The storybook concept of the midwife—the earthy woman who arrives at the mother’s bedside just in time to order someone to boil water—is a far cry from the modern reality. Today’s midwives go through a rigorous training and certification process that prepares them to care for women at all stages of pregnancy.

“When you hire us, we become your pregnancy healthcare team,” says Margo Dandreano of Practical Midwifery, based in Crestview. “You don’t need to see another healthcare provider unless something is going on with your health that we would need to collaborate with a doctor on.”

She and her fellow midwives Kizie Tosi and Julia Del Valle draw all the necessary, standard-of-care pregnancy labs and involve the client in all decisions leading up to her tests. Their prenatal schedule is the same as a provider’s who plans to deliver in the hospital: monthly visits until the client is 28 weeks pregnant; every two weeks from 30 to 36 weeks; weekly from 36 to 41 weeks; and every three days after 41 weeks.

“We spend a lot of time on education—diet, nutrition and exercise; birth processes; preparing the home for birth; preparing new parents for baby doctor visits; and routine care and procedures,” Dandreano says.  

Practice Qualifications

As a licensed midwife (LM) and certified professional midwife (CPM), Dandreano is trained to handle out-of-hospital births and care for people for the entire childbearing year. Tosi and Del Valle, both certified nurse midwives (CNMs) and advanced practice registered nurses, are trained to care for women preconceptionally through menopause. All team members are CPR (cardiopulmonary resuscitation) and NRP (neonatal resuscitation program) certified, including any birth assistants attending a birth.

“In the state of Florida, both CNMs and LM/CPMs are recognized as healthcare providers,” Dandreano says. “That means that we can send referrals to other care providers, prescribe medications in the case of the CNMs, administer some medications, be reimbursed by insurance companies, carry malpractice insurance and work collaboratively with other healthcare providers.”

She says the provider’s qualifications should be an important factor when a woman decides whether to choose a home birth. Other considerations include health issues, safety protocols and finances.  

Risk and Safety

There are some underlying health issues that would make home birth a riskier option, Dandreano says.

“Things like diabetes, heart disease or high blood pressure, or a history of multiple or close cesareans, may increase your risk factors,” she says. “We discuss your full medical history and current status to help determine if home birth is a good option for you.”

The fact that Practical Midwifery screens all their clients to ensure that they are low risk indicates that safety is a top priority at the practice, she says. 

“All our birth team members are trained to help baby or mom with issues that may suddenly arise. We also carry certain medicines that would help in an emergent situation. Another part of our screening process is to ensure we are within 30 minutes of a hospital with labor and delivery, in case we do need some help during or after the birthing process.”

Pensacola to PCB

The team sees clients at their office, in the clients’ homes and through virtual visits, which are reserved for consultations and by the client’s request due to illness or exposure. Practical Midwifery accepts clients from Pensacola to Panama City Beach. 

“Let me explain how we cover such a large area of Florida’s Panhandle,” Dandreano says. “We draw a one-hour circle around each midwife’s home, and that tells us if we can get to the client in a timely fashion on Labor Day. And there we have Pensacola to Panama City Beach—up to the border and down to the ocean. That and being within 30 minutes of a hospital that has a labor and delivery unit.”

 While Practical Midwifery does not accept insurance as payment, they do what they can to help clients get the highest insurance reimbursement, she says. They have experience with Tricare, private insurance and Christian share plans. While they are not currently Medicaid providers, they offer a discount to clients who qualify for 100 percent Medicaid. And because they send out for labs and ultrasounds, those can be processed through insurance or Medicaid.

For more information, contact Practical Midwifery at 850-859-4100 or visit PanhandleMidwife.com.