about me

Frequently Asked Questions

How long have you been attending births?

I have been attending births since 2010. I became a Licensed Midwife in Virginia in 2016.

How long have you been attending births?

I have been attending births since 2010. I became a Licensed Midwife in Virginia in 2016.

Which route did you take to become a midwife?

I chose the PEP process through the North American Registry of Midwives. I completed my apprenticeship with Breath of Life Midwifery in 2016, passed the NARM exam, and received my CPM( Certified Professional Midwife) license from NARM at that time. I am licensed by the Virginia Board of Medicine as well.

What is your birth philosophy?

My philosophy is simple: Women were created to give birth. When left alone, birth almost always happens perfectly. Women deserve to be provided with informed consent, respect and support in their birth choices. With these three things in place, birth will have more favorable outcomes.

What inspired you to become a midwife?

My birth journey started in 2008, when I was preparing for the birth of my first child. I knew I wanted a natural birth, but I didn't know that it would be so hard to accomplish in the hospital setting. I did everything right, hired a doula, received natural childbirth education, and did most of my laboring at home. Despite being fully dilated within 30 minutes of arriving at the hospital, my birth ended in a traumatic, unnecessary cesarean under general anesthesia. This ignited a passion in me to help others achieve the births they desired.

How many births have you attended?

I have attended 98 births as of 02/18/18.

How many births do you attend each month?

I prefer to attend no more than one birth per month.

Do you work alone or do you have a team?

I never attend births alone. Due to safety, I typically work in a team of three at each birth. Everyone I bring are highly trained doulas and certified in neonatal resuscitation. This allows us to provide optimal safety at each birth.

How much do you charge? What does this include? Do you offer payment plans?

I charge $3500 for the package deal and am flexible with payment plans. This package includes:

~ A three person birth team

~ All prenatal care, routine, and otherwise- in your own home.

~ 24/7 support via phone, text or email

~ Continuous support during labor; continuous care after birth for at least two hours or until mom and baby are stable

~ Unlimited breastfeeding support

~ Postpartum care for mom and baby for the first six weeks after birth

~ Referrals

Do you recommend working with a doula?

Because we bring a three person team, and each person IS a skilled doula, hiring a doula is typically unnecessary when hiring Mireya Midwifery. If you desire to hire a doula, we love doulas!

Do you use herbs for pregnancy and/or birth routinely?

I believe that herbs should be used just as conventional medicine- as needed, and under supervision. I do not believe herbs need to be used routinely, but I do use them when necessary.

Do you offer or recommend taking a childbirth education course?

Although I do not offer a childbirth class at this time, I most definitely recommend taking one. Breath of Life Midwifery offers an amazing class that I highly recommend.

Do you provide options for prenatal screenings for things like ultrasounds and gestational diabetes?

I provide the same options for screening as you would have with an OB. Since we are licensed by the Board of Medicine, we can order any lab that may be needed. The most common screenings are as follows:

~ Blood work that gives us important information such as iron levels

~ Ultrasounds- the anatomy scan is the most common. (This is the one you are likely most familiar with).

~ Group B Strep (GBS)

~ Gestational Diabetes

How do you maintain records? Electronically and/or written?

We keep all records electronically. Not only is this more professional, it also makes it easy to share records with you or other providers when necessary.

If you are unable to attend my birth for any reason, do you have a backup?

If I were unable to attend your birth for any reason, another licensed midwife would be on call. I never plan to attend births without backup. You would still have a three person birth team( one licensed midwife and two advanced midwifery students).

What happens in the case where two clients are laboring at the same time?

The second midwife would stay with the woman who is earlier in the stages of labor and I would join her as soon as possible.

Do you have a preference on how many people are at my birth, not including the birth team? What about my other children?

This is your birth, therefore you are the one running the show. You may have as many or as few people at your birth as you want. Your children are more than welcome to be at your birth. If that is your plan, it is a good idea to have a designated care provider specifically for your children at you birth that is not you or your partner.

At what point in labor should I call you?

If you think it is at all possible that you are in labor, I want to hear from you. This gives me the time to get my ducks in a row and also allows me to assess your personal circumstance and provide you with recommendations of what you should/could be doing as well as not doing.

What tools do you use to monitor my baby during labor and after birth?

During labor, I use a waterproof handheld doppler to monitor your baby. After birth I use a stethoscope, thermometer, and a neonatal pulse oximeter when necessary.

Do you facilitate water birth? Do you bring the birth pool?

I do facilitate water birth and can provide the birth pool for a nominal fee of $25.

What is your transfer rate?

Out of my planned homebirths, 17% have transferred during labor.

What is your most common reason for transport?

The most common reason for transfer during labor is a long labor when mom gets too tired and decides that an epidural is needed for rest. First time mothers and primary VBACs are more likely to transfer than mothers having latter babies that have had vaginal births. This is due to the likelihood of a longer labor, not for emergent reasons. That being said, even primary VBACs and first babies have a great chance of birthing at home, especially if they take advantage of the childbirth education classes at Breath of Life Midwifery.

If I have to deliver preterm or post-term in the hospital, or if I have to transport for any other reason, will you be with me at the hospital?

I believe continuity of care is of utmost importance and will accompany you to the hospital.

Are you trained in neonatal resuscitation?

Yes, I am certified in both neonatal resuscitation as well as adult resuscitation.

Have you ever lost a mother or baby?

I have never lost a mother. During my apprenticeship, we lost a baby. Although baby was full term, it was not during labor or birth and was not due to homebirth. Baby died in his mother's womb due to unknown causes.

Are you willing to suture tears at home? Do you ever recommend transfer for sutures?

I do not suture tears personally, but there are other local midwives that I can call into your home. Most midwives will not suture tears at home that involve the muscle layer. I recommend transferring to the hospital for anything involving the muscle layer.

Have you ever cut an episiotomy?

Thankfully, no.

How long will you and your birth team stay after the baby is born?

We stay a minimum of two hours after birth but always stay until everyone is stable and doing well.

How many postpartum visits do you do and on which days do they occur?

We provide comprehensive postpartum care for mom and baby for the first six weeks following birth. Our typical postpartum follow up exceeds most others. With this routine in place, women will have more opportunities to seek help with breastfeeding issues and postpartum depression, should these concerns arise. Our routine postpartum schedule is as follows:

~ 24 hours after birth

~ 1 week after birth

~ 2 weeks after birth

~ 4 weeks after birth

~ 6 weeks after birth

Is breastfeeding support offered?

Yes, breastfeeding support is unlimited with Mireya Midwifery.

Do you have references available for contact?

Yes, references are available upon request.

What is your protocol concerning vaginal exams?

I do not perform vaginal examinations routinely. Many women receive zero vaginal exams during labor/ birth.

Are you familiar with other ways of assessing progress?

Yes, there are many signs to look for other than cervical dilation. Contractions that are getting longer, stronger, and closer together are the best indication for progress. Also, women who are becoming increasingly serious and/or irritable or becoming shaky and/or vomiting are likely progressing to a later stage of labor. Many times there will be a brief period of time, right before pushing, where everything slows down and there seems to be a pause in labor. We call this laboring down. We consider this a lucky time to catch your second wind. Last but not least, the spontaneous bearing down of the uterus is a tell-tale sign that baby is coming soon.

Are you skilled in breech birth?

I have attended one breech birth, therefore I would not consider myself skilled in breech birth. Should your baby be breech, we will do everything in our power to turn the baby before birth. If this doesn't work, we can discuss your options including transferring to the hospital or searching for providers to help who are skilled in breech birth.

Are you experienced in turning babies, not in hospital?

Yes. Most babies will turn head down before the 36th week of pregnancy. I highly recommend spinningbabies.com to help your baby into the optimal position for birth. Chiropractic care is extremely helpful as well.

How do you feel about overdue babies?

As long as mother and baby are doing well, I am happy. We can perform non-stress tests and biophysical profiles as needed.

What do you do about nuchal cords (cord around the neck)?

Babies born with the cord are pretty common and typically don't cause lasting issues. The easiest way to resolve a nuchal cord is to perform the somersault maneuver. Basically, that means I am gently holding the baby's head against the thigh of the mother and letting the body somersault out.

How do you feel about delayed cord clamping?

Delayed cord clamping is the routine, standard of care for Mireya Midwifery.

Can I catch my own baby? What about my partner?

Of course! It is YOUR baby, after all:)

Do you have any recommendations for prenatal nutrition?

My biggest recommendation is to eat as many whole foods as possible. You want to be sure to eat plenty of fresh fruits and veggies as well as being sure to get 80-100 grams of protein per day(this will take effort). Staying hydrated with plenty of water is equally important.

Are you skilled in twin birth?

I am not skilled in twin birth. If you want a twin homebirth, that would require hiring extra hands that are experienced as well as showing us that you are well educated and fully understand the risks.

Are you connected to a community of like-minded people that I could get to know?

Absolutely! There is a great local community of women who are doing life together that I will most definitely connect you with. I am of the old-school mindset that it takes a village.

Do I have to drink the Glucola for the gestational diabetes screening or are there other options?

The only screening recognized by doctors as adequate screening requires drinking the Glucola. Some clients opt to skip the Glucola and keep a dietary journal along with a record of their glucose levels in the mornings and after meals. This method requires you to prick your own finger.

Are you willing to continue care with someone who has gestational diabetes? Or does this automatically risk me out?

If you end up having gestational diabetes, I will do my best to keep you in care and on track for having your homebirth provided you sign the appropriate informed disclosure documents. Dietary changes along with exercise will typically control gestational diabetes and taking charge of your diet and exercise will be a must.

Do you treat your clients more professionally or personally?

By nature, I tend to bond with my clients and have a personal relationship with each one. If you are someone that needs more distance and a more professional relationship, I can meet you where you are.

How do you feel about birth photography? Can I hire a photographer?

I absolutely LOVE birth photography! I am completely supportive if you want to hire a photographer. Although we are not professionals, my team and I are getting very good at capturing great moments at births and we can do so for free at your request.

My partner has fears about homebirth, have you dealt with this before?

Partners are often more skeptical about homebirth and have fears involving safety. We see this on a regular basis. This typically subsides as the partner learns more about homebirth and the level of skill that the midwife offers. Once they see that we do the same things at our visits as the doctors and that we are well trained and licensed by The Board of Medicine, they come around.

What is your preferred method of communication for emergent and non-emergent needs/inquiries prenatally?

Any emergency requires a prompt phone call. For non- emergent needs/ inquiries, I prefer text messaging or email.

I am overweight. Is it possible for me to have a homebirth?

Yes. If your BMI is above 30, you will need to sign the Va informed disclosure document but you can still have a homebirth.

Do you accept Virginia Medicaid?

I am proud to say I am a Va Medicaid Provider and am able to serve so many who wouldn't otherwise be able to have a homebirth.

Have a question I missed? Contact me!