Informed Disclosure of Practice

We, Michelle Bartlett and Kathy LeBaron, testify that the following statements are true to the best of our knowledge. This disclosure is for the women and families, for whom we provide services at this special time in their lives. This disclosure contains the status of midwifery in the state of Idaho, the type of care you will receive from Agape' Birth Service, the risks and benefits of out of hospital birth, our personal and professional philosophy, education, training, and experience, and a consent for out of hospital midwifery care. This document will also include status of liability insurance coverage for the practice, a list of conditions that could arise during delivery.  

Status of Midwifery in Idaho

Currently, midwives in Idaho are required by law to be licensed. The law was passed and went into effect in 2009. Midwives that are Certified Professional Midwives are eligible for licensure.  Certification is gained through the North American Registry of Midwives. Idaho law also requires certification in Pharmacology for Midwives, Suturing, and the treatment of Shock & IV Therapy.

Liability Insurance

            Midwives in Idaho are not legally required to carry liability or malpractice insurance. Malpractice insurance coverage would make out of hospital midwifery care unaffordable for most families. It could also have a detrimental effect on the quality of our services to you. Therefore, we will not carry malpractice insurance. We feel that our best insurance is our relationship with you and our dedication to providing top quality care.

National Certification

The North American Registry of Midwives (NARM) is an international certification agency whose mission is to establish and administer certification for the credential “Certified Professional Midwife” (CPM). CPM certification validates entry-level knowledge, skills and experience vital to responsible midwifery practice. This international certification process encompasses multiple educational routes of entry including apprenticeship, self-study, private midwifery schools, college-and university-based midwifery programs, and nurse-midwifery. Created in 1987 by the Midwives’ Alliance of North America (MANA), NARM is committed to identifying standards and practices that reflect the excellence and diversity of the independent midwifery community in order to set the standard for North American midwifery.

Statement of Care

Care with Agape' Birth Services is more personalized than physician care, with each visit lasting approximately one hour. However, regular prenatal visits are scheduled according to the 'Gold Standard of Obstetric Care'. This means that visits are scheduled monthly until 28 weeks, bi-weekly until 36 weeks, and weekly until delivery. In the event of deviations from the norm, a mother may be seen more often and/or referred to a physician for consultation or transfer of care. Routine lab work is done typically on the first visit and repeated at 28 weeks.

Labor and delivery care is also very personalized. Birthing plans are highly recommended with an open mind that birth doesn't always go as planned. Fathers are highly encouraged to take a very active role in the delivery of the baby. Monitoring of labor begins during the active phase of labor and continues until 2-4 hours postpartum and/or until both mother and baby are stable.

Postpartum care includes a 24-36 hour visit, a 5-7 day visit, a 2 week visit and a 4-6 week visit. Newborn screening tests are performed as mandated by state law at 24-36 hour visit and repeated at 2 weeks. If the necessity arises more visits will be scheduled. A pediatrician visit is recommended for the baby by 7 days after birth, but is not mandatory.

Phone consultations are available 24 hours a day should difficulties be encountered during your care with us. However, please remember that midwives are very busy people with families. Calls during business hours are greatly appreciated. 

Risk/Benefits of Out of Hospital Birth

All births including those that occur outside of the hospital, involve a natural process with risks both to the mother and the baby. The outcome of any birth, even in the hospital, cannot be guaranteed to be perfect and uneventful.

Out of hospital (OOH) birth has many advantages. Primarily, women choose OOH birth to have more control over their birth experience. This usually means no routine intervention in the natural process. There are no unfamiliar bacteria and germs in one's own home. The family is never separated. The mother/baby never receive drugs in labor. Statistically, having an OOH birth is safe for low-risk healthy women.

However, it is possible, although rare, during any labor or the immediate postpartum that complications may arise.  These may include but are not limited to: 

• Non-reassuring fetal heart tones

• Prolapsed of the umbilical cord

• Placental abruption

• Failure to progress

• Hypertension

• Retained placenta

• Uterine rupture

• Neonatal respiratory distress

• Meconium aspiration

• Shoulder dystocia

• Severe postpartum hemorrhage

The risk is inherent, in that emergency facilities are only as close as the nearest hospital. Intensive care may not be immediately available. Also, transfer of care is not always smooth and easy. Staff may not be readily available and extra time could be wasted calling personnel to the hospital in an emergency situation. Also, realize that the possibility of hostility from doctors and nurses could put a woman and/or her baby at higher risk.

These are considerations that have to be made when contemplating an out of hospital delivery. Emergency care may not be quick and easy.

Certified Professional Midwives are specifically trained in the handling of the most common of obstetric emergencies. We are trained in the use of emergency medications, IVs, and in resuscitation for mother and baby.

Out of hospital birth can be a wonderful experience for mothers and their families. However, it is not for everyone. It is important that with all the glamour surrounding out of hospital birth and midwifery care, you make an informed and educated decision about the best place to have your baby.

Personal and Professional Philosophy

            We, at Agape Birth Services, believe that birth is a natural and normal event in a woman’s life. Ninety-five percent of the time, pregnancy and birth occur without complications. We trust the process of birth and a woman’s ability to give birth. With the support of her midwives and significant others,  a woman’s birth can be one of the most empowering experiences of her life. We believe that natural childbirth is a right and a privilege, creating a universal bond for women and families, that goes beyond borders and the generations of time. We also believe that the current 31.7% cesarean rate in the United States has become a barbaric act inflicted upon women. This procedure is not only cutting away at their bodies, but their minds, spirits, and the very essence and purpose of how and why women are created.

            We believe that a woman’s emotional state plays a large part in her birth experience. This is why we spend an hour with each woman at each prenatal visit. During these visits she will get to know us very well. Establishing this kind of relationship paves the way for smooth communication. Communication about all aspects of care, physical needs or concerns, emotional needs, or life stresses helps to reduce the chance of complications during the childbearing process. We work together in a partnership with the woman and her significant others to create a personalized birth experience.

We also believe that a healthy diet and regular exercise play a key role in a healthy and safe pregnancy and birth for both baby and mother, and will prevent many complications from arising. We emphasize and teach good nutrition as part of your prenatal care.

 Michelle Bartlett, CPM

   I was born and raised in Dallas, Texas. I have had the privilege of being married to the same wonderful man, my husband Russell, since 1982. He has been my biggest supporter. In all the adventures that life has taken me through, he has been there cheering me on. We have 7 children. Some of them are grown and having families of their own and some of them are still home. We are even blessed to have 9 beautiful grandchildren. I had my first child in the hospital, two at a free-standing birth center, and the last four at home. The last one my husband and I had unassisted. Some of my hobbies include needle work, gardening, horseback riding, and reading.  My newest interest is training and competing in triathlons and running.

I started attending births as a doula (personal labor attendant for women having hospital births) in 1987. We moved to the northwest in 1989 where I began assisting/apprenticing with a very experienced midwife in the Kalispell area. Over the course of my apprenticeship in that state, I worked with 4 wonderful midwives. This gave me many perspectives from which to learn. I also attended Casa de Nacimiento midwifery school and birthing center for 6 weeks in 1995 and for 4 weeks in 1997. While at Casa, I completed 756 clinical hours of intense training.

On average, 40 to 70 women a month choose to birth at the school. During this time, I was also enrolled in Ancient Art Midwifery Institute. This is an at home distance-learning midwifery program. Completion generally takes 3-5 years for most students as the course is extensive.

  I have attended, assisted and/or supervised over 300 births. I am fully trained in adult and infant CPR and neonatal resuscitation. I became a Certified Professional Midwife in 1998. At the time of certification, I had been practicing midwifery for 5 years in Montana. We moved to Idaho Falls in 1999 where I have been a practicing CPM since.

Recertification with NARM is every 3 years and requires 35 continuing education units (CEUs). Continuing education is important for all midwives. I try and go to workshops and conferences between births to stay up to date. I testify that I am currently in good standings with NARM.

I am currently the Vice President and Legislative Chair with the Idaho Midwifery Council. I also serve on the state of Idaho’s first Board of Midwifery.

 Kathy LeBaron, CPM

I was born in Salt Lake City, Utah. At the age of 7, my family moved to Mexico where I lived for over 30 years. I have 12 children (11 living) all of whom were born in Mexico. All of my births took place at home - with or without an attending midwife. Five of my children are married and I have 14 grandchildren, nine of whom I delivered as the attending midwife. I spent many years studying herbology and natural healing and was fortunate enough to attend seminars on herbal healing by Dr. Schultz. I enjoy playing the piano and horseback riding.

In 1982, I began my midwifery apprenticeship with a registered nurse and a Certified Professional Midwife. In 1987 I took a midwifery course from a midwife who had traveled down from Utah. By 1999, I was a registered midwife in Mexico attending over 100 births as the primary midwife, along with providing all the emergency and natural health care to the surrounding area in which I lived. I moved back to the U.S. in 2002, and to Rexburg, Idaho in 2003 where I currently reside with 6 of my children. In 2005, I began my midwifery apprenticeship in Idaho with the goal of becoming a CPM through NARM. I did my academic studies through Ancient Art Midwifery Institute and in September of 2007 I attended Casa de Nacimiento for 4 weeks. While at Casa I completed over 250 clinical hours of intense training. I have attended, assisted and/or supervised an additional 150 births (for a total of over 250) since 2005, completed my training and passed the qualifying examination to become a Certified Professional Midwife. I will be seeking licensure in Idaho as soon as the licenses are available. I have also attended several Continuing Education workshops and conferences. I am currently providing full care as a practicing midwife. I am fully trained and certified in adult and infant CPR and neonatal resuscitation. I am an independent midwife and contractor. I am not under the employment of Agape' Birth Service & Birth Center.

Please initial each line and fill in your names, as appropriate.

_____ I/We, _________________________________________________, understand the risks/benefits of home birth. We have had all of our questions answered regarding the experience and services offered by Agape Birth Service, and the limitations of giving birth in an out of hospital setting.

_____ I/We release Agape' Birth Service & Birth Center, Michelle Bartlett, CPM, Kathy LeBaron, CPM, and any associates from any and all liability.

_____ I/We agree that in the event of a dispute, I/we agree to seek arbitration before taking legal action.

_____ I/We are comfortable in our decision to have an out of hospital and have in no way been coerced to make this decision.

Client's Signature _________________________________________ Date _____________________

Spouse/Partner's Signature __________________________________ Date _____________________

Midwife's Signature ________________________________________ Date _____________________

Midwife's Signature ________________________________________ Date _____________________

NOTE:  This document must be signed by both client and spouse before initiation of services. If client is unmarried only the client’s signature is required.