Midwives are skilled birth attendants who specialize in physiologic pregnancy, birth, postpartum care, early newborn care, and often well-woman care. In the United States, midwifery can feel confusing because there are several training pathways, professional titles, and state-specific laws.

You may encounter a variety of acronyms, including CPM, CNM, DEM, LM, CM, or TM. These reflect differences in education, certification, scope of practice, and legal recognition.

In Ohio, families may encounter:

• Certified Professional Midwives (CPMs) — nationally certified by the North American Registry of Midwives (NARM), specializing in out-of-hospital birth

• Community or Direct-Entry Midwives (DEMs) — trained primarily through apprenticeship and community-based practice

• Certified Nurse-Midwives (CNMs) — nurse-trained midwives who most often practice in hospitals, though some attend births in other settings.

Ohio does not currently offer state licensure for community midwives, meaning families have a wide range of legal options for midwifery care. Each pathway has strengths and limitations, and most midwives choose their route intentionally.

The best way to determine whether a particular midwife is right for you is simply to talk with them. Ask questions. Learn how they practice. Ohio law supports the autonomy of birthing families, and families here have meaningful choices.

For healthy, low-risk pregnancies, planned home birth with a trained midwife is supported by a growing body of research. Multiple studies demonstrate comparable safety outcomes when appropriate risk assessment, training, and transfer systems are in place.

Globally, midwifery care is associated with improved maternal and neonatal outcomes. Practices that support physiologic birth — including continuity of care, freedom of movement, individualized decision-making, and respect for the body’s natural processes — are protective regardless of birth setting.

Risk assessment is ongoing, individualized, and multifaceted. Safety is not a one-size-fits-all concept, and thoughtful care considers both evidence and lived experience.

Maybe. Or maybe not — and that’s okay.

Home birth is not something I try to convince anyone to choose. Instead, I enter into conversation with families to understand their hopes, concerns, health history, and circumstances. Together, we talk honestly about how normal labor and birth are supported, how situations outside of normal are handled, and what options are available if circumstances change.

The best birth experiences — in any setting — are those in which the birthing person feels safe, supported, informed, and respected. Pregnancy and birth are deeply personal experiences, and choosing where and with whom to give birth deserves time, reflection, and trust in your own intuition.

This is one of the most common concerns — and one of the biggest surprises for families.

While birth does involve body fluids, midwives and birth assistants are very skilled at preparation and containment. Most families are surprised by how little disruption there actually is. While you focus on resting and getting to know your baby, your midwife and assistants handle cleanup and leave your home looking much as it did before the birth.

Water is a wonderful tool for labor and birth. Deep water immersion can increase comfort, promote relaxation, support pelvic mobility, and provide gentle warmth for stretching tissues.

Many families plan to use water during labor, and some choose to give birth in the tub as well. Whether water birth is appropriate depends on individual circumstances at the time of labor and is discussed throughout prenatal care.

These concerns are usually rooted in love, fear, and misunderstanding — not lack of care. Clear communication, patience, and empathy go a long way.

Partners and primary support people need to feel confident that both parent and baby will be cared for safely. In this practice, the birthing person and any partner who will be present at the birth must be supportive of the home birth plan.

One of the benefits of relationship-based midwifery care is time. There is space for questions, discussion, and building trust. Often, even hesitant partners become strong supporters once they understand the model of care and have the opportunity to engage directly.

Prenatal care includes ongoing conversations about a wide range of scenarios — from normal labor to less-common complications. If a situation arises in which a higher level of care is needed, or if a birthing person simply changes their mind, care is transferred to a hospital setting.

In this practice, transfer is not viewed as a failure. It is a tool — and an important one.

I am proud to practice in a way that prioritizes timely, appropriate transfer when it best serves the safety, wellbeing, or preferences of the family. In some communities, midwives may feel pressure to avoid or discourage transfer in order to protect statistics. That approach does not align with my values. Advocacy means supporting families through all outcomes, not steering decisions to preserve numbers.

When transfer is indicated or desired, I accompany families, provide labor support, and help ensure continuity of information and care. Postpartum and newborn care typically resume following discharge.

The goal is not to avoid the hospital at all costs, but to ensure that care remains responsive, respectful, and centered on the needs of the birthing person and baby.

Both.

Midwifery draws from a wide range of tools, and no single approach fits every situation. In this practice, traditional herbal support and modern medical tools are used thoughtfully and responsively, depending on what the situation is calling for.

Herbs may be used to support comfort, nourishment, recovery, or physiologic processes when appropriate and desired. Medications and medical interventions are also carried and used when they are the safest or most effective option. These approaches are complementary, not opposed.

Care decisions are guided by clinical assessment, experience, evidence, and informed choice.

Home birth midwifery is sometimes misunderstood as being “minimal” or unprepared. In reality, midwives arrive equipped to support both normal birth and unexpected situations.

Equipment typically includes tools for monitoring maternal and newborn well-being, managing postpartum bleeding, neonatal resuscitation, suturing and perineal repair, administering medications when appropriate, and supporting water birth if planned.

Preparation is quiet and unobtrusive, allowing the focus to remain on the birthing person while ensuring readiness if circumstances change.

Trauma-informed care recognizes that many people carry past experiences — medical, personal, or systemic — that can affect how pregnancy, labor, and examinations are experienced.

In practice, this means prioritizing consent, choice, and communication. Procedures are explained before they happen. Touch is never assumed. Interventions are offered, not imposed.

This approach also includes minimizing unnecessary vaginal exams, honoring a client’s right to decline exams entirely, and respecting that labor progress cannot always be measured by numbers. Autonomy, dignity, and trust are central to care.

No. Recommendations within this practice are offered thoughtfully and without financial incentive tied to sales.

When supplements or wellness products are discussed, families are encouraged to ask questions, take their time, and choose what feels right for them. In general, families are advised to be mindful when products are recommended for purchase, or especially when they are positioned as an avenue for personal income.

The focus of this practice remains on informed choice, safety, and individualized care rather than product-based solutions.

Birth is powerful, intimate, and deeply sacred. While images of birth can be beautiful, they also capture moments of profound vulnerability — especially for newborns, who cannot consent to having their image shared.

In the same way that moments of grief, illness, or death are often held with care rather than displayed, birth deserves reverence and protection. Advocacy includes protecting the dignity and privacy of both parents and babies, even after birth.

Families are always free to document and share their own experiences in ways that feel right to them. This practice chooses to witness birth, not showcase it.

Midwifery care through this practice is offered as a comprehensive, full-spectrum package that includes prenatal, birth, and postpartum care.

The global fee for care is $5,000, with an option of $6,500 for families who choose to receive all prenatal care in their home. A $500 retainer is required to reserve a space in the practice, with the remaining balance due by 36 weeks of pregnancy.

This practice does not offer payment plans. Clear financial boundaries help ensure that care remains ethical, sustainable, and fully present for the families served.

This practice is not in-network with insurance companies. Care is paid directly, prior to birth.

Out-of-network insurance billing may be available through a third-party billing service specializing in out-of-hospital care. Claims are submitted after care is complete, and any reimbursement depends on individual insurance benefits and plans.

While structured payment plans are not available, families are welcome to reach out early with questions so expectations are clear from the beginning.

In some circumstances, yes.

Midwifery has deep roots in community-based, trade-supported care. Long before formal billing systems existed, midwives were often compensated through shared labor, goods, and skills — arrangements that strengthened both families and the communities around them. That tradition still matters to me.

Barter is considered thoughtfully and on a case-by-case basis. Any trade arrangement must be mutually agreed upon in advance, clearly defined, and equitable for both parties. Examples of past or potential barter may include skilled labor, home repair, produce or farm goods, or other forms of tangible, meaningful contribution.

I live and work in a historic home that requires ongoing care and stewardship. Being able to maintain it through shared effort feels deeply aligned with the spirit of community midwifery. When appropriate, the many hands of clients contributing their skills or labor is not only practical, but meaningful to me.

Because this practice requires significant availability, responsibility, and on-call presence, barter does not reduce the scope of care or expectations around availability. Clear agreements help ensure that care remains ethical, sustainable, and respectful.

If you are interested in exploring a barter arrangement, this should be discussed early — ideally during the initial consultation — so expectations are clear from the beginning.

While this is a private practice, it is rooted in community care. Support does not always take the form of full-scope, contracted services.

When appropriate, this may include:

• guidance or conversation outside of formal care

• connection to lower-barrier community resources

• help navigating systems, referrals, or transitions

• offering time and presence when it matters most

Care is not always transactional, and support can look different depending on circumstance.

Absolutely.

Pregnancy loss, infant loss, and grief surrounding fertility or birth deserve care, presence, and respect. I am always willing to offer support to families navigating loss, regardless of whether they are receiving full-scope midwifery care through this practice.

This support may include compassionate conversation, guidance around next steps, help navigating decisions or systems, and referrals to grief-specific resources when helpful.

Grief should not be rushed or monetized. Offering presence and support during loss is a responsibility I hold with care, and I am glad to offer this support when needed.

Routine prenatal lab work can often be completed directly through the practice and includes standard prenatal labs as well as screening for certain nutrient deficiencies when indicated. Recommendations are individualized and based on health history, current pregnancy needs, and informed choice — not a fixed checklist.

Diagnostic ultrasound imaging is available through Bloom Mobile Ultrasound, a trusted local service that provides in-office imaging. Ultrasounds are used when clinically appropriate or when families desire additional information, and results are reviewed together as part of care.

Additional testing, imaging, or specialty labs can be ordered and coordinated as needed. When testing cannot be completed in-house, referrals are made to trusted local providers.

Genetic screening options, including UNITY testing, as well as SneakPeek testing for families who wish to learn fetal sex early, are available and discussed in detail during prenatal visits.

As with all aspects of care, perinatal screening is offered — not required. Families are supported whether they choose to accept or decline specific tests, and decisions are revisited as needed throughout pregnancy.