We are a private-pay (self pay) practice. Payment is due by 36w, regardless of whether insurance reimburses any portion. After care is rendered, a Superbill may be provided ($25 fee) for the client to submit to insurance.

Submission of a superbill does not guarantee reimbursement. We do NOT submit the claim for you, appeal insurance denials, nor negotiate reimbursement rates.

“Can I submit my bill to Insurance?”

Insurance reimbursement for homebirth and midwifery care varies widely. We have chosen to be a self pay/cash pay practice. We are not contracted with any insurance companies and do not participate in insurance billing. For $25, we will create a superbill for you at the conclusion of your care. We do NOT submit the claim for you, appeal insurance denials, nor negotiate reimbursement rates. Payment is due in full by 36w regardless of insurance outcome. 

Understanding Insurance & Superbills

Our practice is a private-pay homebirth midwifery practice. This guide explains how insurance reimbursement works and what to expect if you choose to submit a Superbill.

What Private-Pay Means

Payment for services is due regardless of insurance reimbursement. We do not bill insurance directly or communicate with insurance companies on behalf of clients.

What is a Superbill? 

A superbill is a detailed receipt that you may submit to your insurance company for potential

reimbursement. Reimbursement is not guaranteed and varies by plan.

Before You Submit

• Confirm you have out-of-network maternity benefits

• Verify coverage for licensed midwife services

• Ask if homebirth services are excluded

• Ask how claims are reimbursed (CPT or global)

• Ask what percentage of charges may be reimbursed

Each insurance company processes claims differently. We are unable to predict, influence, or appeal insurance decisions.

Having an out of hospital birth requires trust in physiologic birth, “that is that birth is

1) characterized by spontaneous onset and progression of labor,

2) includes biological and psychological conditions that promote effective labor,

3) results in a vaginal birth of infant and the placenta and

4) results in physiologic blood loss.

5) facilitates optimal newborn transition through skin-to-skin contact and keeping the mother and infant together during the postpartum period and

6) supports early initiation of breastfeeding.”

(C.E. Neerland, MD Avery and M.A. Safter et al. Midwifery 77 (2019) 110-116)

As long as the mother continues to be deemed “low risk,” then a mom can stay under the care of the midwife at Streams of Life. Please discuss this criteria at your consult.

Pain relief offered: Nitrous Oxide and Hydrotherapy - through shower or tub.

We are working on a new process for accepting TOLACs (Trial of labor after cesarean) or VBACs (Vaginal Birth After Cesarean). This will be on a case by case basis, so please reach out for a consult to see if you are a good candidate.

The ideal plan is for there to be two providers, the midwife and a birth assistant at each birth. Both are certified in NRP (Neonatal Resuscitation Program) and CPR as well as other obstetrical emergencies.

If a mom or baby need help beyond the scope of the provider, EMS will be called and mother will be transported by ambulance to the closest hospital, which is Bristol Regional Medical Center, 9 min away.

No, epidurals are not an option in out-of-hospital birth settings.

It is expected that the mother and support person to plan ahead and prepare for how to manage labor pains prior to the onset of labor. This could be through virtual classes, in person classes, on-going reading and discussion during prenatal visits. A doula is also a great option for direct hands-on care before and during active labor.

Chronic Conditions That May Contraindicate Home Birth

The following is a list of pre-existing chronic conditions that are generally considered contraindications or high-risk factors for home birth. While these conditions do not automatically exclude the possibility of a home birth, they often require collaborative care with an obstetrician or a hospital-based birth plan for the safety of both parent and baby.

• Pre-existing insulin-dependent diabetes (Type 1 or poorly controlled Type 2)

• Chronic hypertension requiring medication or associated with end-organ damage

• Severe asthma requiring frequent hospitalizations or steroid dependency

• Cardiac disease (e.g. congenital heart defects, arrhythmias, valve disorders)

• Renal disease (e.g. chronic kidney disease, especially stages 3–5)

• Clotting disorders (e.g. Factor V Leiden, antiphospholipid syndrome)

• Epilepsy requiring frequent medication adjustments or with recent seizures

• HIV with high viral load or poor antiretroviral compliance

• Autoimmune disorders (e.g. lupus, multiple sclerosis) with organ involvement

• Thyroid disorders (especially poorly controlled hyperthyroidism)

• Severe anemia unresponsive to treatment

• Active or recent cancer diagnosis

• Significant psychiatric conditions (e.g. schizophrenia, bipolar disorder) with recent hospitalization or impaired decision-making capacity

• Morbid obesity (BMI > 40), depending on co-morbidities and midwife scope

• History of organ transplant or immunosuppressive therapy