Ugh…I just need dessert!

woman wearing white tank top holding two donuts
Photo by Renato Abati on

Sometimes, we just want a dessert… Something sweet to satisfy a craving, BUT on the healthier side. Here are a few ideas that are tried-and-true.

Blog by W. Yvonne Silbernagel, CPM and Dawn Karlin, CPM

We still recommend moderation but these are some yummy treats….



Almond butter chocolate chip cookies


  • 1 cup all natural creamy or chunky almond butter (use your favorite brand) – I prefer cashew butter but any nut butter works
  • 1/3 cup honey or pure maple syrup
  • 1 egg
  • 1 teaspoon pure vanilla extract, gluten free if desired
  • 1/2 teaspoon baking soda
  • 1/2 teaspoon sea salt
  • 3.5 oz dark chocolate bar coarsely chopped and divided (use your favorite dark chocolate bar and chop it) sea salt, for sprinkling about 18 almonds for topping, if desired (not included in calorie count) I use Cacao bibs and almond slivers.INSTRUCTIONS

Preheat oven to 350 degrees F.
In a medium mixing bowl, beat together almond butter, honey (or maple syrup), egg, vanilla, baking soda, and salt until smooth and creamy; about 2 minutes. Fold in 1/3 cup of chocolate chunks.  Drop tablespoon sized balls of dough onto a baking sheet lined with parchment paper, top each cookies with extra chocolate chunks and an almond if desired. Bake for 10-12 minutes or until cookies turn a slight golden brown underneath; they will be puffy! Cool on the baking sheet for 10 minutes then transfer to a wire rack to cool completely. Repeat with remaining dough. Makes 18 cookies.


Paleo Peach Crisp – it is peach season in Oklahoma



Crisp Topping 

  • 1 cup raw pecan halves
  • 1/4 cup blanched almond flour or almond meal
  • 2 tbsp maple syrup
  • 2 tbsp coconut oil melted
  • 1 tsp ground ginger optional
  • 1/4 tsp sea salt
  • I added slivered almonds to up the protein.


Preheat oven to 350 degrees F.

  1. In a large bowl, mix together all ingredients for the filling.
  2. Pour into an 8×8 baking pan or a 9-inch pie pan, and evenly spread out.
  3. Place the raw pecan halves in a food processor and pulse until crumbly.
  4. Add the rest of the ingredients for the crisp topping into the food processor and pulse together until sticky.
  5. Spread out this mixture evenly over the peaches.
  6. Bake in the preheated oven for 40 minutes, until the topping is golden brown and crispy.
  7. Serve with dairy free ice cream or coconut whipped cream.
  8. Store the leftovers in the refrigerator covered, for up to 3 days. The topping won’t be as crunchy after you store it, but you can bake it again until it gets crispy again.


5 Ingredient Muffins

  •  1 cup almond butter
  • 2 ripe bananas
  • 2 large eggs
  • 1 teaspoon vanilla
  • 1 tsp. baking soda
    Blend. Grease muffin tin. Pour batter into muffin tins
    Cook for 12-15 minutes (muffins should be fluffy all of the way through and should not sink or settle)


Honey almond fudge cups


  • 1 and 1/2 cups smooth almond butter
  • 1/4 cup + 1 tbsp raw honey (substitute pure maple syrup for a Vegan option)
  • 1 tsp pure vanilla extract
  • 1/2 cup organic coconut oil melted and then cooled to almost room temperature
  • Generous pinch of fine grain sea salt
  • 2/3 cup chopped raw almonds

*Pinch more sea salt to top


  1. Line a 12 cup muffin pan with cupcake liners.
  2. In a medium mixing bowl, blend together the almond butter, honey (or maple syrup) and vanilla extract. Then whisk in the melted and cooled coconut oil until smooth.
  3. Stir in the almonds and the pinch of sea salt, then spoon the mixture evenly into the cupcake liners.
  4. Freeze for 15-20 minutes until firm, then enjoy!

Store leftovers covered and chilled in the freezer or refrigerator (for a softer creamier texture.) They’ll melt if left too long at room temperature! Makes about 14 generous fudge cups


5-Ingredient Crunchy Almond Butter Cups


  • 16 ounces chopped dark chocolate
  • 2 tablespoons melted coconut oil
  • 1/2 cup almond butter
  • 1/3 cup chopped almonds
  • sea salt for garnish


  1. Add cupcake liners to a muffin tin. Set aside.
  2. In a bowl, add coconut oil and chocolate and microwave in 30 second increments until completely melted.
  3. Into each liner, pour a tablespoon of the chocolate. Place muffin tin in the freezer for 5 minutes. In a bowl, mix together almond butter with chopped almonds until smooth.
  4. Remove muffin tin from freezer and add 2 teaspoons of almond butter mixture into the center of each liner. Make sure to smooth out that layer before adding the melted chocolate.


Top the almond butter mixture with the remaining melted chocolate. Sprinkle with sea salt and freeze for 1-2 hours. Enjoy!


Coconut Cake with Lemon Curd, Strawberries and Whipped Cream (Grain Free, Paleo, Primal)…I’ll be honest, this takes more time but it is AMAZING!!!


For the Cake Batter:

  • 1 cup coconut flour
  • 1/2 teaspoon Celtic sea salt
  • 8 large eggs
  • 1 teaspoon baking soda
  • 1/2 cup plain whole yogurt (or a coconut yogurt)
  • 6 tablespoons unsalted butter or coconut oil , melted
  • 1/2 cup honey (I used clover)
  • 1 tablespoon vanilla extract

For the Lemon Curd:

  • 8 tablespoons unsalted butter or 6 tablespoons coconut oil
  • 1/2 cup honey (I used clover)
  • 4 large eggs
  • 3 large egg yolks
  • 1/4 cup lemon zest (make sure the lemons are organic)
  • 1/2 cup freshly squeezed lemon juice (about 6-8 lemons)
  • 1/8 teaspoon Celtic sea salt
  • 2 cups heavy cream or coconut milk , whipped
  • 2 cups strawberries, tops removed, cut in half


  1. Preheat oven to 350ºF and adjust rack to middle position. Butter a 9” round cake pan and dust with coconut flour (this will ensure the cake doesn’t stick). Place all cake ingredients in the bowl of a food processor and blend until smooth. Pour batter into the buttered cake pan and bake for 40-45 minutes, or until just turning golden brown on top and a cake tester inserted in the middle of the cake comes out clean. Cool for ten minutes, then run a knife around the edges and invert onto a cake platter. Cool completely.
  2. Melt butter in a double boiler set over medium heat. Whisk together honey, eggs, yolks, zest, juice and salt in a large measuring cup. Slowly, while constantly whisking, pour in egg mixture and continue to whisk for 6-8 minutes until thick like pudding. Pour curd through a fine mesh sieve over a medium bowl, cover and chill in the refrigerator for 2 hours or until cold.

To assemble:

  1. Cut cake in half. Spoon half of curd mixture on top of bottom cake layer and spread evenly. Spoon half of whipped cream on top of curd and spread evenly. Top with 1 cup berries. Place second cake layer on top and repeat with curd, cream and berries, Serve. 


Chocolate Avocado Cookies -haven’t tried it yet but on my list


  • 1 ripe avocado about 1/2 cup mashed avocado
  • 1/4 cup natural maple Flavored Sugar-Free Syrup or maple syrup (if not low carb)
  • 1/2 cup nut butter peanut butter or almond butter (if paleo)
  • 1 egg or chia egg if vegan
  • 1/2 cup unsweetened cocoa powder


  • 1/4 cup dark chocolate chips, no sugar added or choose your favorite one
  • 1 teaspoon vanilla extract
  • 2-3 drops liquid stevia drops


  1. Preheat oven to 180 C (360F)
  2. Cover a baking sheet with parchment paper. Slightly oil the paper with 1/2 teaspoon of liquid vegetable oil (coconut or peanut oil) . This will prevent the cookies to stick to the paper. Set aside.
  3. In a food processor, with the S blade attachment, add ripe avocado and sugar free maple syrup (or liquid sweetener you like). Process for 30 seconds until it forms a creamy avocado batter with no lumps.
  4. Stop, add egg, nut butter and cocoa powder. Process again for 30 seconds. Scrap down the bottom and side of the bowl and process for an extra 15 seconds to make sure all the batter is combine – no lumps.
  5. Transfer the chocolate cookie batter onto a mixing bowl. It will bit moist and sticky that is what you want. Stir in chocolate chips and vanilla – if used.
  6. Combine with a spatula until the chocolate chips are evenly incorporated. Test the batter and adjust with 2-3 drops of liquid stevia – only if you want a sweeter cookie. I did not add any to mine and my kids love them but if you have a sweet tooth I recommend few drops of stevia to make them sweeter. Add one drop at a time and see how it taste.
  7. Prepare a small bowl with warm water, dip a spoon in the water and use that spoon to sample some chocolate cookie batter from your bowl. The water will prevent the batter to stick too much to your spoon.
  8. Spoon the chocolate batter onto the baking sheet – I used another spoon to push the batter out of the first spoon.  Use a silicon spoon or spatula to flatten the cookie into a cookie shape. The batter won’t stick onto silicon which makes it easier to spread.
  9. Repeat until you form 6 jumbo cookies. Those cookies won’t spread so you don’t need to leave more than half thumb space between each.
  10. Sprinkle extra chocolate chips on top of each cookies if you like.
  11. Bake for 12-15 minutes or until the centre is set.
  12. Cool down 5 minutes on the baking sheet then transfer onto a cooling rack to cool down.

Store the cookies in the fridge for up to 5 days in an airtight container


I’ve Decided To Do An Out of Hospital Birth…How Do I Pick My Birth Team?

By Dawn Karlin, CPM and Yvonne Silbernagel, CPM

First of all- 

Interview, Interview, Interview.….most Midwives offer free consults and want you to pick the right midwife for you. We know that there are many different practices in the area, and each of us have our special interests and different personalities.  The interview is important for you to pick the right midwife for YOU.  Friends, family and Facebook can be a good place to start to get names, but then it is essential to interview them for yourself.  Of course all of our goals are the same…having the right team for YOU so that you can work toward the birth you want with the right people supporting you.


What should you ask? 
Every Midwife and her practice is not the same, so you need to ask lots of questions.

Questions we suggest you ask and wish you would ask…

Is it an individual midwife or a practice of many? If so, can you choose who will be there?

Does she work with an assistant? Do you get to choose or is it chosen for you? Is she a doula also? How long has she done this work? Do you get to interview her also?

What training has your midwife had? Is she a CPM or CNM or Traditional Midwife?

If they work with an assistant, what training have they had?

Does the assistant ever come before the midwife? If so, when does the midwife come?

Has she taken emergency training?

If she does VBAC….What restrictions does she have? Why? What would risk you out of a HBAC?

What would risk you out of a Homebirth/Birth Center Birth?

What continuing education has she taken? Does she have anything interesting coming up?

What state organizations is she part of? Oklahoma Midwives Alliance? Midwives Society of Oklahoma? Both? None? Why?

How long have you been a midwife?

What is your emergency plan?

What if I need a prescription?

What hospitals does she prefer to go to in case of a transfer?

How many transfers has she had this year? Last year? What was the typical reason?

Does she charge extra for the birth pool? Newborn Screen? Hearing Screen? Metabolic Screen?

What supplements does she suggest? Why?

This is by no means an exhaustive list of  questions you should ask but just a good start.  This is someone that sees you at your most vulnerable…You want your midwife to be the right midwife for you.

What are our (Yvonne and Dawns’) answers to these questions?

  • We both have individual practices.
  • We also both have clients choose their assistant from a list of approved assistants. Each one of our assistants are required to have emergency training and have also been trained and work sometimes as doulas. To choose which one of our approved assistants would be right for you, you can interview them and/or look at their websites.
  • We both do VBAC for low risk candidates.
  • We each have guidelines for risking a client out of HBAC or homebirth or birth center birth with us.
  • Yvonne and Dawn both not only attend continuing education but also collaborate to bring better continuing education opportunities to our community!
  • We believe that our local Midwifery organizations are important for fellowship among other midwives, as well as resources and education opportunities. We each belong to both the Midwive’s Society of Oklahoma (MSO)and the Oklahoma Midwive’s Alliance (OMA).
  • Education, transfer rates, and reasons for transfer are unique to each of us so you would need a consult to discuss these with us individually!
  • Each of our clients have access to a borrowed pool from one of your birth team members. There is not an additional cost for this, however, there are additional supplies necessary like a pool liner and a fish net.
  • Yvonne and Dawn both offer state mandated newborn screenings to their clients. These include the hearing screening, heart screening, and metabolic screening at no additional cost.
  • There are specific supplements we recommend for each pregnant mama and other supplements will be recommended throughout pregnancy depending on each individual woman’s experience and symptoms.


We asked some midwife clients how they chose their birth team:

Word of mouth. I had heard GREAT things about the birth team I chose, and I’m glad I listened.- Veronica K.

Research, prayer and faith.- Cameron W.

My friends had all had you or recommended you- it was an easy decision. For my assistant, I just read a little about each one and went with what I felt would fit my personality/needs best.- Jess H.

I asked my friend, who was pregnant at the time, what a midwife even was! Lol, after that I did my own research and talked to my hubby. I think it really comes down to knowing your strengths and weaknesses, knowing what you truly want and then finding the people who fill those spots. Finding the people who believe in you is the biggest thing for me. -Annie M.

I asked my friends in the area who they birthed with. Then I researched them on internet like a stalker. 😂 I read birth philosophies and their own birth stories. I also checked experience levels and statistics like how many transfers/ C-section percentages. Really, it came down to my in person consult that solidified the decision. There’s just a gut feeling I get if I really click with someone. I wanted a team who I trusted, who really listened to me, and empowered me. Being in a fear free environment was most important to me, so I chose someone who made me feel at ease while at the same time was professional. With my second and third, I knew I was doing hypnobabies, so that played a role also.- Tiffany R.

I wanted accountability partners who would keep me honest and help shape my choices. At the same time, I wanted people who would feel natural enough with me to feel vulnerable with them . Erika C.

I wanted someone experienced and someone I clicked with. I know myself and the type of support I wanted, so I wanted someone that would do/honor that. Braylon B.


Made sure that those around me respected that space when I couldn’t verbalize that for myself. Amy P.


W. Yvonne Silbernagel, CPM,

Dawn Karlin, CPM,

Have You Ever Wondered…..What Does Midwifery Care Look Like?

Dawn Karlin, CPM and I (Yvonne Silbernagel, CPM) thought we would give you a little glimpse at what midwifery care looks like in our practices.  Our care begins with the first call, text, Facebook message or email…not the first payment$. It is family centered care, we love to have the whole family come.  Kids are always welcome, and we make sure they can help and be part of the journey.  If you want your visits to just be your self care time that is good, too.  It can also be a great time to bring moms, grandmas and relatives so they can see for themselves what midwifery care looks like.


Typically, we start your care between 10-13 weeks. However, we are often contacted way earlier than that. And since we work with a lot of mothers that have a history of loss, we often start the journey with your first positive pregnancy test.  We work hard to get your testing early and fast so you can have what you need as far as progesterone supplementation and/or ultrasound. At your first visit, we review the supplements and nutrition for you, and we also offer you the same labs as an OB.  Within a few days, we have talked to you again about your labs, and if we would advise anything different as far as supplements and nutrition. Those visits are every month until 28 weeks (when we recheck vitamin D levels and hemoglobin and do glucose screening), then every 2 weeks until 36 weeks (when GBS testing is offered) then every week until your little one is born.  Some moms need more visits, that is always available, and there is not an extra cost for the additional visits.

One of the most important parts of midwifery care is that we are available to you by phone if you need us…no office hours or third person to talk through. One of the biggest things you will notice during our hour long visits is the personalized care we give along with informed choice. We discuss everything!!!!  Decisions are always the clients to make, we give you the information and you make the choice that’s right for you and your family!


For care with either of us, your midwife and/or assistant can provide a birth pool if wanted at no charge, then you would need to only purchase or have on hand the other water birth or water laboring supplies- a new drinking water safe hose, a birth pool liner, whatever connection is needed to connect the hose to the water source, an air mattress type pump to blow up the pool and a small fish net. The pool  is brought to you typically at your home visit. This prenatal visit is done in your home between 35-37 weeks. It allows us to have a dry run to your house (we don’t want to find out we can’t find you at 2am when you call us in labor!), how to work your washing machine : ) and where you keep your birthing supplies.


What does care during labor and birth look like? Well, again, you call the midwife and she comes to you, along with an assistant that you have chosen during your care.  Your assistant comes to several of your prenatal visits so that you have gotten to know her along the way, too. No strangers at your birth, if we can help it.  It is a rare event that we have to use a backup.  During your birth, we are as hands on or hands off as you would like.  We are doing vitals on the mother every 4 hours and doing intermittent monitoring with a doppler on the baby.  We are encouraging you to eat and drink during labor, change positions and frankly being wherever you need us, doing whatever you need us to do.


Who does the catching?…that can be you the mother, dad or the midwife, or some combination of those!


After the cord is done pulsing, cord cutting or cord burning is always an option.  During the quiet family bonding time, we are working to get all vitals and make sure everyone is stable as well as cleaning and charting. During this golden hour (or two), we peak in and check on you every 15 minutes or so and make you something to eat and drink.  Newborn check is then done: head to toe, checking reflexes, weight and length, making sure we don’t miss a thing. Then it is mom’s turn, bathroom, shower and any repairs that need done.  While mom is up, we make sure you are getting into a fresh clean bed.  Our goal before we leave is for you to be tucked into bed with your new family, a fed tummy, a load of laundry in the washer, the pool broken down and the area clean.



Sometimes an herbal bath is requested:

indexTavia Redburn Photography

We come back between 24-36hrs, you don’t have to go anywhere. At that visit, we not only do a thorough check on everyone, we also do a metabolic screening and pulse ox heart screening for the baby.  There is no extra cost for us to do these state mandated screenings if you want them to be done.  You are seen again in your home at one week by the assistant. Then again at 2 weeks, 4 weeks and 6 weeks at the office, sometimes more, especially if more breastfeeding assistance is needed or breastfeeding is not going well.


As you can see midwives make it a family affair.  Birth is a beautiful journey. One that we love to share with you and work to get as much or as little of your family involved as you would like. Midwifery care is a gentle approach and a lovely combination of  expertise on normal pregnancy care, labor and birth, informed consent and decision making and getting to know your provider as we get to know you and your family on a whole new level. Midwifery care is holistic care at its finest ❤️.


 W. Yvonne Silbernagel, CMP,

Dawn Karlin, CPM,

Photographers featured today:

Tavia Redburn 

Andrea Jett

Belinda Briscoe

How to Prepare for a Homebirth 

How to Prepare for a Homebirth: What should I do to prepare? How can I improve outcomes? 

Dawn Karlin, CPM and Yvonne Silbernagel, CPM

Congrats! You have achieved a pregnancy and chosen out of hospital birth, what now? Are there things that you can do to improve outcomes and prepare for a better birth? The lists below identify areas that we feel are important for good outcomes. We also asked clients what they felt helped them prepare for home birth and listed some of their responses too!

Pick your Birth Team

  • Does your midwife have the same ideas about birth that you do?
  • What is her transfer rate? Why?
  • What are her protocols?
  • What is your midwife passionate about?
  • Do you get to pick everyone that will be there?
  • Interview several midwives and assistants- finding the right choice for you
  • Talk to other moms who have had a homebirth

Healthy Diet


  • Keep yourself low risk with healthy eating
  • Higher protein lower carb
  • Low sugar
  • Stay hydrated


Exercise, Stay Active

  • 15-20 minutes a day, at least 3-4 times a week
  • Walking
  • Swimming
  • Prenatal yoga
  • Prenatal Pilates

Natural Childbirth Education

  • Birth Boot Camp
  • Hypnobirthing
  • Bradley Method
  • Hypnobabies
  • Birthing at Home

Books, Videos, other

  • Read books on natural child birth-  The Bradley Book, Birth Partner, Pushed, Birth Matters, The Thinking Woman’s Guide to a Better Birth, Ina May’s Guide to Childbirth, Mindful Birthing, Birthing from Within
  • Homebirth Videos- YouTube has a plethora of homebirth videos, in varying graphic detail
  • Listen to Mindful Birthing
  • Pinterest
  • Blogs😉

Emotional and Mental Prep (ideas from our wonderful clients)

  • Visualize the birth you want
  • Keeping your home an emotionally safe place with healthy boundaries
  • Learning to relinquish control over where and when the baby will come
  • Mindful breathing and relaxation
  • Prayer
  • Birth Affirmations
  • Learn to trust the process

Chiropractic Care

So much of what we do in our daily lives causes imbalances. Chiropractic care can help fix that.

  • Find a Webster’s Certified chiropractor- ask your midwife, we will usually have recommendations for you!


  • Balance- so many influences that knock hormones and body systems out of balance. Acupuncture brings balance.


Unfortunately, no matter how good our diet is, it is hard to get everything we need. So here are some supplements that can help:

  • Food based prenatals with Folate not folic acid
  • Vitamin D
  • Probiotics
  • Vitamin C with Rose Hips
  • Magnesium

For After the Baby Comes- prepare yourself for an easier postpartum

  • Food prep- freezer meals
  • Easy healthy snacks
  • Snacks that younger kids can easily get to
  • Teach older kids to cook simple meals
  • Consider placenta encapsulation

What worked for other homebirthers?

While there are no guarantees in the birth process, we wanted to do everything we could to support the out of hospital birth experience we wanted. I prepared physically with chiropractic care throughout the entire pregnancy, weekly acupuncture treatments, prenatal Pilates classes, and Spinning Babies exercises at home the last trimester. Mentally and emotionally I prepared by attending a HypnoBirth class series with my husband, reading Ina May, a Mother’s Blessing, choosing the right birth team for us (midwife, midwife assistant, doula(s), photographer), and being at rest in all the decisions I made during pregnancy so when labor began I didn’t have to think or worry and I could just be in the moment.   Josiah H.

Reading Ina May’s Guide to Chilbirth and learning about the farm made me feel so confident in my choice to birth at home.   Julia W.

Taking a Birthing at Home class and just hearing about stories from other women who birthed at home helped me feel like I could do it.   Jessica W.

Personally, what I know helped me specifically: nutrition (hands down) and knowing I didn’t need to worry about my wishes/desires/preferences. The confidence of being respected during labor (for me) was 75% of it. It gave me the mental and emotional space to prepare for birth in other ways. The other was reviewing my relaxation, taking time for myself <3. Then, of course, having a team that I trusted to help me get the job done.   Brandy H.

Nutrition, prenatal yoga DVD, Hypnobirthing home curriculum, EPI-NO 😬, Webster technique chiropractic, having a team I 100% trusted, birth affirmations and scriptures, prayer and journaling my thoughts in order to process the emotional journey. And honestly, who knows if I really needed all of that, but it’s what helped me feel confident after two homebirth to hospital birth transfers.   Mindy H.

Not being afraid to ask questions, and being willing to seek help from as many professionals from all different arenas of health care (birth team, Perinatology, my pcp, naturopath, chiro, acupuncturist/herbalist/nutrition response testing team… a whole paparazzi of people). Whatever it took to get the birth we wanted! Even with all of that, sure, maybe something wouldn’t have worked out–
BUT, I knew I’d rather feel like I exhausted every avenue available to me in order to succeed in the face of a few stumbling blocks in my journey!!! And, it worked, and I even made some friends along the way! 💕   Alisha C.

Praying and trusting God! Trusting my body to do what He created it to do. Having a balanced diet for sure. I think just the fact that I KNEW I could and would do this made it better. I knew it was going to be a testament to those who were against it as well. Plus having an amazing hubby and birth team! ❤   Deanna S.

I watched a ton of videos of animals giving birth and it truly helped. (Do you know how hard it is to find a video of a gorilla giving birth?)  Kathleen S.

With my first reading Natural Childbirth: The Bradley Way. Doing the exercises every night was extremely beneficial, practicing relaxation was key. Lots of reading and self education.
With all of them eating a healthy diet (it was best with 2nd, and that was the easiest labor/birth) taking the recommended vitamins, having supportive husband and family members, having great midwives at each birth and caring for me throughout my pregnancies! Shelby P.

Reading, journaling, constant fear release and protecting my gestation bubble, choosing the right team, being brutally honest with myself abput the what ifs and contingency plans, gathering friends to celebrate with me, Hypnobirth classes and mediation tracks, copious amounts of prayer and self-revelation, counseling, meticulous logistical planning, chiropractic care, acupuncture, massage, Spinning babies, nutrition (when I could get anything down) and supplements, replacing every negative/fearful/self defeating thought with like 3 birth affirmations, having my entire friend base (in OKC) work in the birth field, gardening (lots of hands and knees while pulling weeds), really long showers/baths. Lots of prep work but at the end of the day…I can’t explain it…I already knew how it was supposed to go. There were days when I doubted what I had been told about my story and my baby but most days, I knew. I knew her despite never having an ultrasound. I knew her name. I knew her purpose in my life. Her birth story was written before my eyes years before she arrived in so many tiny but significant ways and on the days I had nothing left to fall into, on the days I struggled with the weight of HBAC and the trauma of my first birth and the complications of family life and the waiting and waiting and waiting and insomnia and WAITING on her arrival, the KNOWING is what I clung to…sometimes desperately so.   Brittany F.

My husband and I taking a child birth class(just for my first pregnancy), food preparation for easy meals after birth and also making sure I had snacks on hand for labor, learning to completely relax and breathe, hiring an amazing midwife and assistant, chiropractor visits, and walking a lot. Kaci C.

I read Natural Childbirth the Bradley Way with my husband before my first, which helped both of us practice mindful relaxation and really empowered him to feel calm and prepared instead of freaked out when the time came, which allowed me to stay peaceful. I also read a bunch of other natural birth stuff and watched home birth videos on YouTube and just generally built up my confidence and trust in my body.

Also finding great midwives who I trusted completely. Both you and my first midwife provided great information on pregnancy and especially good nutrition, which I think helped a bunch. ❤ Julia P

Photos used with permission from moms and photographers

W. Yvonne Silbernagel, CPM,

Dawn Karlin, CPM,

Homebirth vs Hospital Cost….A few things to consider

Yvonne Silbernagel, CPM and Dawn Karlin, CPM

Many people in Oklahoma pay their insurance premiums every month reassured that if anything happens, they will be able to get what they need. Most have been reassured that birth and their care will be covered because of changes in healthcare a few years ago. Many want to have a homebirth, but find it isn’t covered or it is out of network coverage, and are torn about what they should do.
It is often surprising to people when they get their bill, just how much more it is between the OB, the anesthesiologist, pediatrician, medication, and their hospital stay. We took a survey among other moms and found out of pocket costs with insurance was ranging from zero to  $10,000. Unless they had Federal insurance, soonercare or tricare, many were surprised how much their out of pocket costs were. Those out of pocket costs averaged $2,000-6,000, with insurance.

So why pay a Midwife out of pocket $2,400-3,000? What is so different about the care?

  • One hour visits
  • Personalized care
  • Very little wait time in the waiting room
  • True Informed Consent and Refusal
  • Costs are up front from the start
  • Picking your birth team
  • Being in the comfort of your home
  • 24/7 – being able to call or text the midwife with any urgent questions or concerns, no answering services or nurse to go through first.
  • Honoring your birth plan
  • Not being a number….you are a client not a patient
  • Less intervention
  • Lower cesarean rate
  • VBAC availability
  • Automatically have skin to skin and delayed cord clamping

Why do moms say they chose homebirth?

– “Paying for a homebirth out of pocket wouldn’t be much more expensive – if at all – than paying our share of a hospital birth.  And I feel my risk for c/section would be higher at a hospital – thus skyrocketing our expenses, not to mention the recovery.  I loved the beautiful simplicity and calm of my homebirth.  And feeling more in control.  I knew everyone in the room well, I chose them.  No strangers, no rushing around doing things without notifying me or explaining – I was consulted and had a voice.  I was free to move about, not strapped to a bed.  I could eat, use the bathroom…I felt human!  Laboring and giving birth in the water – huge natural pain relief!  The water is my zone.  My older kids can be a part – they’re in their zone as well.  And when the baby arrives, it’s just calm.  We’re already home.  In our bed.  In our clothes.  I don’t know anyone who loves hospitals – even if you like the peace of mind of a 24-hour trained medical staff, the space itself is just not a comfortable place, incomparable to your own home.  (And aside from the actual birth, nine months of midwifery care is so much more relaxed and family-friendly than traditional dr visits.  No long waits, no germy clinics, having someone who gives me a solid hour of attention and knows me personally.  No wondering if who I’m seeing will be who actually attends my birth.  Involving my kids in the process.  Involving ME in the process!  Direct calling and texting available at all times of day.  It really feels like someone taking care of you rather than managing your care.)”- Jamie Fraser

– “1. Personal whole woman care

2. Not having to leave the comfort of your home during labor

3. Not having to worry about someone doing something to your baby that you didn’t want
-baths, vaccines, cord cutting, X-rays, sugar water, formula, etc.

4. Not having your baby taken away from you. That first hour to yourself!

5. Peace of mind

6. Instant family time and bonding with siblings and daddy

7. No hospital germs

8. No unwanted visitors

9. No unwanted interventions” – Candace Ousley

– “To put it as simply as possible I would say it’s worth the extra money to have the whole homebirth experience(prenatal care, comfort of home, much more personal and you have a relationship with your midwife, no pushing of interventions from doctors… just to name a few things).” – Kaci Cody

– “For me, I would be paying for a birth either way, so I wanted my births to be family-centered with no restrictions on me or my progression. I loved having water births. That was actually huge for me. The ability to immediately sleep in my own bed and be attended to by birth team was priceless. The personal care that I received in pregnancy and postpartum were worth their weight in gold.” – Deanna Norris

– “Control!  Short and sweet homebirth gave me control. And even though I never achieved homebirth the process empowered me and you can’t put a price on that!!”- Shyla Dwyer

– “People have asked me that and I just say because baby and I deserve the sort of care that comes with choosing the midwifery model of care and doula support.
What’s most important to me is pre/post natal care, laboring alongside people with whom I have a heart connection, and being able to actually rest afterwards in the comfort of my own bed with my own food and things and no timeline of when I need to put my sore vagina into a car and drive back to said home or people waking me up to draw labs and bring me lackluster food. The average American wedding costs 30k and sure, we didn’t even pay a third of that for ours but still more than each of these home birth experiences. Maybe there will be a season where we just couldn’t make it work, there’s no judgement there from me, but it will always be something we will prioritize because my babies and I deserve it. Ultimate self care 🙌🏽” – Erika Cerda

– “Because I wanted a waterbirth! I called every hospital in oklahoma to see if they would let me have a waterbirth and the response was a resounding no. I was healthy, low risk and there was no reason why I shouldn’t be able to have my baby my way.”- Megan Jennings

– “choosing who was going to be there (not random nurses or whoever was on call). The people who would be there were people who loved me and respected my family!”- Tavia Redburn

“I wanted to feel “at home”. To be in my own clothes and my own bed, making my own decisions. After our baby was born, and we were snuggled together in our big bed, my husband cracked open a beer and said, “We are never going back to the hospital. This is perfect.””-Cierra Jennings

“Even though we wound up needing medical intervention in the end (boooo pre-eclampsia) there’s nothing like midwifery care! Personal, client centered visits, so much good information and the ability to make informed decisions. It was worth every penny! Even if I had a hospital birth in the future I would have to do co-care because there’s nothing like good midwifery care!!!” Anissa Cornelius

“I switched to home birth late in my pregnancy after watching “the business of being born” and “breath.” I thought to my self I can do this…I felt empowered! How great will it be to welcome Fin earth-side in the peaceful comfort of our home I thought, and to truly have the uninterrupted bonding time I wanted for my first birth.”- Lillie Khorsand-nia

“I wanted to hold my baby! I didn’t want her rubbed, suctioned, gooped, and prodded if it wasn’t necessary.”- Kelli Walter
“I chose home birth because I was ready to finally trust my body to do the amazing thing it was made for.”- Dacia Pennington
“I wanted to give birth in a comfortable, intimate setting and to make my own decisions for how my baby was born. We wanted our birth to progress naturally rather than be rushed by medical personnel.” -Veronica Krause

“We chose a home birth because we wanted to give our son a peaceful and calm entrance into the world. After having a hospital birth with my daughter, I also knew I wanted to be surrounded by a strength-giving tribe, not by complete strangers. I completely trusted my midwives to do what was best for our family, not what was best for their schedule. Through our time together, they got to know me, and gave me an anxiety & fear-free birth.❤️”- Maryann Maimo

“I chose home birth because after two fine hospital births and one pretty great hospital birth, I finally decided it was time to make my DREAM a reality. I had to work harder than I imagined and there were times I was sure in the end it wasn’t going to work out, but every effort was worth it. Literally not a day passes that I don’t reflect on our homebirth and smile. ❤️” – Alisha Cary

“I chose to give birth out of the hospital because many of the standard practices and policies at hospital don’t give you the best chance at having a VBAC. I wanted to give my body and baby the best chance I could at having a VBAC so I chose to hire an amazing midwife and gave birth at a birthing center.”- Cacey Malone

“I was fortunate to know many other moms who had had home births so I knew it was an option. Not every state allows the freedom to choose. Once we explored the idea by interviewing midwives, we felt safe with it being a good fit for our family. It felt good knowing we could avoid certain risks that come from just being in a hospital. I had a strong desire to birth in my own time and not be rushed or feel that I may need to defend my choices if hospital staff didn’t agree. The idea of not knowing who you may be working with in a rotation of nurses and doctors compared to having one midwife and assistant and maybe a doula who you have built a relationship with and have discussed birth plans with and who you have chosen because you feel they respect your wishes makes for an easy decision.”- Keri Kelley

“I chose a homebirth because I wanted a birth team who love me on top of being wise, experienced, smart, and intuitive. I wanted to give birth in the comfort of my home, where we were amongst the microbes our bodies are used to. I wanted care providers who wouldn’t pressure me into decisions I didn’t want to make; who would see me as an intelligent woman who’s done research and decided what’s best for herself and her baby. I wanted people to care for us who wholeheartedly believed in me to have the birth of my dreams and would never suggest intervention unless it was very necessary. I wanted to eat, walk around, and be minimally monitored. I wanted to be understood, seen, and known. I wanted a team that valued the experience just as much as the healthy baby. I wanted people who understand the heart, soul, and mind are connected to the experience of the body. And that’s just some of my reasons for choosing homebirth. 🙂” – Mindi Hamell

“I chose homebirth because I wanted to feel the comfort and love and care throughout my labor instead of someone coming into the room when it was time to deliver. I wanted to know exactly who was going to be there during my birth and not wonder who would be on call and be introduced to someone at my most vulnerable time. I wanted someone that would watch me and my body and know that when I was in my weakest state would encourage me and remind me of my strength instead of reminding me that I have options to get out of this. Ones that told me it was ok to cry and ok to not be ok for a minute. I wanted a team around me that were safe-keepers of my space. Ones that I could look up and see eye to eye and know they were 100% behind me, praying for me and one look in their eye and I could see and feel the strength and love they were giving me. I wanted to hold my baby as long as I wanted to and not feel rushed to do anything other than hold him/her and just be. And I wanted that proud look after baby comes out. That look of you did it, and you did it beautifully, and I’m so proud of your hard work. That look, That look! you get from your homebirth team who has stood with you for hours and felt the pain and exhaustion along with you. I wanted different, and ones that were ok with whatever that different looked like.”- Morgan Phillips

As mentioned above some choose homebirth for the lower cesarean rate and the ability to VBAC. So, how do area Midwives compare to hospitals in their cesarean and VBAC Rates? 

Out of hospital birth CPM/Senior Midwife/CNM in Oklahoma- the last 5 years

Total births -2013
C-section rate- 6.4%
VBAC rate – 87%

Picture by Megan Markeyl

The World Health Organization says a cesarean rate should be between 10-15%.
It is truly hard to find a comparison for Homebirth vs Hospital data on Cesarean and VBAC rates, because homebirth clients are screened to be low risk and these hospital numbers do reflect women who did want a repeat cesarean.

2013 Cesarean Rates and VBAC Rates

  1. OU hospital 28.5%. / VBAC rate >15
  2. St Anthony 25.4% / VBAC rate 5-9%
  3. Integris Baptist 33%. / VBAC rate too few to count
  4. Lakeside 35.6% / VBAC rate too few to count
  5. Mercy 37.5% ( The unicorn is bringing change )

Excludes deliveries with complications (abnormal presentation, preterm delivery, fetal death, multiple gestation diagnosis, or breech procedure).

Ok, we are convinced! Now, how do people pay for for their homebirths? What do moms say?

  • tax return
  • husband did pizza delivery
  • art sales
  • garage sales (everyone pitched in)  or B/S/T pages
  • side work
  • sale of a car
  • handmade items
  • budget cuts
  • took photos
  • HSA – Health Savings Plan
  • payment plan

W. Yvonne Silbernagel, CPM,

Dawn Karlin, CPM,

The Bliss of a Mother’s Love- by Yvonne Silbernagel, CPM and Dawn Karlin, CPM

Something new

This is a little collaboration between A Mother’s Love Midwifery and Bliss Birth Services….The Bliss of a Mother’s Love (yes we got a bit cute) blog is our way of promoting midwifery in Oklahoma. Stayed tuned

W. Yvonne Silbernagel, CPM,

Dawn Karlin, CPM,

%d bloggers like this: