All expecting families can be part of our community and join our various support groups. Out-of-hospital birth is safe because we serve only low-risk people. Do you wonder if you are low-risk? If you desire midwifery care, it is worth asking if you are a safe candidate for care. Just give us a call at 903.662.1648.

Yes! For low-risk pregnancies it can be safer to birth at home than in a hospital. New Studies Confirm Safety of Home Birth With Midwives in the U.S.

We do attend breech and twin births with specific criteria. We have attended multiple breech trainings and births, and we strive to keep our skills and knowledge of breech up to date. Breech babies must be in a complete or frank breech position. We also like an ultrasound around 37 weeks to confirm the position, cord location, and estimated baby weight. For twins, there is a bit more criteria involved. If you are pregnant with twins or would like more information, feel free to reach out to discuss.

According to the latest Centers for Disease Control, the cesarean birth rate in the US is 31.9% (2017); with such a high surgical birth rate, the question of how to give birth after a previous cesarean is a frequent question. The short answer is; yes! We can attend a TOLAC for a woman who has had an uncomplicated birth by surgery, with at least 18 months spacing from the surgical birth to this baby’s due date. Obtaining surgical records and being willing to see a chiropractor and other complementary providers as needed to increase your chances are highly encouraged.

No, we are out of network with all insurance providers. While it may seem like giving birth at home will cost more, this is not normally the case. In most cases, it is still cheaper to give birth at home with our discounted cash pricing. We are happy to give you a superbill in the postpartum so you can work with them on getting reimbursed or getting your payments applied to your out-of-pocket expenses. But, we cannot guarantee what your insurance company will do with the claim.

We are able to greet about 4 new humans each month. Call as soon as you get that positive pregnancy test to make sure you hold a spot. Some months are open long enough to accept people late in their pregnancy as long as they have records of care from their previous midwife or MD.

Yes, we do have a “bedside” in-office ultrasound and also refer out for ultrasounds to be read by a radiologist. We offer no-charge ultrasounds to gather basic info, like how many babies, viability in early pregnancy, head or butt down? For diagnostic ultrasounds, we refer you to one of our trusted sonographers.

Yes, we are able to discuss genetic screening, do some in-house labs, and refer out to others. Genetic testing is available after 10 weeks of gestation for those who desire it.

Nutrition in pregnancy is one element you may be able to control. Each of us comes with a blueprint--think genetics. New research shows that blueprints can change when higher quality "building materials" are available--think epigenetics. Your baby could still be on the planet in 90+ years if he/she is built to last. No pressure! Just do your best. Eating while nauseated or with gestational diabetes can be challenging. People also wonder if their diet is adequate: vegan, vegetarian, meat and potatoes, paleo... so many questions! Let's work together to guide you through optimal nutrition in pregnancy while honoring your own diet preferences.

See our link Client Resources above and choose the option that suits your search.

Yes, we do have ones that we prefer over others. You can find a complete list of our favorites here.

Yes! Every person and pregnancy are different, and there is no one-size-fits-all approach. We will always discuss options and give you the pros and cons of each.

As licensed midwives in Texas, we can attend births between 37 and 42 weeks gestation. Most births occur between 38 and 41 weeks. Before 37 weeks or after 42 weeks, there can be more complications for the baby, and we refer you to our MFM, who discusses your options with you to make a plan.

No, we do not. Unfortunately, malpractice insurance is so expensive that we would have to take on far too many clients to afford it, and we would no longer be able to provide the type of care we prefer to give our clients.

In our practice, the answer is no. There are some options that you can opt out of, but we feel that it is our duty to practice safely and within the scope of the law by which our license is governed. We cannot prove a mother is low-risk without assessments to back that up. This is for your safety and for ours. We keep lab work to the minimum we feel is necessary unless a condition arises that says, “Hey, this warrants deeper investigation.” There are some labs where you have a choice on how to perform the test such as gestational diabetes screening. You may choose to forgo Group B strep Screening after a thorough conversation on the risks. The state requires HIV, Syphilis, and Hep B in the first and third trimester or at the onset of labor. We require one sonogram at 20 weeks for most mothers. Should you want more, we will order them for you. We believe, at minimum, the 20-week anatomic survey lets us know your baby is currently growing on target, your placenta is in a good position (especially important for moms looking to VBAC), you have a 3 vessel cord, the baby looks as if all his/her organs are where they should be and that this, by all accounts, looks to be an appropriately developing baby. Sometimes, we see something that may need follow-up in the third trimester, such as a low-lying placenta, or at some point, we feel like there may be too much or too little fluid, or maybe we can’t quite tell on palpation if your baby is breech and we need to get a good position on him/her. Most of our clients start care at around 12 weeks, and many do not have an early dating sonogram. If you begin care early, we can certainly order it, or if you are uncertain of your conception, we can have a dating sonogram done.

Yes, if you are pregnant at this moment, please consider that your baby is completely underwater, and nobody is too concerned! Your baby is getting oxygen from the umbilical cord and, in late pregnancy, will practice breathing with water. A water birth is just a short extension of the womb. Once the face hits the air, the baby will take deep breaths, and the small amount of amniotic fluid naturally found in the lungs is pushed out by oxygen. The lung tissue itself becomes perfused with oxygen. This is a radiant process. Most babies are born with a dusky tone and soon will pink up (this is true of all babies regardless of skin color). The water birth is for the woman's comfort and may reduce vaginal tearing. It has been called the natural epidural.

You may have whoever you choose at your birth. Our advice on choosing guests is to limit it to people who will be there for a specific reason. Do they have anything in particular to offer? Will they give you good labor support, encouragement, and massage? Having people there who you don’t want, feel uncomfortable with, or who are negative/scared about an out-of-hospital birth often creates a challenging experience. As for children, we are glad to have children of all ages at your birth! We ask that your child has an adult there who is responsible for them and who is unattached to witnessing the birth so that they may leave with the child if necessary.

“The more cultured the races of the earth have become, so much the more positive have they been in pronouncing childbirth to be a painful and dangerous ordeal”. - Grantly Dick-Read, Childbirth without Fear We do not have pharmaceutical pain relief: epidurals or narcotics. Prepare: For American women, birth needs preparation! Take childbirth education, read positive books like Ina May’s Guide To Childbirth, watch films like The Business of Being Born, stretch your body in yoga, dance, make love, get out in nature, have quiet time, teach yourself to be patient (take breaks from your cell phone), meditate, and do nothing at times. WHAT? If birth is such a normal, natural process, why do I need so much preparation for my first unmedicated birth? Because most of us live soft lives compared to people of other times and places. Birth has fierce energy. Preparation teaches you to ride the wave of labor and meet it with your own fierce, wild self. You can do it! But you must prepare. Without preparation, birth may be perceived as a terrible, painful ordeal instead of the powerful and wondrous force that will bring your child into your arms. Support: Active labor support from me or a doula lessens the impression of pain and shortens labor. By hiring me, you will have support for your labor no matter which way nature decides to lead you. If a cesarean becomes the safest way for the baby to be born, my role becomes even more vital in providing loving postpartum support. Having a birth is an intense and challenging life event. While it can definitely be interpreted as painful, most women’s interpretation of pain is greatly affected by their environment, relationship with a care provider, level of feelings of safety or fear, and so many other factors. I have many tools for pain management, including the built relationship of trust, water, herbs, homeopathy, and massage. I also have relationships with local chiropractors and acupuncturists who may be available to help with various challenges (including pain management) if I think they may be helpful. We highly recommend Krisha Crosley's class Train for Pregnancy to help you prepare for the marathon of labor and birth.

Approximately 90% of women who choose to give birth at home with us do so without a complication. If something comes up in your pregnancy, labor, birth, or postpartum that indicates it would be safer to be in a hospital setting, we do not hesitate to go there. Our relationship with local hospitals is such that we can join you in the hospital and continue to provide labor support in that setting as long as regulations do not prevent otherwise. If there is an actual emergency where time is of the essence (less than 1% of births that we attend), we may choose to transport by ambulance. We will discuss this possibility with you as your due date approaches. In the case of transport during labor, upon discharge from the hospital, you will continue your postpartum care with us as planned. It is one of the privileges of living in the US in the 21st century that cesarean birth is available to us when it may save the life of a mother or baby. We believe that a cesarean birth rate of 30+% is improper use of this incredible surgery. The World Health Organization recognizes the overuse of cesarean birth as a costly health crisis. Midwifery reduces unnecessary surgical births!

This is the most frequently asked question of all! It is a fearful thought to think of a nooselike experience for a baby; in most cases, the cord around the neck is more like a necklace, and in most cases, there is no harm. The cord is around the neck (nuchal cord) in about 30% of births. We simply loop it over the head during the birth process. A cord accident is a tragic but rare event. The planet has 7.5 billion people, and we all negotiated our umbilical cords.

This question always makes us think for a second….what information does the woman asking us think the number tells her? Does she feel a low transport rate proves we are a good midwives or not? We think it does not. Here are our thoughts: our transport rate is exactly what it should be. Do we know the number? Nope…Do we care? Nope. Why? Well, a transport in labor is not a failure of midwifery care. A transport to the hospital during labor means that midwifery is working exactly as it should be. If you or your baby’s health warrants intervention that we cannot give at home, then the hospital is where you need to be for your safety. If you become exhausted, stop coping, and start suffering, pain medication may be what you need to help you have good memories of your birth; no one should suffer for the sake of a birth plan. There is a line that tips the scale from coping to suffering. If a woman is suffering, and we cannot help her get back to coping, it is in her best interest to explore options for pain relief, which may warrant a trip to the hospital. Again, not a failure on the part of the mother or the midwife but a change of plan based on the circumstance we are working with. We will say that when mothers commit to out-of-hospital birth and healthy pregnancies, when they follow the guidelines we have developed over the years, and through our experience of what works for successful homebirths, and through the knowledge we have gained by consulting with physical therapists, personal trainers, doulas, and organizations that specialize in the mechanisms of birth, our transports drop to near zero. When they don’t…..transports go up. Sometimes, transport is necessary even when you have done everything in your power to get to your goal. Life is unpredictable. But we are committed to working as hard for your birth plans as you are working. We will be right by your side, advising, supporting, and hopefully working towards your goal of a safe and happy homebirth experience. Our hospital of choice for non-emergency transport is Baylor University Medical Center - Dallas, where emergency transports go by ambulance to the nearest appropriate hospital.

The only difference between homebirth and birth center birth is proximity to a hospital. Texas law requires birth centers to be within a max of 30 minutes from the nearest hospital with an L&D department. Most homebirths also fall into that category. At a home birth, we bring all the safety equipment and medications that we would have had at the birth center…only we come to you instead of you coming to us. We bring oxygen and resuscitation equipment for the baby and for the mom. We have IV fluids and antibiotics should you need them or choose that treatment option for Group B strep. We carry both pitocin and misoprostol for postpartum hemorrhage. We can suture 1st & 2nd-degree tears, and yes, you get numbing medicine for that! We have a large selection of herbal remedies and homeopathic medicines we are trained to use, as well as a few essential oils. We maintain NRP (Neonatal Resuscitation ) & Adult CPR certification. Midwives travel in pairs, which means as you near delivery, your midwife will be called a trained birth assistant to your birth as well. Two sets of skilled hands make managing complications smoother.

Thankfully, neither of us has had that experience.

Generally speaking, the answer is yes. Over the years, we have missed very few births. We schedule vacations a year or more in advance and inform prospective clients of when they can expect us to be out of town so they can decide if they are comfortable with that scenario or not. Midwifery is a very demanding profession, and breaks are necessary, but we make every effort to be at the births of our client's babies. The Heart of Texas midwives work in a type of partnership, though the midwife you hire is your primary midwife. We back each other up for unexpected emergencies, illnesses, or time off. We assist each other and work closely together. We have similar styles of practice and work well together. On rare occasions, you may labor too fast for your midwife to make it! Be assured your midwife is on her way, or if we know you live in close proximity to a sister midwife, we may call her to head to you as we are on our way. We make every effort to have your birth attended!

We can care for you and your baby for the first 6 weeks of life. Most people choose to make their first appointment with a pediatrician when their baby is 8 weeks old. It’s helpful to decide on a pediatrician in late pregnancy. We have great pediatricians we can refer your family to.

No, we do not. New research has deemed it medically unnecessary. We'd be glad to provide you with more information if you have questions. We have zero judgment if you do decide to circumcise your child once you have all the info, and we can provide you with recommendations to providers who do them.