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Frequently Asked Questions


Am I eligible for midwifery care?

Midwifery care is only safe for low risk pregnancies. In order to identify whether you would be eligible for midwifery care, you will need to meet with a midwife and discuss your medical and obstetric history. However, there are some conditions that are automatically considered higher risk, meaning that midwifery care would not be appropriate for these people:​

  • HIV or AIDS

  • Rh or other blood group isoimmunization (this is not the same as being Rh-)

  • Previous cesarean with a vertical or 'T' shaped incision or previous uterine surgery in the fundus

  • Preeclampsia or eclampsia

  • Insulin-dependent diabetes

Do you offer VBACs?

We would be honored to assist you with achieving a vaginal birth after a cesarean section. There are a few criteria that you'd need to fulfill in order for us to consider you low enough risk for midwifery care to be appropriate for you. For example, we'd need to see a reasonable time gap between your cesarean and your current pregnancy, you'd need to have had a transverse incision (the cesarean is across your lower abdomen), and we'd want to see records from your previous care. We are not be able to offer VBACs to an individual who has had more than two cesarean sections.

What is your masking policy?

If you would like us to wear masks to appointments or your birth, please just ask. We will also wear a mask if we feel unwell and suspect that we may be contagious, or will reschedule any appointments that are not time-sensitive. You are free to make your own decision on masking for your family. We do ask that you please reschedule appointments or wear a mask if you are unwell with something you suspect may be contagious. 


How many people can I have at appointments or at my labor and birth?

For most appointments, it's usually best if you have just 1 or 2 loved ones with you so that you feel able to discuss whatever you feel the need to. That said, we love having everyone you hope to have present at your birth attend at least one appointment (usually but not always the 36-week one) so that we can answer any questions or address any fears they may have.

You are more than welcome to have a small support team (and a doula, birth photographer, etc.) present during labor, and we always welcome your children at births, as long as there's another adult there who takes responsibility for watching them. The limit on numbers is based on two questions: firstly, will you be more or less comfortable with the additional people present, and secondly, will your midwifery team have enough room to move around and perform their roles with everyone present? We do have a space upstairs for loved ones you might want nearby but not in the actual room with you, complete with a small kitchen, and with access to a bathroom.

Do you attend births of multiples?

There are greater risks involved with vaginal delivery of multiples. At this time, our midwives will not take on the primary role at a birth with multiples. If you have another midwife who is skilled and experienced at multiple births, we would consider attending as a second midwife, under their lead.

Do you attend breech deliveries?

Unfortunately, our team does not currently have the experience to ensure that we'd be able to safely assist you through a breech delivery. That said, we are trained in breech delivery techniques and will deliver unexpected breech presentations if there is not time to transport you to the hospital before the birth when the breech is discovered.

Do you have payment plans?

All of our clients are offered a payment plan, paying monthly installments to cover the full price by 36 weeks. There is no additional charge for this.

Can I get a refund if I change provider or transfer care?

If you choose to pay upfront for all of your care and then decide to switch to another provider or must transfer out of our care, we will happily refund you for the months remaining (with the last payment being due at 36 weeks). If you are paying monthly, however, this covers your care up to that point as well as holding our calendars open for your due date window, meaning that we have not been able to take on other clients due at that time. Please know that there will be no hard feelings if you change providers, so don't be nervous about telling us if you make this decision. We want you to be happy with everyone who will be in your birth space, and do not want anyone to feel obliged to remain under our care if you don't feel 100% comfortable with this. Please see the contract for full details of our refund policy.

Are Licensed Midwives and Certified Professional Midwives (CPMs) 'real' midwives?

Yes, we are! For example, Jen went through 5 years of didactic and clinical training before she sat her NARM 'boards exam'. The didactic course she took is very thorough, and there were high expectations on grades in every assignment. Midwives are not doctors, however, and cannot perform cesareans or give epidurals, for example. Nor are LMs/CPMs the same as Certified Nurse Midwives (CNMs). CNMs train first as nurses and then specialize in midwifery, and so are trained to provide nursing services outside of pregnancy, birth and the first few weeks postpartum. Many will perform annual exams, for example. LMs and CPMs in Texas are only licensed to do this during or soon after pregnancy.

I'm nervous about birthing with no pain medication. How can you help? Do you have any drugs I can use?

You are strong enough for labor without any medication if you simply believe in yourself and have the support you need during labor and birth. We can help you with movement, pain relief such as showers or the birth pool (even if you don't plan to actually deliver there), and with pain-relief touch techniques. We are also delighted to announce that we have nitrous oxide available for use at more challenging times during labor. While this is not a form of pain relief, it helps some laboring people cope better with the physical and emotional experiences. Nitrous oxide is very commonly used during labor in Europe, but has only very recently started becoming popular in the US. You don't need to jump through hoops to be 'allowed it' with us. If you think nitrous will help you, we are happy for you to try.

What happens if something 'goes wrong' at my birth?

We will be monitoring you carefully throughout your labor, birth and postpartum. Usually, if things start to 'go wrong', we can see warning signs well in advance and can transfer you to a nearby hospital before an emergency arises. Occasionally, an emergency will arise with no warning. If this happens, we are trained to deal with the situation until the emergency services arrive. We would contact the hospital to make report on the situation and would send over your records as quickly as possible. Normally, your midwife would travel to the hospital and would remain by your side as much as possible, taking on the role of a doula once your care had been transferred to an OB. During the COVID-19 pandemic, this will not be the case, however.

I'm interested in getting into birth work as a doula, birth assistant or midwife. What should I do?

We would love to have more birth workers in the RGV, so please get in touch to talk about the various roles you might be considering, the training required for each, and whether we are currently offering training in any of these roles.

Is Heart of Gaia Midwifery Services a non-profit?

We are not a non-profit, primarily because of the additional work involved in this. We do, however, gratefully accept donations to allow those who could not otherwise afford midwifery care to be able to birth with us. If you would be interested in helping in any way, whether it be buying diapers for a newborn or paying for an entire midwifery package or anything in between, we would love to hear from you. Please see the Donations page for more details, including our Amazon Wish list and how we say "thank you" to our generous donors. We cannot offer significant discounts on our prices without these donations, as we have to pay for supplies, blood tests, equipment, continuing education and recertification, birth center licensing, maintenance and use costs, and need to still be able to pay our staff their very reasonable wages. 

The names 'Gaia' and 'Mother's Nature' are feminine and midwife means 'with woman'. Is your care offered only to female clients?

Not at all. We celebrate women and the power they have within themselves, but this in no way implies that we think all people who give birth are female or that other genders are any less wonderful. If you do not identify as female and would be interested in out of hospital pregnancy and birth care, we would be honored to serve you. 

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