Frequently Asked Questions

• Well-Person 
• Pre-Conception 
• Fertility / Infertility
• Prenatal
• Labor / Birth
• Postpartum
• Newborn (up to 4 weeks)

• 24/7 access to the midwife and her collaborating physician
• Care provided by an experienced certified nurse-midwife with expertise in functional health management, out of hospital birth, birth emergency management, and complex laceration repair. 
• Prenatal Care - monthly until your 3rd trimester, every 2-3 weeks until 36 weeks, weekly until delivery, ultrasounds performed by midwife during visits
• Labor & Birth - including birth pool rental (plus associated supplies: tarp, pool liner, hose, cover, electric air pump, sump pump); disposable supplies (peri bottle, witch hazel pads, Dermaplast spray, instant ice pack pads, chux pads, Depends, postpartum pads, ibuprofen, sitz bath herbal soak, trash bags, placenta basin, oxyclean, hydrogen peroxide, bulb suction, baby massage oil, newborn diapers, newborn hat); IVs, medications, tinctures, homeopathy, and/or supplements needed during labor, birth, or immediately after birth; surgical procedures (repairing lacerations), newborn medications if desired (Vitamin K injections, Erythromycin eye ointment), full newborn resuscitation with hospital-grade equipment as needed (medical air, oxygen, oxygen blender, mechanical suction, T-piece resuscitator, CPAP, LMA)
• Postpartum Care - Visits Day 2 at home (including full examination, breastfeeding support, bedside hemoglobin),  Day 7-10, Week 3, and Week 6
• Newborn Care -  Visits Day 2 at home (including hearing screen, metabolic screen, congenital cardiac defect screen, bilirubin level check via bilirubin meter), Day 7-10, and Week 3  

• Labwork - covered by most insurance; can be ordered at Quest or LabCorp, or collected in the office for PathGroup
• Visit(s) with Dr. Gosser (accepts most insurance including Medicaid)
• Ultrasounds with Dr. Gosser or his sonographer (covered by most insurance including Medicaid)
• Medications, supplements, herbal tinctures, and/or homeopathy prescribed during prenatal or postpartum care
• Miscellaneous supplies for birth as needed or desired (waterproofing & dark linens for mattress, clean bucket, bleach, towels, baby blankets)

I am a Certified Nurse-Midwife. Certified Nurse-Midwives are Registered Nurses with Master’s Degrees or Doctorates in Nursing and are board certified by a national midwifery organization. I am licensed by the Missouri State Board of Nursing as Certified Nurse-Midwife and Advanced Practice Registered Nurse. Certified Nurse-Midwives in Missouri are required to have a collaborating physician. They can prescribe medications, and catch babies in homes, birth centers, and hospitals. 

I completed a Master’s degree from the top nurse-midwifery program in the nation and completed an extensive clinical practicum specializing in out-of-hospital birth settings. I have post-graduate training in obstetric and neonatal emergency management, and participate in continuing education to maintain the most current information and evidence-based practices. I have been practicing professionally as an out of hospital midwife for several years in home and birth center settings. I also worked for several years as a staff nurse on a high-risk labor & delivery unit prior to becoming a certified nurse-midwife. I am a Basic Life Support and Neonatal Resuscitation Provider instructor, and a certified provider of Advanced Life Support in Obstetrics. I'm also a trained and experienced doula. 

I have the following certifications: Advanced Life Support in Obstetrics (ALSO) to handle birth emergencies, Basic Life Support (BLS) for healthcare providers, and Neonatal Resuscitation Provider (NRP). My certifications are kept up-to-date and renewed regularly. I participate in emergency skills drills, clinical debriefing, and keep current with the latest evidence-based practice via continuing education. 

I practice the midwifery model of care, which includes longer, more intimate appointments, and hands-on, low intervention care. An average prenatal care appointment is 30-60 minutes, and follows the traditional prenatal care schedule: appointments every 4 weeks until 28 weeks, then every 2 weeks until 37 weeks and then weekly until birth. I work closely with you postpartum, with visits at 1-2 days, 7-10 days, 3-4 weeks, and 6 weeks. I am on-call 24/7 to address urgent questions or concerns.  

I am able to attend your birth at home from 37 weeks 0 days of pregnancy to 41 weeks and 6 days of pregnancy. Patients having their first babies or patients who tend to go past their due dates are offered a schedule of homeopathy to reduce their chances of needing an induction at 42 weeks. A Biophysical Profile (BPP), and possibly a Non-Stress Test (NST), are recommended at 41 weeks. These tests can be performed in Dr. Gosser's office or in our office. I offer natural induction methods for some patients. Dr. Gosser will arrange an in-hospital induction at your hospital of choice if you have not gone into labor by 42 weeks. I will still be able to see you for your postpartum visits if you have your baby in the hospital. 

Yes! I have a fantastic Medical Director, Dr. Brian Gosser, MD, OBGYN. He will see you at least once during your prenatal care, and will be there to consult or collaborate if any complications arise. 

Unfortunately, Medicaid does not pay for home births in Missouri. Dr. Gosser's office does accept Medicaid. 

I am unable to attend VBACs at home, including secondary VBACs. I may be able to offer midwifery care in collaboration with Dr. Gosser for a planned hospital birth if that is something you would like to consider. I support women having choices for their births, and have several recommendations for other home birth midwives, if you've had a cesarean and would like to plan a home birth. 

I will have an experienced Registered Nurse, another Certified Nurse-Midwife, or a Certified Professional Midwife as my primary birth assistant during births. Additional support, with your consent, will be an experienced Student Nurse-Midwife and/or an experienced Student Professional Midwife.  

You will notify me when you start having regular contractions. I will head to your home when you are in an active labor pattern. I'll bring all of the gear needed to welcome your baby safely at home, including emergency medications and resuscitation equipment. My assistants and I are experts in labor support; including: optimal fetal positioning, massage, comfort measures, aromatherapy, and “holding space”. We create and safe-guard a supportive watchful waiting approach while promoting comfort, privacy, and respect. We will monitor you and your baby’s health throughout labor, birth, and postpartum via routine assessments, including: vital signs, exams (only as necessary and with explicit permission), baby’s heart rate with a doppler before birth and vital signs after birth, a full newborn exam, and full postpartum exam. 

You will be assisted into whatever labor and birthing positions you would like to try, and encouraged to birth wherever you prefer. The baby will be skin to skin with you after birth and the cord will not be clamped or cut until breastfeeding and bonding skin-to-skin with both parents has occurred, usually about 2 hours after birth. We encourage bonding and breastfeeding and will be monitoring you and your baby’s health. We will weigh, measure, and perform a full assessment on your baby after initial breastfeeding and skin-to-skin bonding. I will check your bottom for tears, perform any repairs you may need (by giving you numbing medicine and stitches), and prepare an herbal bath to soothe your bottom. We will help you get clean and comfortable, and tucked back into bed. We'll go over your discharge instructions, address any questions, and then leave you and your family to rest and begin your babymoon. We will take care of the cleanup after birth, including breaking down the pool, wiping down the bathroom, changing the sheets, starting the laundry, taking out the trash, etc...  All we leave for the family is to enjoy the baby!

Certified Nurse-Midwives care for healthy babies within the first 28 days of life. I will do their first health exam at birth, follow up with a telephone call around 24 hours postpartum, and will return to your home 24-48 hours after birth (usually day 2) to do a check-up, assist with breastfeeding, answer any questions or concerns, and perform the metabolic screening, newborn cardiac screening, and hearing screening. I offer postpartum visits at my office for you and your baby at 7-10 days, and 3-4 weeks, and I offer a 6-week postpartum visit for you. 

I am not contracted with any insurance company. My patients are considered self-pay. However, I can recommend a biller to help you find out what your Out-of-Network benefits might cover. Some patients’ insurance plans offer gap exceptions that will reimburse you for my services at in-network rates. I can connect patients desiring to use their insurance plan with an expert home birth billing company that can help determine what their insurance may cover. You will be billed the full fee prior to birth and your insurance will reimburse you after the birth for any coverage they provide. I accept cash, check, and credit cards. 

Yes!

Continuous labor support is paramount to having a satisfying birth. I will support you throughout your labor and birth and love doulas and supportive family and friends! I highly recommend you hire a doula or have a support person in addition to your partner. 

Yes, birth at home is safest when both mom and baby are healthy. The anatomy scan at 20 weeks gestation can find unknown or otherwise undiagnosed problems, like problems with the placenta, the cord, fluid levels, or the anatomy of the baby. 

I am a Certified Nurse-Midwife in St. Louis, MO, and received my MSN in Nurse-Midwifery in 2010 from Frontier Nursing University. I have been a Registered Nurse since 2004. 

I have been passionate about childbirth and working with childbearing families since early childhood. I started my education on a pre-med track to become an obstetrician but realized I wanted to become a nurse-midwife instead. I worked as a patient care tech on a medical-surgical unit while completing an accelerated baccalaureate nursing program with a focus in maternal-newborn nursing. I was hired as a staff nurse on a high-risk Labor & Delivery Unit, where I worked for several years. I became a doula to enhance my labor support skills, started a private doula practice, and began teaching childbirth and infant care classes before enrolling in Frontier Nursing University's nurse-midwifery program. 

I am passionate about the midwifery model of care provided in home and birth center settings. I completed my midwifery training in 2010 at Colorado’s only free-standing birth center where I was trained to attend waterbirth and manage out-of-hospital emergencies. After graduating, I began meeting with two organizations to start the first birth center in St. Louis, and was one of the first CNMs on staff.

I have been adjunct faculty for St. Louis University, Maryville University, and Chamberlain's schools of nursing where I taught junior- and senior-level student nurses maternal-newborn nursing in clinical settings as well as in the schools' high-fidelity simulation centers. I've been a nurse educator for the Women's & Infants unit at Barnes-Jewish Hospital where I taught Basic Life Support for Healthcare Providers, and Neonatal Resuscitation. I love being an educator and teaching in clinical settings as well as running emergency skills drills. I'm excited to be a preceptor for student nurse-midwives and share out of hospital midwifery skills with them. 

My philosophy of birth is to honor that pregnancy and birth are normal while serving as the guardian of wellness and safety throughout the process. I follow a functional medicine approach to health, appreciating that all body systems are interconnected and affected by each other. My strengths are my quick wit, sense of humor, transparency, and ability to connect with others. 

You are carrying a single baby.

Your baby is positioned head down near term.

You have not had a prior C-section. 

You don't have any chronic or complex medical conditions, or taking medication that may affect the baby after birth. 

You do not develop high blood pressure or preeclampsia during pregnancy. 

Your labor begins between 37 and 42 weeks of pregnancy.

You aren’t taking any medication for gestational diabetes and are able to control blood sugar with diet and exercise. 

Your pre-pregnancy BMI is 40 or less. 

Your anatomy scan doesn’t show issues with the placenta, the umbilical cord, the fluid, your baby’s anatomy, or any other concerns. 

Your prenatal test results don’t indicate a need for continuous fetal monitoring during labor.

You do not desire an epidural or IV pain medication. 

There are no restrictions on your age.