcomes when eligibility guidelines are followed.

UBC Midwifery Research: https://midwifery.ubc.ca/u-s-home-births-found-to-have-low-intervention-and-mortality-rates/

What are the current homebirth statistics in the United States?

Homebirth remains a small but steadily growing portion of U.S. births. Planned homebirths account for approximately 1–1.5% of all births nationwide, representing an estimated 35,000–50,000 births each year. Rates of homebirth have increased over the past decade, including a 22% increase from 2019 to 2020 and an additional 12% increase from 2020 to 2021. Growth accelerated during the COVID-19 pandemic as some families sought alternatives to hospital-based care. Increases in homebirth have been documented across multiple racial and ethnic groups

• ACOG: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/planned-home-birth

• CDC: https://www.cdc.gov/nchs/pressroom/releases/2022/20221117.htm

• Pew Research Center: https://www.pewresearch.org/short-reads/2022/07/28/home-births-rose-19-in-2020-as-pandemic-hit-the-u-s/

What do studies tell us about homebirth outcomes?

Research involving large groups of low-risk pregnancies shows that planned homebirth with a qualified midwife is associated with lower rates of medical intervention, including fewer cesarean births and less use of induction or epidural anesthesia. For carefully screened, low-risk individuals, studies have found comparable newborn outcomes to planned births in other settings.

• UBC Midwifery Research Summary: https://midwifery.ubc.ca/u-s-home-births-found-to-have-low-intervention-and-mortality-rates/

Homebirth is generally best suited for healthy, low-risk pregnancies. Factors such as your health history, how your pregnancy is progressing, and specific risk considerations all play a role. Common eligibility factors include carrying one baby, head-down positioning at term, and the absence of significant medical or pregnancy complications.

Because every pregnancy is unique, eligibility is assessed ongoing throughout care, not based on a single checklist. We will review your history, discuss your preferences, and talk through options together during consultation to determine whether homebirth is a safe and supportive choice for you.

Whenever possible, we encourage families to reach out early in pregnancy so there is ample time to build relationship, review health history, and prepare thoughtfully for birth. That said, late entry into care is sometimes possible, depending on availability, gestational age, health history, and current pregnancy factors.

When someone seeks care later in pregnancy, we take time to carefully review prior records, labs, ultrasounds, and overall well-being to determine whether community midwifery care remains an appropriate and safe option. Acceptance into care is always guided by safety, informed consent, and the ability to provide continuous, attentive support.

If we are unable to accept you into full prenatal care due to timing or clinical considerations, we will do our best to offer guidance, resources, or referrals so you are not left without support.

If you are considering midwifery care and are further along in pregnancy, we encourage you to reach out as soon as possible so we can explore your options together.

Eligibility depends on your full history, current pregnancy, and clinical findings. Some families may be best served with collaborative care, consultation, or hospital setting care. If homebirth is not appropriate, we can still help you navigate options and support your transition of care.

While ultrasounds are not typically performed in-office, we help coordinate labs and imaging through trusted local providers in accordance with Hawaiʻi regulations.

We take time to talk through each recommended test or screening, what it looks for, and how it may support your care. Results are reviewed together during our visits, creating space for questions, understanding, and informed choice. Nothing is rushed, and you are always invited into the decision-making process.

When ultrasounds or additional testing are needed, referrals are made, and findings are thoughtfully integrated into your ongoing care plan.

As a Certified Professional Midwife in Hawaiʻi, I do not independently write prescriptions in the same way a physician or Certified Nurse-Midwife does. However, within my licensed scope of practice, I am able to carry and administer certain medications commonly used in community birth care and work under standing orders or collaborative arrangements when required. If a medication outside my scope is needed, I help coordinate care with the appropriate provider to ensure you receive safe, timely, and well-supported care.

Care is offered within the community setting and is shaped by both collaboration and place. When I am working alongside local midwives, the location of care will depend on the primary practice and birth setting being served at that time.

When operating within my own practice, care is provided in your home, beginning with prenatal visits and continuing through birth, postpartum, and early newborn care. This allows for continuity, familiarity, and support within the space where families feel most at ease.

My typical travel range is approximately 1 to 1.5 hours, depending on location and road conditions. On Oʻahu, this generally includes families living in and around:

• Central Oʻahu (including areas near Schofield Barracks and Wahiawā)

• Honolulu Urban Core

• Leeward Coast (ʻEwa, Kapolei, Waiʻanae side)

• Windward Coast (Kāneʻohe, Kailua)

• North Shore

Availability and travel details are always discussed during consultation, with thoughtful consideration given to safety, accessibility, and continuity of care.

Yes. I would be honored to support you. Doula or monitrice support may include prenatal education visits to help prepare your mind and body for what lies ahead, gentle and continuous labor support, and thoughtful postpartum care. This approach offers steady guidance, encouragement, and advocacy while working alongside your hospital care team.

Yes, I do. Education is naturally woven into each visit, with space to learn, ask questions, and prepare along the way. If you are seeking a more in-depth childbirth education experience, whether in person or virtually, I would be honored to walk alongside you and provide thoughtful, evidence-informed guidance to help you feel prepared, confident, and grounded for what lies ahead.

Yes. Comprehensive well-woman care is an important part of lifelong health and is offered within the scope of licensed midwifery practice in Hawaiʻi. Services may include preventative care visits, health education, cycle awareness, fertility and family planning support, sexual and reproductive health counseling, and menopause transition support.

Well-woman care may also include Pap screening coordination, STI testing and education, breast health education, and referrals for age-appropriate preventive screenings. When laboratory testing, imaging, or procedures fall outside the midwifery scope of care, we coordinate referrals with trusted local providers to support continuity and seamless care.

Once care is established, you will receive a secure link via email to access your client portal and begin the intake process. At your initial prenatal visit, you’ll receive a Welcome Packet designed to help you feel oriented, supported, and prepared as we begin this journey together.

Your Welcome Packet serves as a living resource throughout your care and may include:

• Sections to record well-being and reflections from each prenatal visit

• Curated handouts and evidence-based information on recommended screenings and options

• Herbal remedies and supportive care suggestions, thoughtfully tailored to each trimester

• Space for journaling, reflection, and intention-setting

• Guidance on nutrition, nourishment, and gentle movement during pregnancy

• A homebirth preparation checklist

• A newborn care checklist

• Postpartum handouts supporting healing, adjustment, and life beyond the early weeks

• A personalized emergency transport plan for clarity and peace of mind

Your initial prenatal visit is typically about two hours, allowing time for unhurried conversation and connection. This visit includes a comprehensive health and pregnancy history, discussion of initial prenatal lab work and screening options, and education about what to expect in the weeks ahead. We will also begin shaping your personalized care and birth preferences together.

Follow-up prenatal visits are usually 45 minutes to one hour, offering continued assessment, education, and support as your pregnancy unfolds.

Prenatal care is designed to support both your physical well-being and your overall experience of pregnancy. Visits typically include routine maternal assessments such as blood pressure, fetal growth measurements, and listening to your baby’s heart tones. Prenatal lab testing and screening options are discussed thoughtfully, with time to review what each test looks for and how results inform care.

Laboratory testing may include standard prenatal labs such as blood type and Rh factor, anemia screening, infectious disease screening, and other assessments recommended during pregnancy. Results are reviewed together during visits, allowing space for understanding, questions, and informed decision-making. Nutrition, emotional wellness, education, and birth planning are woven throughout care, along with preparation for postpartum recovery and newborn care.

You will receive a birth kit link and a homebirth supply checklist in your welcome packet, allowing you to gather items gradually throughout your pregnancy. The birth kit typically includes essentials for comfort, a clean and prepared birth space, and postpartum recovery. Your midwife will review the list with you and is always available to answer questions or offer guidance along the way.

I come prepared with medical equipment and supplies necessary to support normal, physiologic birth and to monitor the well-being of both parent and baby in the out-of-hospital setting. This includes tools for assessing maternal vital signs, fetal heart tones, labor progress, and newborn transition after birth.

In accordance with Hawaiʻi midwifery laws and scope of practice, midwives also carry emergency equipment and medications appropriate for community birth, as well as supplies to support initial newborn care and postpartum monitoring. All equipment is maintained to meet safety standards, and protocols are in place for consultation or transfer if a higher level of care becomes necessary.

The intention is to offer care that is well-prepared, attentive, and grounded in safety, while honoring the normal rhythms of birth in the home setting.

Safety is always held at the center of care. Certified Professional Midwives prepare for unexpected situations by maintaining clear protocols for management and, when needed, timely transfer to a hospital.

Throughout pregnancy, risk is continuously assessed. Around your 36-week visit, we will review your personalized emergency and transport plan together not to cause worry, but to ensure you feel informed, prepared, and supported. This conversation helps everyone know what to expect and how care would continue smoothly if plans need to shift.

Decisions are made collaboratively, with transparency and respect, and consultation with other healthcare providers occurs whenever it supports the safety and well-being of you and your baby.

Care is always provided with safety, collaboration, and continuity in mind.

When I am operating within my own practice, homebirths are attended by myself and a trained birth assistant. Prenatal and postpartum visits are typically provided one-on-one, allowing for unhurried, personalized care in your home.

When I am working in collaboration with local midwives, births are attended by the primary midwife’s team, with my presence added as part of that collaborative care model. In these situations, prenatal and birth care follow the structure and protocols of the primary practice while still offering additional support and continuity.

Regardless of the setting, roles and support are clearly discussed ahead of time so you know exactly who will be present and how care will be coordinated.

Your safety, presence, and continuity of care are always carefully planned for. We intentionally limit the number of families accepted each month so that on-call availability is protected and each birth is met with attentiveness, calm, and unrushed support.

In the rare event that two labors overlap, a pre-established backup plan is already in place. This plan includes collaboration with a trusted, licensed backup midwife who are familiar with practice guidelines to ensure continuity and consistency.

Clear communication is prioritized throughout this process. You will know who is attending your birth, and care will continue seamlessly, with the same focus on safety, informed choice, and compassionate presence.

Labor and birth support begins well before labor starts. This includes on-call availability as you approach your birth window, guidance during early labor, and in-person assessment when labor is active.

During labor and birth, support includes continuous presence, skilled monitoring of both parent and baby, and hands-on comfort measures such as position support, breathing guidance, hydration reminders, and emotional reassurance. Care is attentive yet respectful of the natural rhythm of labor, allowing space for your body to work while remaining watchful and responsive.

Clinical care during birth includes ongoing assessment, support of physiologic birth, immediate newborn care after birth, and careful monitoring in the hours following delivery. Throughout the process, communication remains clear, calm, and collaborative, ensuring you feel supported, informed, and held during this sacred time.

After the birth, your midwife remains with you for several hours to support the immediate postpartum period. This time includes monitoring your recovery, supporting newborn transition, assisting with initial feeding, and ensuring both you and your baby are stable and comfortable before leaving.

Postpartum care begins immediately after birth and continues through the early weeks as your body, baby, and family adjust. Care typically includes multiple home visits in the first days after birth, followed by ongoing check-ins and visits during the first 4–6 weeks postpartum. These visits focus on physical recovery, emotional well-being, infant feeding, newborn growth, and family adjustment. Your specific visit schedule is outlined in your personalized care plan.

Yes. Newborn care includes early assessments, weight checks, screening support, feeding observation, and guidance on normal newborn behaviors and transitions. Ongoing newborn care is provided during postpartum visits, and support is offered as families establish routines at home. Assistance is also provided to help coordinate pediatric care or referrals when needed.

Yes. Feeding support is a core part of postpartum and newborn care. Support includes latch guidance, positioning, assessment of feeding effectiveness, and encouragement as you and your baby learn together. If additional or specialized lactation care is needed, referrals to trusted lactation professionals can be made.

Vaginal tears can happen during birth, even when labor unfolds gently. If a laceration occurs, it is carefully assessed right away.

CPM are trained to evaluate minor vaginal and perineal lacerations. When appropriate and within scope, first- and second-degree tears may be repaired in the home setting using sterile technique, local anesthesia, and comfort-focused care. Many small tears may also heal well on their own without suturing, and this option is discussed together based on your comfort, healing needs, and the nature of the tear.

If a laceration is more complex or outside the scope of safe home management, transfer for repair is recommended. This decision is made calmly, collaboratively, and with your safety and healing as the priority.

Yes. Postpartum care is a vital and honored part of the childbearing journey, and we offer supportive services designed to nurture healing, rest, and integration after birth.

Postpartum offerings may include placenta encapsulation, vaginal steaming education and support, and closing of the bones ceremonies, when desired. These services are offered as non-medical, supportive practices intended to complement postpartum recovery and emotional well-being.

Cultural respect and traditional practices disclaimer:
Many postpartum traditions come from diverse cultural and ancestral lineages. These offerings are shared with deep respect for their origins and are provided in a way that honors cultural integrity. They are not intended to replace medical care, diagnose, or treat medical conditions. Participation is always optional and guided by informed choice, personal beliefs, and comfort.

In addition to these offerings, postpartum care includes emotional support, guidance through physical and hormonal changes, and space to process the birth experience. When medical evaluation or additional care is needed, referrals are made to trusted providers to support comprehensive postpartum wellness.

After the initial postpartum period, care naturally shifts from frequent check-ins to longer-term support and continuity. Around six weeks and beyond, we focus on helping you transition confidently into this next season.

This may include a final postpartum visit to reflect on your birth experience, assess healing and emotional well-being, review family planning options, and ensure you feel supported as your body continues to recover. Guidance around nutrition, movement, sleep, emotional health, and the evolving needs of parenthood is also part of this transition.

For families who desire continued support, care may extend into ongoing well-woman services, interconception care, or postpartum support offerings, depending on your needs and preferences. When care transitions to another provider such as a primary care provider, OB-GYN, or pediatrician, we support that handoff with clear communication and referrals to trusted local providers.

Accepted payment methods may include electronic invoicing, bank transfer, card payments, or other secure options. All available methods are listed in your enrollment paperwork.

Yes. A deposit is usually required to reserve your place in care and begin services. Deposit amounts, refund terms, and related policies are clearly outlined in the service agreement before enrollment.

Yes. Payment plans are available. Which includes a deposit to reserve your due-date space, followed by scheduled installments leading up to your birth window.

What are my payment options?
We accept:

• Private pay (payment in full)

• Payment plans (monthly installments)

• Credit or financing support options

• Superbills for insurance reimbursement (as offered)

Refund policies depend on the timing of care, services already provided, and on-call commitment. All terms are explained clearly in the client agreement so you can review them before making a commitment.

Insurance acceptance varies based on credentialing and payer requirements. If direct billing is not available, many families choose to seek out-of-network reimbursement using superbills when applicable.

What can I do if my insurance doesn’t cover my homebirth?
If insurance does not cover homebirth care, families often choose self-pay. Options may include requesting a superbill for possible reimbursement, exploring out-of-network benefits, or using payment plans. Many families find a combination of these approaches helpful.

Will TRICARE cover my midwife services?
TRICARE typically covers services by Certified Nurse-Midwives (CNMs), but does not cover services provided by CPMs or lay midwives.

Do you accept Medicaid, Medicare, or private insurance in Hawaiʻi?

This is one of the most common questions I’m asked, and I want to be as clear and honest as possible so you can plan with confidence.

In Hawaiʻi, Certified Professional Midwife (CPM) care is most often self-pay. Insurance coverage for community birth is still limited and varies by plan.

Medicaid (Hawaiʻi Med-QUEST / QUEST)

At this time, Hawaiʻi Med-QUEST generally covers care provided by Certified Nurse-Midwives (CNMs), but does not routinely reimburse Certified Professional Midwives (CPMs). Because of this, families with QUEST usually plan to self-pay for CPM care.

Medicare

Medicare coverage is designed around Certified Nurse-Midwives (CNMs). Since CPMs hold a different credential, Medicare does not typically cover CPM-attended homebirth care.

Private insurance (Aetna, Kaiser, Blue Cross Blue Shield/HMSA, and others)

Private insurance plans vary widely:

• Many plans consider community birth care out-of-network

• Some may offer partial reimbursement, while others exclude homebirth

• Coverage depends entirely on your individual plan

I always encourage families to call their insurance provider directly to ask about out-of-network or homebirth benefits.

How I support you

Even when I’m not in-network, I can provide:

• Itemized receipts or a superbill

• Documentation you can submit for possible out-of-network reimbursement, if your plan allows

If you ever want to talk through your options or have questions about payment, I’m always happy to have that conversation with you.

Many families use HSA or FSA funds for midwifery and maternity-related expenses, depending on their plan’s rules. Receipts and superbills can be provided as needed to support reimbursement.

Many Christian health sharing ministries do share maternity expenses, and some allow reimbursement for homebirth and midwifery care when specific criteria are met. Coverage depends on:

• Length of membership before conception

• Adherence to faith and lifestyle guidelines

• Documentation submitted (contracts, invoices, birth records)

• Whether the provider meets their eligibility rules

Families are encouraged to contact the ministry directly to confirm current policies.

Can I combine a Christian health sharing ministry with self-pay or payment plans?
Yes. Many families choose to:

• Use payment plans with their midwife

• Submit expenses for potential reimbursement later

• Use health sharing as partial financial support rather than full coverage