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Most healthy, low-risk pregnant people are eligible for care with a Licensed Midwife and may be good candidates for an out-of-hospital birth. Your midwife will review your individual health history and pregnancy to make sure community birth remains an appropriate option throughout your care.

Licensed Midwifery care is ideal for people who want to allow labor and birth to unfold as naturally and undisturbed as possible, while having skilled midwives present to closely monitor the wellbeing of both client and baby and provide guidance or intervention when needed.

Out-of-hospital birth is especially well suited for those planning to labor without medical pain medication. Midwives use portable and waterproof monitoring equipment, allowing you to move freely, change positions, eat and drink, and use water throughout labor while still receiving ongoing clinical assessment and support.

This freedom of movement, combined with hands-on comfort measures and continuous emotional and physical support from your midwife team, can provide more options for coping with the intensity of labor and creating a birth environment that feels comfortable, familiar, and your own.

The question of what is considered “low risk” can be confusing because risk is assessed differently depending on the provider, the individual pregnancy, and the planned birth setting.

Some factors that may lead to additional monitoring or consultation in traditional obstetrical care—such as advanced maternal age, a history of pregnancy loss, or a previous cesarean—do not automatically mean someone is unable to have an out-of-hospital birth. With individualized assessment, appropriate monitoring, and collaborative care when needed, many people with more complex histories may still be good candidates for midwifery care. At the same time, certain lab findings, ultrasound results, or changes that develop during pregnancy may make hospital birth the safer option.

The best way to know if you are a candidate for midwifery care is to schedule a consultation with our midwives so we can review your personal health, pregnancy, and birth history and discuss whether out-of-hospital birth is an appropriate option for you. We regularly work with people who have more complicated histories and provide individualized care aimed at supporting the healthiest pregnancy possible.

Choosing an out-of-hospital birth also means being an active participant in your prenatal health. Nutrition, hydration, appropriate supplements, movement, keeping recommended appointments and testing, and communicating openly with your care team all play an important role in maintaining health throughout pregnancy.

As your midwives, we take your health and your baby's wellbeing seriously. Our goal throughout prenatal care is to support you in having the healthiest pregnancy possible while continually assessing that out-of-hospital birth remains a safe and appropriate option.

We often hear from people later in pregnancy who waited to reach out until they knew they were “low risk.” While this makes sense, the best time to begin care with a Licensed Midwife is as early as possible—and some of our clients even begin care before conceiving.

There are two important reasons:

1. “Low risk” can mean different things in different models of care. Being considered low risk by an OB does not automatically mean you qualify for an out-of-hospital birth. Midwives assess risk specifically for community birth, and certain health history, lab values, ultrasound findings, or pregnancy conditions may need additional attention. Starting early gives us more time to support your health, address concerns when possible, and prepare for birth together.

2. Midwives intentionally limit their monthly client load.
We accept a limited number of births each month to ensure our availability throughout each client’s due window. If you wait until later in pregnancy, we may already be full.

Licensed Midwives can order routine labs, genetic screening, ultrasounds, and other pregnancy testing, while giving you time to understand your options and make informed decisions. Beginning care early also allows more time for nutrition, movement, education, childbirth preparation, and building a relationship with your birth team.

Already later in pregnancy? Still reach out!  When space is available, we may accept late-transfer clients. We’ll review your history and records, determine whether community birth is still an appropriate option, and help you prepare as thoroughly as possible.

In many ways, giving birth at our birth center or in your own home is very similar. Your midwife team brings the same level of care, monitoring, and emergency preparedness to both settings. Both options include access to water labor and birth, emergency equipment and medications, a birth stool, rebozo, and the other tools and supplies we use to support labor and birth.


Benefits of Birth Center Birth
Birth center care is offered at a lower cost because your midwife team does not need to transport, set up, and break down our extensive birth equipment and birth pool or travel to and from your home. You also don't need to purchase a home birth kit, prepare your home for birth, or gather the additional supplies needed for a home birth.

For some families, location is another benefit. Our birth center is close to several hospitals that we are familiar with and comfortable transferring to if additional care becomes necessary. Depending on where you live, this may offer easier access to hospital care than your home location.


Benefits of Home Birth
The biggest benefit of home birth is exactly that—you are home. There is no need to travel to the birth center while in labor or transition back home several hours after your baby is born. You can labor, birth, recover, and settle in with your baby entirely in your own space.

Ultimately, both options provide the same relationship-centered midwifery care and preparation. The choice often comes down to which environment feels most comfortable and practical for you and your family.
 

No. Beginning care later in pregnancy often means longer and more frequent prenatal visits so that we can get up to date on the care, education, and preparation that would normally take place over several months. The majority of the time, preparation, and clinical responsibility involved in midwifery care also occurs during the final weeks of pregnancy, labor, birth, and postpartum.

For late-transfer clients, our team must obtain and thoroughly review previous medical records, transfer relevant information into your chart, review your complete health and pregnancy history, identify any outstanding labs or testing, and provide months of education, recommendations, and birth preparation within a condensed timeframe. This can require many additional hours of clinical and administrative work to make sure everything is complete before your due window.

Our goal is to have your records, required testing, labs, and overall clinical picture complete and appropriate for out-of-hospital birth by 37 weeks, when your midwife team goes on call for you. If important records or testing are still outstanding, or a health concern has not been adequately evaluated or resolved, we may not be able to safely attend an out-of-hospital birth until those requirements are met.

For these reasons, our full midwifery fee applies even when care begins later in pregnancy. The earlier you begin care, the more time we have to prepare together and make the transition into midwifery care as smooth as possible.


 

In California, Licensed Midwives may attend an out-of-hospital birth once you are past 37 weeks and before 42 completed weeks of pregnancy, as long as you continue to meet the other criteria for community birth. If labor begins outside of this window, your birth will need to take place in the hospital.
 

There are different types of transfers—non-emergent and emergent—and either can happen during pregnancy, labor, birth, or postpartum.

The most common is a non-emergent transfer during labor. This may happen when labor has been very long, someone becomes exhausted, or labor is no longer progressing as expected. In these situations, there is typically time to discuss options together and transition calmly to hospital care.

Occasionally, something develops during pregnancy that makes hospital birth the safer option. This may include certain concerns with baby's health or development, preterm labor, hypertension, or changes in labs or other clinical findings. These changes may develop gradually or sometimes more quickly.

Emergent transfers by ambulance are much less common. If an urgent or emergency situation occurs, your midwife team begins providing appropriate care and stabilization immediately while EMS is on the way. Whenever possible, your midwife will accompany you during the transfer and help support continuity of care as you transition to the hospital.

Transfer planning is part of responsible out-of-hospital birth care. Our goal is to recognize concerns early, respond appropriately, and make the transition to a higher level of care when it is needed.

 

For an urgent or emergent transfer, your midwife WILL typically accompany you to the hospital** and remain with you until the situation is stabilized and your care has been safely transitioned to the hospital team.

For a non-emergent transfer, your midwife DOES NOT typically accompany you to the hospital, but DOES arrange and facilitate the transfer for you. Together, we will determine which hospital is most appropriate based on your preferences, insurance, location, and the circumstances surrounding the transfer.

Your midwife will call the receiving hospital and speak directly with the care team, provide a full report explaining your labor and reason for transfer, and send your prenatal records. This allows the hospital to know you are coming, understand your situation, and have your pregnancy history available when you arrive.

Throughout your hospital experience, your midwife remains available virtually for questions, support, input, and recommendations as needed. Transferring to the hospital does not mean that your relationship with your midwife or our support for you ends.

Once you and your baby are discharged home, your midwifery care resumes, including your scheduled postpartum and newborn visits, ongoing support, and the remainder of your postpartum care with our team.

Non-emergent transfers most commonly happen after a very long labor when the birthing person has become exhausted and needs additional support. By this point, your midwife has often been providing continuous care for many hours as well.

In many of these situations, the reason for transferring is to access pain relief, such as an epidural, so you can sleep, recover your strength, and continue laboring. Labor may then continue for many more hours before your baby is born.

Because your midwife may have already been awake and providing care for an extended period of time, it is not safe or practical for her to remain at the hospital throughout the remainder of a long labor without adequate sleep and recovery. Your midwife also remains on call for other families who may need care during this time.

Your midwife is still available for virtual support throughout your hospital stay. You can call or message us for support, questions, or input, and we want to stay updated on how you and your baby are doing.

Clients are always welcome to call their midwife to discuss hospital recommendations, get additional explanation, and receive support in understanding their options. At the client's request, your midwife may also speak directly with the hospital or OB team to help clarify recommendations, provide relevant information, and support informed decision-making and collaboration with your hospital care team.

Even if you transfer to the hospital, you remain a client of your midwife and our practice. Because we do not have hospital privileges, the hospital team assumes responsibility for your in-person medical care while you are admitted, while your midwife remains available for virtual guidance, support, and collaboration as needed. Once you are discharged home, your active, in-person midwifery care resumes.

No matter what type of transfer you experience, your midwife continues to provide your postpartum midwifery care after you return home. This includes a postpartum home visit, followed by three comprehensive in-office postpartum visits through 6 weeks postpartum, along with ongoing support between visits. Depending on the circumstances of your transfer or recovery, you may also need follow-up care with an OB or other specialist alongside your midwifery care.

A hospital transfer changes where you give birth—it does not end your relationship or care with your midwife.

Transfers do not qualify for a discount on your midwifery fee. Transfers often require additional assessment, coordination, communication, and support from your midwife team. Your fee covers the care and services provided throughout your pregnancy, birth, and postpartum—not simply where your baby is born. You are also reserving one of a limited number of spaces in your due month, allowing your midwives to maintain availability for your birth.

If a high-risk condition requires transfer to obstetrical care before 33 weeks, you may choose to continue co-care with your midwife team for prenatal, birth, and postpartum support, in which case the full fee remains due. If you choose to completely discontinue midwifery care, you are responsible only for services provided up to that point.

After 33 weeks, the full midwifery fee is due and no refund is provided, even if you choose to discontinue care. Most clients do choose to continue with their midwife team for support throughout the remainder of pregnancy, birth, and postpartum alongside their hospital care team.

Out-of-hospital midwifery care is designed for low-risk pregnancies, and part of our responsibility is continually assessing that you and your baby remain appropriate candidates for community birth. Certain labs, screenings, and ultrasound findings provide important information about your health, your baby's wellbeing, and any factors that may affect your birth plan.

There are many options for prenatal labs, genetic testing, and ultrasounds, and we discuss these with you in detail throughout your care so you can make informed decisions. For healthy clients without specific risk factors or concerns, some optional testing may be declined if desired.

However, we do require certain basic prenatal lab panels and at least one complete anatomy ultrasound. Additional testing or monitoring may also be required if a concern develops or your pregnancy continues past your due date. These requirements help us provide responsible, informed care and continually assess that out-of-hospital birth remains an appropriate option for you and your baby.

Yes! Doulas are amazing, and we highly recommend having one as part of your birth team. Your midwives are your medical care providers, which means we are responsible for continually monitoring the health and wellbeing of you and your baby. Emotional support, kindness, informed consent, and shared decision-making are always part of our care—but a doula has the unique ability to focus entirely on your physical comfort and emotional support.

Doulas can support not only you, but also your partner and family throughout labor. They can also accompany you during a hospital transfer, which can be especially valuable during a non-emergent transfer when your midwife does not typically remain at the hospital.

Doula Options Through Mind Body Birth
We have experienced doulas within our Mind Body Birth network and care team, making it easy to add doula support to your overall care. Your midwives can help connect you with a doula who feels like a good fit for your family, preferences, and birth plans.

Doula Coverage + Scholarships
Many private insurance plans and Medi-Cal now offer coverage for doula services, and additional scholarship programs may also be available. Your midwives can help guide you through your options, including how to access insurance benefits, covered doulas, and available financial assistance.

Postpartum Doula Support
Doula care can continue well beyond birth. Families can also add postpartum doula support, with daytime or overnight care available during the early weeks and months. Postpartum doulas can provide newborn and feeding support, help protect time for rest and recovery, offer light household support, and provide an extra set of experienced hands as your family adjusts to life with a new baby.