Jocelyn Brown, CPM, LM

Midwifery and Labor Support

Big changes around here!

I’m retiring Borealis Birth to go to work as a midwife with Gracefull Birthing Center in Los Angeles, California!  I couldn’t be more excited about my big move!

Los Angeles folks can visit Gracefull’s website to inquire about midwifery services. If you are curious about doula or monitrice support, you can contact me directly.

Portlanders shopping for a doula would do well to check out Sapling Birth. If you are looking for a midwife, please click on the following links for my favorite practices. I have worked personally with all these midwives and you’ll get the best care around:

Glow Midwifery

Nest Midwifery

Vivante Midwifery

Andaluz Waterbirth Center

Services

Click the titles above to learn more about the services I offer.

Midwife Care

Midwives are specialists in natural birth. The Midwifery Model of Care is a philosophy that views pregnancy and birth as normal, physiological events, and believes that women and midwives are partners in care. To this end, we provide informed choice about benefits and risks of your options so that you can make the choices that are right for your family. Our standard of care encompasses the following:

During pregnancy, we provide:

  • A consultation to answer your questions, learn about your individual circumstances,  and cover policies and schedule of care.
  • Prenatal visits every month until 32 weeks, every two weeks until 36 weeks, then every week until your baby is born
  • Informational folder with hand-outs for pregnancy, birth and the postpartum
  • Genetic carrier testing, non-invasive prenatal testing and referrals for other prenatal tests such as ultrasound, CVS, and amniocentesis
  • Pregnancy-related lab testing, such as OB panel, gestational diabetes, urinalysis, and GBS
  • Well-woman care (such as Pap smear, breast exam, and STI testing)
  • Co-care with other care providers, such as naturopaths, obstetricians, and perinatologists
  • Post-dates testing for fetal well-being
  • Informed choice and education for special circumstances, such as twins and breech
  • Availability by phone, text and email during business hours  for general inquiries and scheduling
  • Availability by phone ’round the clock for urgent matters

In each prenatal visit we cover:

  • Maternal urinalysis
  • Blood pressure and other vitals
  • Monitoring of fetal well-being and growth
  • Time-sensitive prenatal testing, as indicated or desired
  • Nutritional, herbal, and fitness counseling
  • Pregnancy discomforts
  • Warning signs
  • Addressing fears and concerns
  • Planning for your birth

At your birth we provide:

  • Water birth, if desired
  • The standard medical equipment necessary for a planned out-of-hospital birth
  • Ongoing support from your midwife and her assistants
  • Medical monitoring of fetal and maternal well-being throughout active labor and second stage
  • Suturing and anaesthetic for vaginal lacerations
  • Cord blood banking collection, if desired
  • Maternal and newborn monitoring for a minimum of three to four hours postpartum, ensuring that both mother and baby are stable before our departure
  • A full newborn exam, including optional newborn procedures such as Erythromycin, newborn metabolic screening, and vitamin K
  • Breastfeeding support
  • Clean-up after the birth
  • Emergency measures such as IV for shock, medications for postpartum hemorrhage, and newborn resuscitation
  • Should the need to transport to the hospital arise, your midwives will accompany you and provide support in-hospital (See our FAQ section for more information about hospital transport and our relationship with area hospitals.)

During the Postpartum we provide:

  • Maternal care and well-baby care for up to 6-8 weeks after your birth. These hour-long visits happen at 24 hours,  1 week, 3 weeks, and 6-8 weeks. Visits are in the home for all clients during the first week postpartum
  • Breastfeeding support
  • Screening for postpartum mood disorders
  • Critical Congenital Heart Defect (CCHD) screening
  • Pediatrician, family practice, or lactation specialist referrals, and referrals for community resources such as newborn hearing screening, new moms groups, and postpartum fitness classes
  • Birth certificate filing

Each postpartum visit includes:

  • Assessment of maternal vitals and bleeding
  • Assessment of newborn vitals, growth, and milestones
  • Breastfeeding assessment
  • Guidance with newborn care
  • Maternal emotional well-being
  • Processing your birth experience

Pricing: 

Call GraceFull Birth at 323.379.4614. Staff will walk you through pricing and help you learn more about your insurance coverage.

 

Doula Care

A doula is a unique part of a woman’s birth team, especially given the time demands on doctors, midwives, and nurses.  The presence of a doula at a birth can significantly decrease the need for interventions, including Cesarean birth, pain medications, and vacuum-extractor or forceps. Perhaps most important, women who have doulas report having a better birth experience. Though it is true that labor support could come from a  friend of the mother or a member of the hospital staff such as a nurse,

“Continuous support from a person who is present solely to provide support, is not a member of the woman’s social network, is experienced in providing labour support, and has at least a modest amount of training, appears to be most beneficial.”

Your doula does not provide medical care. Instead, her job is to focus on the emotional and physical comfort of a laboring woman. A doula is present to help you to have your ideal birth, as you define it.

Doulas provide the following services, and more:

  • Consultation, 3 prenatal visits, your doula’s presence at your labor and birth, and 3 postpartum visits.
  • Nutritional and herbal support for pregnancy-related discomforts
  • Referrals to resources in your community, such as alternative healing modalities, lactation support, or midwives and doctors
  • Pain coping support during labor, such as hydrotherapy, movement, massage, visualization, affirmations, deep relaxation, and aromatherapy
  • Breastfeeding support
  • Help with newborn care and postpartum discomforts
  • Round-the-clock phone availability for urgent matters
  • Availability by phone, text and email during business hours  for general inquiries and scheduling
  • Back-up doula support, included in your care package. Your back-up doula will attend one of your prenatal visits

Pricing: $2400.00 covers all of your care, including prenatal and postpartum visits, your doula’s presence at your birth, and her call fee.  We ask for half of the global price at the onset of the relationship, and the remaining half is to be paid at 36 weeks.

Some FSAs, HSAs or RSAs will cover doula or monitrice care, and we can run your FSA card just as we would run a credit or debit card (plus a 3-4% service charge).

There is also a possibility that your insurance may reimburse you for your doula’s services. In fact, there is a CPT   code for doula services, and your doula can walk you through the steps needed to make a claim to your insurance company once you have paid your doula in full and your birth has taken place. A link to a helpful article and a list of insurance companies that may reimburse you can be found here. We encourage everyone to file a claim to their insurance for their doula fees but we cannot guarantee that you will receive any reimbursement.

To inquire about need-based discounts, please contact Jocelyn by email at jocelyn@jocelynbrowncpm.com.

Monitrice Care

Think of your monitrice as a doula, plus! Monitrices are certified midwives who, in addition to providing the labor support of a doula, are also able to monitor your blood pressure, do intermittent fetal monitoring, and check cervical dilation at home. Your monitrice will not deliver your baby. Instead, she offers more clinical information than a doula is able to help you make an appropriate decision about when to travel to your planned place of birth. Hiring a monitrice does not require that you are planning an un-medicated birth, though many people find a monitrice invaluable in helping them to avoid using pain medication.

Though each laboring woman has a unique set of needs, monitrices provide the following services, and more:

  • Consultation, 3 prenatal visits, your monitrice’s presence at your labor and birth, and 3 postpartum visits.
  • Each prenatal visit offers the educational materials included in doula support, as well as auscultation of fetal heart tones, maternal blood pressure, and other vitals
  • Nutritional and herbal support for pregnancy-related discomforts
  • Referrals to resources in your community, such as alternative healing modalities, lactation support, or midwives and doctors
  • Pain coping support during labor, such as hydrotherapy, movement, massage, visualization, affirmations, deep relaxation, and aromatherapy
  • All postpartum visits take place at home
  • Breastfeeding support
  • Help with newborn care and postpartum discomforts
  • Round-the-clock phone availability for urgent matters
  • Availability by phone, text and email during business hours  for general inquiries and scheduling
  • Back-up doula support, included in your care package. Your back-up doula will attend one of your prenatal visits
  • Substantial discount on placenta encapsulation

Pricing: $2400.00 covers all of your care, including prenatal and postpartum visits, your monitrice’s presence at your birth, and her call fee.  We ask for half of the global price at the onset of the relationship, and the remaining half is to be paid at 36 weeks.

Some FSAs, HSAs or RSAs will cover doula/monitrice care, and we can run your FSA card just as we would run a credit or debit card (plus a 3-4% service charge).

There is also a possibility that your insurance may reimburse you for your monitrice’s services. In fact, there is a CPT   code for doula services, and your monitrice can walk you through the steps needed to make a claim to your insurance company once you have paid your monitrice in full and your birth has taken place. A link to a helpful article and a list of insurance companies that may reimburse you can be found here. We encourage everyone to file a claim to their insurance for their doula fees but we cannot guarantee that you will receive any reimbursement.

To inquire about need-based discounts, please contact Jocelyn by email at jocelyn@jocelynbrowncpm.com.

 

 

 

 

 

About Jocelyn

Jocelyn Brown, CPM, LDM

Licensed Midwife

 

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I grew up in the suburbs of the Twin Cities and originally wanted to be either a ballerina, Cyndi Lauper, or a doctor. In high school I discovered contemporary dance, and I attended the University of Minnesota with a major in modern dance and a minor in women’s studies. When the Ailey School came to town in 1997, I auditioned and was accepted, and was off to New York. Two semesters at Alvin Ailey convinced me that a career in dance wasn’t in the cards, but that New York was definitely where I wanted to be. At that point, yoga was the thing that helped me transition from the life of a dancer  to the life of whomever I was going to be next.

It didn’t take long for me to figure out that yoga was a path for me to follow my interest in health and physiology. I taught vinyasa yoga full-time for four years, with a specialty in prenatal and postnatal yoga. Even with thriving classes, it didn’t feel right that I was helping women prepare for birth when I had never actually attended one, so I asked my students if any of them wanted my help during their labors. To my delight, a few of them called me!  Going to my first birth sealed the deal: I wanted to be a midwife.

I moved to Portland, OR in 2008 to attend Birthingway College of Midwifery and completed a two-year clinical training at Andaluz Waterbirth Center. Upon graduating, I worked for four months as a midwife at MamaBaby Haiti, in Morne Rouge, Haiti, and, returning to Portland, I started my own practice, Borealis Birth. Los Angeles is a new adventure for me, and I’m excited to join GraceFull Birth as a primary midwife.

I feel equally comfortable with birth at home and in the hospital, and I’m grateful that women in Portland have so many options. My yoga and meditation practices inform my midwifery practice every day. I approach birth from the viewpoint of the mindfulness tradition, which means supporting normal birth just as it is and helping my clients make informed, intuitive decisions within their present circumstances.  I live on Mt. Tabor and I like to read, sleep, travel, spend time with my people and my dog, and feed my addiction to fashion and design blogs.

Jocelyn Brown, CPM, LDM
jocelyn@jocelynbrowncpm.com
503-481-8639

 

 

FAQ

What is Jocelyn’s philosophy of care?

It’s really more of a vision: What if we eliminate the polarity between in-hospital birth and home and birthing center births? Let’s streamline maternal-fetal health so that birthing individuals and babies can move freely between the two realms, get the best possible care and receive non-judgmental support from all care providers.

Why choose a midwife?

If you feel that pregnancy and birth are normal life events, and want to make informed decisions regarding your and your baby’s care, a midwife may be the way to go. During pregnancy, midwives are able to spend more time with clients than OBs are, and thus are able to offer more education and choice to their clients. Midwives have lower rates of birth interventions such as epidurals, vacuum extractors, and Cesarean birth. Though both midwives and OBs are focused on the goal of a healthy mother and baby, midwives understand that the process of birth is meaningful, too. After your birth, midwives offer extensive support and care for both mothers and babies, including breastfeeding support.

Why would I have a doula at my birth?

A doula is in the unique position of being able to focus solely on your emotional needs and physical comfort during labor, and she will stay with you throughout your birth, when other care providers may come and go. A doula is also able to simplify medical language in order to help you to make decisions for your care. The presence of a doula can lower your chances of having an intervention (if desired) and increase your happiness with your birth experience.

Why would I hire a monitrice?

A monitrice offers all the support of a doula, but with the added benefit of offering maternal vitals and blood pressure checks, cervical checks, and intermittent fetal monitoring at home. This information can help you make a clear decision about when it is appropriate to move to the hospital for your birth, at which point your monitrice will accompany you and assume the role of doula for the remainder of your birth.

How will labor support enhance my partner’s experience?

Midwives and doulas value the birth partner’s experience, too.  We want to find out how each partner visualizes his or her own involvement in pregnancy and birth, and we respect the wide range of needs that come up.  One recent study of fathers involved in pregnancy and birth showed that continuous professional support during labor not only increased satisfaction with the father’s experience, but made fathers more likely to take an active role in labor support, and to enjoy and feel empowered by his role.

Why would I want to give birth in a hospital?

A woman who is higher risk will probably probably plan a hospital birth. Just a few examples of situations that may be safer attended in the hospital are a mother on insulin therapy, who has very high blood pressure, or monoamniotic twins. A low-risk mother might choose a hospital birth because of the immediate availability of epidural or narcotics for pain relief.

Why would I want to give birth at home?

Imagine your care team coming to you! Imagine not having to leave the house for postpartum and newborn care! A 2012 Chochrane Review of home birth vs. hospital birth suggests that for low-risk women and babies, giving birth at home is as safe as hospital birth. Home is a place where many women are able to feel the most calm and at ease. This sense of security can often facilitate a more efficient labor and make coping with labor easier. Privacy, fewer time restrictions, and broader choices are added benefits.

What kind of pain relief is available at home?

Midwives help women use natural pain coping techniques that range from warm water to verbal guidance to position changes, and more. Often, women cope with contractions by “going within,” and a midwife’s job is to simply be present, standing by if assistance is needed. Your midwife can bring a birth tub to your home. Epidurals and narcotics are not available at home.

Home birth sounds so messy!

It’s really not. Your midwives use soft, protective underpads on any surface you’ll be resting on during labor and birth. A few inexpensive and non-toxic cleaning supplies are an essential part of the home birth kit, and midwives use them for quick spot-cleaning.  Water birth is particularly tidy, as any mess is contained in the tub. After the birth, while your midwives are monitoring you and your baby, we’re also restoring your home environment to a condition the same or better than when we arrived. One of the reasons we love home birth so much is that you and your baby will only be exposed to your own germs, rather than in a hospital or birth center, where others have given birth before you.

Why would I give birth in a birthing center?

Freestanding birth centers (such as Gracefull Birth) are home-like facilities where birth is facilitated much like a home birth. Smartly-designed birth rooms contain birthing tubs, large beds, and a private bathroom. You won’t have access to epidural or narcotic anaesthesia at the birth center, but you will have access to nitrous oxide, which has been used safely by laboring women in Europe for years.

Who will attend my home birth or my birth at the birthing center?

GraceFull births are attended by one primary licensed midwife and one assistant who is another midwife or a licensed nurse. Assistants are an integral part of the birth team: They assist the midwife so that she may better take care of you and your baby. Midwives also love birth partners, doulas, and helpful friends and relatives. During your pregnancy, your midwife will help you assemble your best birth support team.

Should I plan a water birth?

Your midwives are happy to help you give birth in any position that is working for you and your baby, either in the water or “on land.” We like to say that water birth is fluid (pun intended).  Women tend to get in and out of the tub a few times throughout labor, and your midwives will refresh and rewarm the water when you’re not using it.

For labor, water immersion offers comfort, relaxation, pain relief, freedom of movement, and increased circulation for laboring women. This may result in both mothers and babies coping with labor better.  For birth, water may help reduce vaginal tearing and give the baby a gentler transition into extra-uterine life.

Water is just one tool available for labor and birth, and not all women find it effective. But in general, our clients express a great deal of gratitude to the birth tub.

What happens if something goes wrong during a planned out-of-hospital birth?

Occasionally, mothers and babies give us signs before, during, or after labor that they need the tools a hospital can provide.  Your midwives are prepared for this possibility and we believe that the option of  a smooth transport to the hospital is part of what makes home birth safe.

Your midwife assesses your and your baby’s wellbeing throughout labor, birth, and the immediate postpartum. If your birth strays out of the range of normal, your midwives will inform you and talk about your options. In the event that hospital transport is required, your midwives will accompany you to the hospital for support.

The majority transfers of care are not emergencies, and the goal is to transport a woman safely and efficiently before an emergency occurs. Women who have transported to the hospital for their births will usually continue to see their midwife for postpartum care. In the rare event of an emergency at home, midwives carry and are trained to use several anti-hemorrhagic medications (to stop bleeding), IV fluids, and resuscitation equipment.

What kind of a relationship does Jocelyn have with area hospitals?

I believe that cooperation and rapport with hospital care providers are the best way to provide mothers and babies with excellent care and ensure the future safety and longevity of all birthing options. Fortunately, more area hospitals feel the same and are welcoming incoming transports, respecting clients’ choices, and honoring the midwives’ role in client care.

What about VBAC? Can I do that at home or at the birthing center?

VBAC stands for “vaginal birth after Cesarean.” We welcome and support women who are considering birthing out-of-hospital with their subsequent baby after a Cesarean, and we believe that out-of-hospital VBACs can be a safe and sensible option. There are a lot of medical factors, emotions, and a gut knowing that go into planning a VBAC, and we’d love to get together to discuss whether a VBAC in-home or at the birth center is right for you.

How much is a birth at home or at the birthing center going to cost me?  Will my insurance cover it?

The good news?  Several private insurance plans cover birth with a midwife.  Although the coverage is usually out-of-network, if you do the math and understand your percentages, you might find that your out-of-pocket cost for home birth will not be much different than a hospital birth.

Some insurance companies don’t cover out-of-hospital birth, even though midwives have comparable (and in may cases, better) statistics and cost significantly less than a vaginal birth in-hospital.

We believe that midwifery care is an investment in your and your baby’s long-term health.  We also want to help you make a financial plan that works for your family. Please contact us directly for pricing information that applies to your unique situation.  If you have insurance, we can check into your benefits.  If you don’t have insurance, we can come up with a payment plan, together.

In general, midwifery care is charged “globally,” meaning that one set price covers the majority of prenatal, birth, and postpartum care. Lab tests, ultrasounds, supplements and visits for other healing modalities are not included in the global fee and are paid separately to the individual practitioner providing the service. Even if you have insurance that doesn’t cover midwifery care and home birth, it will often cover lab tests, ultrasounds, and the like.

To inquire about pricing for midwifery care, contact GraceFull directly.

Will my insurance cover a doula or a monitrice?

Maybe!   Some FSAs, HSAs or RSAs will cover doula or monitrice care, and we can run your FSA card just as we would run a credit or debit card (plus a 3-4% service charge).

There is also a possibility that your insurance may reimburse you for your doula’s services. In fact, there is a CPT   code for doula services, and your doula can walk you through the steps needed to make a claim to your insurance company once you have paid your doula in full and your birth has taken place. A link to a helpful article and a list of insurance companies that may reimburse you can be found here. We encourage everyone to file a claim to their insurance for their doula fees but we cannot guarantee that you will receive any reimbursement.

For cash pay doula and monitrice prices, please see the Services section. To inquire about need-based discounts, contact Jocelyn directly.

Contact

Book an appointment at Gracefull:

www.gracefull.com (hello@gracefull.com)

2815 West Sunset Blvd., Los Angeles, CA 90026

P: 323.379.4614

F: 323.430.8054

Contact Jocelyn directly:

jocelyn@jocelynbrowncpm.com

P: 503.481.8639

F: 503.766.6491

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