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Healthcare in the US

Midwives and Ways to Give Birth in the USA

Giving birth is a very exciting life event and even more so if it happens outside of your home country. But never fear! We tell you all about what your insurance covers, how to choose the right ob-gyn or midwife, and which places are suitable for giving birth in the US.

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Choosing a Midwife

Midwives can supplement or partly substitute for the care you would usually receive from your ob-gyn. They support expecting women, advise you on how to stay healthy during your pregnancy, and assist you when giving birth to your baby. In comparison to ob-gyns, midwives often rely on a more holistic approach towards pregnancy and birth.

This does not mean that they cannot ensure a healthy and safe childbirth. Studies have shown that most midwife-attended births are just as successful and low-risk as births assisted by physicians. Licenses and certifications for midwives vary from state to state. Generally speaking, there are three kinds of midwives in the USA:

  • Certified Nurse Midwives (CNM) or Certified Midwives (CM) cannot perform surgeries but are experts in all other aspects of pregnancy and birth. They usually have an extensive education in this field and are certified to practice in all fifty states of the country. They can assist you during birth at any place of delivery and are often allowed to prescribe medication.
  • Certified Professional Midwives (CPM) completed a specific course of studies and have gone through a process of examination and certification. They are able to assist you during your pregnancy and birth at home.
  • Direct-entry Midwives are midwives who have not obtained a degree in this field but gained their knowledge in different ways. Some states license these midwives as they are often very professional and experienced.

The care and services midwives offer are usually not covered by health insurance providers. Some insurance companies offer reimbursements for midwifery services. If this does not apply to you, you should ask your midwife about different payment options or services for Medicaid recipients. That way, midwifery may still be affordable for you. Many midwives work with ob-gyns, too, assisting with births and providing advice during the patients’ pregnancies.

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The Right Kind of Delivery

Your baby can be delivered naturally, without major medical interference, with an epidural or via a C-section. A great number of women prefer natural births without any medication or surgical interference that could be a potential risk for their baby. They are a good choice if you have a low-risk pregnancy without any pre-natal complications.

However, in some cases, a C-section will be necessary. This mostly applies to medical emergencies, for example, if your pelvis is too small to deliver the baby naturally or if the baby is not lying in the right position. Talk to your midwife and your ob-gyn and make sure to choose a hospital where you feel comfortable and safe.

If the pain is getting unbearable, you can get an epidural. During this procedure, pain medication will be inserted in your lower back, causing effective pain relief and numbness below your waist without making you tired or affecting your mental health.

However, you will not be allowed to get out of bed after you have received an epidural. Even though you will no longer feel any pain, you will still feel the pressure of the contractions. Some women find this just as uncomfortable. Epidurals may sometimes cause fever or dropping blood pressure and weaken your body otherwise. This can have a negative effect on your baby’s health as well. Furthermore, home births or water births are not possible with an epidural.

The Right Place to Give Birth

Apart from the maternity ward at the hospital of your choice, you can also choose to give birth at home. Home births should be supervised by a competent midwife and only make sense for low-risk pregnancies as they are, of course, not fit for medical emergencies. However, home births are ideal for women who want a natural birth with little or no intervention at all. Epidurals or C-sections are not possible at home. Insurance plans usually don’t cover home births, but the costs may be lower than for a hospital birth. Talk to your midwife about different payment options.

Free-standing birth centers offer a perfect alternative to hospital births and home births. These centers usually allow the assistance of midwives and nurses. They often offer water-birth options, too, and are aimed at women who’d prefer a natural delivery. They try to offer the mother-to-be a relaxed and peaceful environment during childbirth as well as the assistance of professional staff. Many of them are attached to hospitals to make sure medical treatment or surgery is available in case of an emergency. Nevertheless, free-standing birth centers are not suited for high-risk pregnancies and do not provide epidurals.

The Birth Certificate

In the USA, your birth certificate is one of the most important official documents to prove your identity. It is usually required when applying for a social security number, a marriage license or driver’s license and on many other occasions. After the birth of your baby, you should make sure to obtain the birth certificate and keep it in a safe place.

If you have given birth at a hospital, the hospital staff will provide you with the necessary paperwork. Only if you have decided on a home birth will you have to apply for a birth certificate on your own. The information you have to submit varies from state to state, but it usually includes:

  • Your child’s full name
  • The legal names of both parents (including the maiden name of the mother)
  • The place of birth
  • The time and date of birth
  • Gender
  • Registration number

Fill out the birth certificate registration form and send it to your state’s Department of Vital Records. In some cases, you have to pay a small fee to get a certified copy.

Updated on: December 11, 2018
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