Frequently Asked Questions
What is your philosophy of birth?
“I believe in autonomy for both the midwife and the birthing families, and support licensed midwifery with full scope care, traditional midwifery, and attendants rooted in a lineage of cultural tradition, freebirth, and medical birth as desired. I believe in sovereign birth. I believe birth is a natural, normal, physiological event, that when respected, feared, and understood, rarely needs medical help but maintain skill and tools to do so and will not hesitant when needed. I believe you don’t need a midwife, until you need a midwife. That a midwife should sit in the corner on her hands holding space or prayer while you triumphantly bring your baby earthside and knowing normal so well that they can use their hands, heart, skill, and intuition to bring it back on track should it stray off course.
I believe in anti-racism, inclusivity, medical freedom, and making more midwives for our daughters and granddaughters. I believe in abundance, that there is a right midwife for everyone, and that’s not always me.
My philosophy of care is deeply rooted in these beliefs and will hold them on the highest of esteem in every part of care that I offer.”
Leila considers her spirituality to be nestled in duality, a christian and highly aware of the nuances of spirit, soul, and energy.
What is midwifery care like? How is it different from my OB?
The midwifery model of care is fundamentally different than the medical model. Midwives are the protectors of normal birth and specialize in care for the low risk, healthy woman or birthing person. Obstetric doctors are surgeons and specialize in high risk pathological pregnancy and birth.
Even in prenatal care midwifery is quite different than a visit to your OB. Our appointments generally last an hour and a half, which allows plenty of time to ask all of your questions. We take the time to really understand what is going on with you, your baby, your family and your pregnancy. We offer resources such as reading suggestions, referrals to classes and other providers. We discuss this pregnancy and birth from a mental, spiritual, physical, logistical, and whole family perspective. Also, because Devotion Midwifery is a small private practice, you have continuity of care… seeing the same midwife every visit and the one who knows you best at your birth.
Another cornerstone of our care is informed choice - we offer the same standard of care when it comes to labs, ultrasounds, and procedures that you would get anywhere else, but shared-decision making is what sets us apart. We fully support and respect your decisions, knowing that you are the best and final expert on your body and your baby.
We are continuously keeping up to date on evidence based research, while maintaining perspective and remaining humble. Although we help guide your journey, you are in charge.
Are there different kinds of midwives?
Yes. In the United States and especially at Devotion Midwifery, we believe in sharing about all of the kinds of midwives so you know how to find the one that will best serve you. Please ask the midwives you interview about their title and experience.
Traditional Midwife: Usually this type of midwife is unlicensed, has been taught midwifery through apprenticeship, was called to this work through her community, and does not carry medications, is not certified by a governing body, and truly has full allegiance to the woman and family they serve along with their own designed boundaries. In some states, these midwives are illegal or can be fined, imprisoned, or required to cease practice. This midwife can be called many names; Birthkeeper, Midwife, Traditional Midwife, Birth Attendant.
Certified Professional Midwife (CPM): This is a national certifying credential that shows that this midwife has “proven” their experience by attending approximately 100 births as a student, passed a national board exam, and maintains certain continuing education. CPMs practice in home birth or birth center practices and similar to transitional midwives, are designed to support low risk, healthy, physiologic birth outside of the hospital.
There are 2 pathways to becoming a CPM. One is the performance evaluation process that follows the traditional apprenticeship model and the other is by graduating from a midwifery education accreditation council school with a degree. Both of these pathways must still pass the national exam and attend required clinical skill experiences.
In some states only midwives who graduated from a MEAC school and passed the national board exam can become licensed.
Licensed Midwife(LM): Midwives in states where licensure exists are usually required to become a CPM prior to licensure. Licensure can be good and bad. A state where licensure exists allows the midwife to carry and administer life saving medications to manage complications and stay out of the hospital. An example can be IV fluids for dehydration in labor or to replace blood volume after postpartum. On the contrary, licensed midwives are required to practice within the state’s regulatory boundaries and that can mean they can or cannot serve certain births or experiences.
Certified Nurse Midwives(CNM): Nurse Midwives are nurses first, followed by a a masters in midwifery. These midwives primarily work in hospitals and serve women and birthing folks who are low risk but may want an induction, epidural, or medically focused birth experience. They are also trained in natural birth and in some states work in homes.
In the state of Louisiana, home birth midwives must be licensed and hold the CPM credential to practice legally at home. CNMs are unable to attend home births without a backup OB/OB approval.
Midwife Leila is a licensed midwife, certified professional midwife, graduated from a MEAC college with a bachelors in midwifery, and was trained by traditional birth attendants, CPMs, licensed midwives, CNMs, and OBs throughout her education journey.
How do I know if I am a good candidate for out of hospital birth?
The majority of people are considered low-risk and a good candidate for out-of-hospital birth. To learn more about the safety of birthing out of the hospital, check out this research study conducted by the Midwives Alliance of North America (MANA), which confirms the safety for low-risk families who choose to birth at home with a Midwife. Study after study shows that hone birth is just as safe as hospital or birth center birth with less interventions.
However, you and your partner or person supporting you during pregnancy and birth’s mindset surrounding birth is key! If your philosophy is that birth is a natural event that sometimes needs medical assistance, you normally care for your self and family in that way, and you don’t want pain medication during labor, home birth is probably your JAM!
In addition to desiring a natural home birth without pain medication and supporting physiology, the state of Louisiana requires the following criteria to be eligible for community midwifery care. We know many of the below is unacceptable and barriers to good midwifery care. We believe birthing families have the right to informed consent, shared decision making, and autonomy for where and with whom they birth… we are actively seeking for a change to these regulations.
Examples:
Initial pregnancy confirmation appointment with an OB is required by Louisiana. This OB does NOT have to “approve” of your choice to home birth or “sign off” on one. But does need to find you “low risk” (some exclusions apply, ex. AMA is not considered high risk)
No history of uterine surgery (Cesarean)
Head down single baby
Delivery between 37-42 weeks
Routing lab work: inducing anatomy ultrasound, STD screening, GBS screening, and gestational diabetes screening
Maintain normal low risk status throughout pregnancy and birth
What standard labs do you offer?
Complete blood count (CBC): Evaluates the cells that circulate in your blood, like iron and platelets.
Blood type and Rh factor: Determines your blood type and Rh factor (negative or positive)
Antibody screen: Tests for antibodies that attack red blood cells
Rubella Antibody titer: Screens for German Measles
Urinalysis: Evaluates components of the urine
Pap smear: Screens for cervical cancer
Genetic screening: Screens for fetal chromosomal abnormalities and neural tube defects
Carrier screening: Screens for maternal chromosomal abnormalities
HIV, Syphilis and Hepatitis B&C screening: Standard sexually transmitted infection (STI) screening
Gonorrhea and Chlamydia cultures: Screens for gonorrhea and chlamydia
Urine Culture: Screens for bacteria in the urine
Glucose screening: screening for Gestational Diabetes Mellitus
Thyroid and hormone testing: Screens the thyroid hormones, as well as additional hormones, if necessary.
Vitamin D: Evaluates Vitamin D levels
Vaginal Microbiome: Candida, BV, Trichomoniasis, etc.
Group beta streptococcus culture: Screens for presence of vaginal/rectal GBS
Unity Genetic screening (includes fetal sex, blood type, and genetic profile)
SpeakPeek Gender Blood Test
What are the costs, insurance information, and payments?
Please see the our investment page to learn more about cost of care, sliding scale, and payment options. For information about insurance reimbursement, check out the financial FAQ.
What do midwives bring to the birth and what do I need to buy?
Devotion Midwifery brings all medical equipment and labor support tools. This includes professional birth pool, birthing stool, birth sling, peanut balls, birth balls, resuscitation equipment, medications, herbs, vitals, etc.
We require the purchase of a home birth kit which we have already compiled for you. We ask that this kit is purchased and delivered before our birth prep visit at 36 weeks. In addition to the birth kit, we recommend comfort items, towels, baby blankets, a bowl, and snacks that you would normally desire.
What if Midwife Leila is at another birth on my prenatal/postpartum visit or even while I’m in labor?
If Leila is called to a birth on the day you have a prenatal or postpartum visit scheduled, your visit will be rescheduled to the next available day. Mother’s in labor are top priority and you will appreciate the same respect on your birthing day. You will receive a text message same day with information and hope you will share in the excitment of a new soul being born in our community.
We are very clear that we only accept a certain number of clients each month as to reduce the chances of babies being born on the same day. However, God and babies have their own plans and sometimes we have done everything and still they choose to share birthdays. In this event, Midwife Leila has great backup midwives that will either arrive to be with you until Leila can be there, or will attend your birth. The same can be said for acts of God, if Midwife Leila is hospitalized, etc. We know this isn’t ideal but surrender to the unpredictabilities and trust the process.
How do you monitor the health of baby and mom during pregnancy?
The foundation of prenatal care is preventative care. We support you to make the healthiest and best choices possible to help keep your pregnancy low-risk. Additionally, we recommend standard of care lab tests and a mid-pregnancy (anatomy scan) ultrasound. We monitor the baby's heartbeat and growth throughout the pregnancy. We monitor your blood-pressure and other vital signs at every visit. Because our prenatal care is based on relationship building and listening; we are often able to catch issues before they become major problems. We also believe that trust and intuition is a huge part of care. Talk with your midwife when you have concerns!
We recognize that pregnancy and birth are unpredictable and stay vigilant to any developing problems or concerns. If additional tests or consultations are needed, we have refer to other providers, imaging centers and labs.
How do you make sure we are safe and healthy during labor and birth?
During labor the midwives will monitor the baby's heartbeat frequently and discreetly. We work to keep you hydrated, fed, and rested while also checking vital signs regularly. We have a midwife and trained birth assistant, second midwife, or student at every birth. We follow our carefully researched and frequently re-evaluated protocols and practice guidelines to make sure you stay low-risk and safe for out of hospital birth. These are available upon request.
Due to having low-risk clients with healthy, low-risk pregnancies, our transfer rate is very low (5%-7%) . We are trained to identify risk factors, manage complications, or transfer to the hospital before complications become true emergencies. We carry medications such as pitocin, IV fluids, oxygen, and resuscitation equipment that allow us to manage complications at home. As a maternity healthcare provider in the state of Louisiana, we also train and certify in Neonatal Resuscitation and CPR every 2 years.
During your care we discuss the reasons why we might transfer to the hospital and what happens during a transfer. We have relationships with our community hospitals and facilitate a smooth transfer of care in the small percentage of births where it might be necessary.
Lastly however, we cannot guarantee any outcome. No one can. Hospitals have stillbirths and bad outcomes too. The importance really relies on your radical self responsibility to choose the right thing for you and your family every step of the way. Your midwife is there to protect safe birth by knowing signs that it’s going off track and work with you to give you the best possible experience and outcome, but nor we nor any healthcare provider is responsible for it.
How will I cope with labor?
One of the benefits about having a midwife for your unmedicated birth is that we have helped hundreds of people do this. We have trust in you, your body and your baby, and we have skills to help. If there is one thing we know, it is that you can cope with the discomfort of normal labor. We do ask that all first time home birthers take childbirth education class and or hire a doula so that you are more prepared and confident.
Women have been doing this since the beginning of time. We find that the “mind over matter” philosophy really does ring true. The mental state, ability to relax and or overcome is greater than the physical sensation. We truly believe your body was meant for birth, and support the physiology while breaking into the psychology that may get in the way.
Your midwife also will deliver the birth pool to your home at 36 weeks. We LOVE “aquadurals” and encourage using water as a coping tool. Additionally, we bring birth balls, peanut balls, TENS units, Birth Slings, and our heart and hands to fully support you.
Lastly, we always encourage hiring a doula. They are professionals for supporting the physical and emotional “labor” of birth. Doulas and Midwives go together like Peanut Butter and Jelly!
Do you offer VBAC?
Short answer, no. In the state of Louisiana home birth midwives are not allowed to attend VBAC clients at home in Louisiana. We do offer midwifery prenatal care package for $2500 with plans of birthing in the hospital. Alternatively, we can offer VBAC at home or hotel in Mississippi. Contact us to discuss this option.
We know this is unacceptable and a barrier to good midwifery care. We believe birthing families have the right to informed consent, shared decision making, and autonomy for where and with whom they birth… we are actively seeking for a change to these regulations.
What if we have to transfer?
The midwfery model of care highly focuses on preventative measures, which means transfer rates are usually low. If higher level of care is needed during the pregnancy this may be temporary, like a consultation, or permanent like being risked out of care for a medical reason. In the event of a transfer during labor, a midwife will accompany you to the hospital until delivery as your doula (even if you already have one) and complete all standard postpartum visits.
Sometimes, we need the hospital, and it’s important to recognize that need before it becomes emergent. Leila has a very low transfer rate on nearly 5%-7% of all births, which is similar to the national average of 10%. This means we don’t just transfer for no reason and sabotage your birth, and we also don’t put you or your baby at unnecessary risk.
It’s also important ot note that the number 1 reason for transfer is not a medical emergency, or even pain relief… It’s exhaustion. So please listen to your midwife when we ask you to rest, hydrate, and eat in early labor. It’s a marathon, not a sprint.
Leila or a member of the team will transfer in with you and remain until you both are stable.
What if I have twins, my baby is breech, or I refuse standard Louisiana rules/laws?
Informed consent, shared decision making, autonomy, and sovereign birth are pillars of Devotion Midwifery’s care. While Midwife Leila is trained and skilled in home birth of breech, twins, and supports your right to choose the tests and screeninings or interventions, it is not legal to attend in Louisiana. For this reason we engourage families to review ALL options. This includes finding a great OB for a planned hospital birth, choosing to birth unassisted, or hiring Devotion Midwifery for a birth in a neighboring state (Mississippi or Texas) where these options ARE legal and supported.
We know this is unacceptable and working to change the landscape of registered midwifery in Louisiana for the next generation. We need your help! Reach out to the Louisiana state board of Medical Examiners, your local representative, or Governor and make sure the voices of birthers are heard.
Can I switch to Devotion Midwifery if I am already in care with another provider?
Absolutely! We take transfers as far as the third trimester. However these is not a “Late to care” discount. We often find that the energy it takes to build a relationship in such little time is just as much as a full pregnancy with our care.
Please schedule a phone consultation to discuss details.
When should I start prenatal care?
Devotion Mifdwifery books up quickly. As soon as you know you are pregnant and looking for a home birth, start your consultation and reserve your spot.
We love to see you starting in the first trimester, specifically by your 12th week gestation. This will give us plenty of time to build a trusting relationship. If you are currently being seen by another practice, we will facilitate transfer of records and can establish you into even into the third trimester. Per Louisiana state law, you must see a Louisiana OBGYN prior to the start of care with a Licensed Midwife and be low risk criteria. Therefore, we often find that people wait to come into care until that visit is complete around 12 weeks. However, the earlier the better as evidence shows that the midwifery model of care prenatally reduces poor outcomes, inductions, gestational diabetes, preeclampsia, cesareans, and poor birth experiences.
Can I eat and drink in labor?
Yes! We encourage it. Your uterus is a muscle, it would be a disservice to not allow you to refuel as you work hard to birth your baby.
What if I tear?
Leila is fully trained and experienced in laceration repair and carries all legal medication to make the experience more comfortable.
Who can come to my birth?
You can have whoever you want at your birth, its YOUR birth. Some people like to give birth in complete privacy, while others want their mom, sisters, cousins, a doula, a photographer, oh and their kids too! However, We encourage each person you invite to have a specific role in supporting you and your birth goals. Simply consider if you feel ok pooping, being naked, and crying in front of them. Additionally, we strongly believe that the people who are present at your birth should align with your values. There is no room for placing their fears on you in this pinnacle time.
Who files the birth certificate? What about the newborn screenings?
Your baby's birth certificate information will be submitted and mailed directly to you. The newborn metabolic screening (PKU), Critical Congenital Heart Defect (CCHD) screening, and hearing screening are offered at the first postpartum visit and or 1 week postpartum visit.
We will perform weight checks at every postpartum visit, ensuring adequate weight gain and timely referrals, as necessary.
Can we do delayed cord clamping?
We do not clamp or cut the cord until you are ready, or unless there is a medical indication to. Many times this does not occur until approx. 2+ hours when we are completing the newborn exam.
Do you have students?
YES! Devotion Midwifery believes in making more midwives for our community to have choices in care and ensuring we have midwifery care for our daughters and granddaughters. There are 3 different levels of student midwives; observe, assist, and primary under supervision.
Students in the observe phase are very new to birth or home birth and are there to clean, set up and breakdown, and “watch” the midwife and birth process.
The assist phase of the journey is a bit more hands on. These students are learning to take vitals, chart, use equipment and tools, and the art of midwifery. They will NOT “catch” your baby, repair a tear, assume management of complications, or ever be left alone at your birth. They are primarily there to literally assist the midwife.
The primary under supervision role is very unique. This student is at the very end of their training and is competent in care. They are under supervision and guidance of Midwife Leila at all times but will be acting at the primary midwife. This means “running” penatal visit, completing necessary or desired exams, managing complications, completing all paperwork, and embodying your midwife. They are a midwife already, and are practicing with the supervision of Midwife Leila for their growth, skill development, fine tuning, and your safety. Usually, these students are sought after for their care individually and are not Leila’s clients “given” to a student. If you are interested in having a primary under supervision student for your lead midwife and Midwife Leila as the supervising midwife, you will signs a special form and have unique discussions regarding the flow of care.
Devotion Midwifery will usually have 1-2 students at a birth. This allows for a well rested team, shared burden of cleaning and equipment care while still keeping your birth team small and intimate. If you prefer NO STUDENTS, this is understandable and will be discussed throughout our care together.
Can I have a doula?
Yes! We love doulas. Check out the evidence on doula care. https://evidencebasedbirth.com/the-evidence-for-doulas/
Are there any Midwife Supportive OBs?
I wish this was a resounding yes, but unfortunately we have not met them yet in Louisiana. However, we do know a few midwife tolerant OB’s and recommend using them for you initial risk assessment visit and or in need of a transfer of care. Send us a message for more information.
I’m not pregnant yet, any fertility or conception recommendations?
Absolutely!
Learning about your cycle:
- Taking Charge of Fertility (the BEST book to get started)
- Basal Body thermometer for temp tracking.
- Inito or Mira are cool tech for tracking your cycle through hormones.
Getting your GUT and nutrition right! There is so much new evidence that the healthy gut affects so much in your life, but especially fertility. The book " The Mind-Gut Connection - by Emeran Mayer” is a great way to start learning. Also, nutrition; this book "Real food for fertility" is the best place to start.
We have some really cool people to follow, and connect with right here in NOLA! My fav. Is a close friend and past home birthing mama of mine Dr. Jackie. She specializes in fertility, pelvic floor therapy, and so much more. Check her out https://drjackiejoy.com/fertility-coaching.