All informed consents can be found in your Client Care client portal. These are documents that list out the risks and benefits of procedures, and need to be signed by you.

First trimester consents include:

• Informed Consent for Practice… usually reviewed during the initial consultation, this document communicates the most basic things about midwifery care with Rebirth Midwifery (i.e schedule of visits, usual discussion topics, equipment brought to births, etc.)

Most informed consents follow in the second and third trimesters.

Initial OB Panel: Includes Blood Type and Screen (i.e. A+), CBC, Antibody screen, Hepatitis B and C, HIV, Herpes, Rubella and Syphilis

Rebirth Midwifery uses a third party services, LaboratoryAssist, to keep costs low for clients who are having all of their care done with Rebirth Midwifery. The estimated cost of this full panel is $165.

Another option, through FullScript is around $100. This includes the above-mentioned tests as well as Vitamin D, which is linked to preventable pregnancy conditions. All of the supplies for testing will be sent to your home and you will be required to bring the kit to our first appointment or to schedule an appointment strictly for drawing labs.

In Maryland law, all of these conditions are outside of licensed direct entry midwife’s scope of practice:

(1) Diabetes mellitus, including uncontrolled gestational diabetes;

(2) Hyperthyroidism treated with medication;

(3) Uncontrolled hypothyroidism;

4) Epilepsy with seizures or antiepileptic drug use during the previous 12 months;

(5) Coagulation disorders;

6) Chronic pulmonary disease; 7) Heart disease in which there are arrhythmias or murmurs except when, after evaluation, it is the opinion of a physician licensed under Title 14 of this article or a licensed nurse certified as a nurse-midwife

or a nurse practitioner under this title that midwifery care may proceed;

8) Hypertension, including pregnancy-induced hypertension (PIH);

(9) Renal disease: 10) Except as otherwise provided in § 8-6C-04(a)(11) of this subtitle, Rh sensitization with positive

antibody titer;

(11) Previous uterine surgery, including a cesarean section or myomectomy:

12) Indications that the fetus has died in utero;

13) Premature labor (gestation less than 37 weeks);

(14) Multiple gestation;

15) Noncephalic presentation at or after 38 weeks;

16) Placenta previa or abruption;

(17) Preeclampsia,

(18) Severe anemia, defined as hemoglobin less than 10 kg/dI;| (19) Uncommon diseases and disorders, including Addison's disease, Cushing's disease, systemic lupus erythematosus, antiphospholipid syndrome, scleroderma, rheumatoid arthritis, periarteritis nodosa,

Marfan's syndrome, and other systemic and rare diseases and disorders;

AIDS/HIV;

(20) Hepatitis;

(21) Acute toxoplasmosis infection, if the patient is symptomatic;

(22) Acute Rubella infection during pregnancy;

(23) Acute cytomegalovirus infection, if the patient is symptomatic;

(24) Acute Parvovirus infection, if the patient is symptomatic;

(25) Alcohol abuse, substance abuse, or prescription abuse during pregnancy;

(26) Continued daily tobacco use into the second trimester;

(27) Thrombosis;

(28) Inflammatory bowel disease that is not in remission;

(29) Primary genital herpes simplex virus infection during the third trimester or active genital herpes lesions at the time of labor;

(30) Significant fetal congenital anomaly that directly impacts the birthing process or requires immediate emergency care, as determined by the Board in regulations;

(31) Ectopic pregnancy; or

(32) Post term maturity (gestational age 42 0/7 weeks and beyond).

Pregnancy at “Advanced Maternal Age”

Pre-Eclampsia Risk Factors:

To prevent pre-eclampsia, persons with 2 or more moderate risk factors should take a low-dose Aspirin daily, ideally starting at 16 (12-28) weeks until delivery.

Systematic Reviews (highest level of evidence):

Midwife-Led vs. Obstetrician-Led Perinatal Care for Low-Risk Pregnancies: A Systemic Review and Meta-Analysis of 1.4 Million Pregnancies (2024)

What do Safety and Risk Mean to Women Who Choose Home Birth? (2025)

Planned Home Birth as a Safe Alternative to Hospital Birth for Low Risk Women

The Skills of Midwives (2023)

Hopefully, this makes you feel confident in your decision to birth at home. I also hope that you don’t feel the need to prove to others why you’ve made the best decision, but if you do, here is some legitimate evidence.

Also these all pertain to low-risk pregnancies, and we are constantly making sure you are still low-risk. If you fail to be during pregnancy, labor and birth or postpartum, we will transfer care to a higher level facility (the hospital).