Frequently Asked Questions

How does it work?  

All families birthing at A Family Affair Birth Center will have their care provided by a Licensed Midwife and her midwifery team.They will oversee your prenatal care during the antepartum period, and continue with your postpartum care, usually in the comfort of your home. You will contract with your midwife and the birth center separately, but our administrative staff will be here to guide you along the way.

How do I pick a midwife?

We have Gerri Ryan, LM, CPM, Heather LeMaster, LM, CPM, and Andrea Bergeleen, LM, CPM, from the private practice of San Diego County Midwives, who serve as our primary midwifery team. They are well connected and well respected throughout the birthing community, garnering the praise of “San Diego’s Dream Team” by many of their clients, birth doulas and educators alike.

Additionally, AFABC has an Open Staff model, so if you have your own midwife, we would be more than happy to work with her to establish privileges so you can deliver here at the birth center.


Are Midwives licensed?

Yes, in California, all Licensed Midwives are licensed by the Medical Board of California. 

Do you take insurance?

We work with you to get maximum coverage by allowing you to sign up with an insurance biller that specializes in Birth Center births, helping to maximize coverage and minimize out of pocket expenses for you. (There is a nominal $250 fee)

Due to the vast array of insurance programs, we discuss insurance concerns with our families on a personal basis.

Can I see a Midwife for prenatal care, even if I want to deliver in a hospital?

Absolutely! And many women chose to do this. The Midwifery Model of Care is such that clients get personalized appointments, in a timeframe that allows plenty of time to get to know each other, ask questions, and to personalize a client’s care. Midwifery care is beneficial to women from preconception, throughout pregnancy and into the postpartum period.

Why does my Midwife call me a “Client?”

Midwives often call patients “clients” because they know you have a choice of who provides your care. And more importantly, being a patient implies an illness or condition that needs medicalized care. A normal, healthy pregnancy is not a condition that needs to be medically managed. 

Are there times for a “Medically-Managed Pregnancy?”

Absolutely. And there are definitely times for an OB to oversee your care or even a Perinatologist. There are times when a hospital birth may be the only option. But each case is individualized. Your private Midwife will discuss any of your concerns and will verify you are a candidate for a Birth Center birth.

I have a Midwife, so why did she recommend a Doula?

Your Midwife will be overseeing your entire pregnancy, labor, and delivery. You want her to be in her medical-state of mind. You want her objective, big-picture thinking, and fresh. You don’t her to be “doula-ing” you throughout labor, and exhausted when decisions have to be made. Ask any doula. Her job, while rewarding, is physical, emotional, and draining. One person should not be doing both. 

What are the benefits of having a Birth Doula?

As professional Doulas, they are here to support you and be your advocate. They have learned specialized techniques to help women cope with the challenges of labor.  They work within an evidence-based standard of practice that has been medically proven to help improve the birth experience, decreasing the need for interventions, including cesareans, providing increased maternal and couple satisfaction, and improved bonding with your baby. 

But I have a birth partner…

That’s fantastic! Doulas don’t replace birth partners. Doulas work with couples ensuring the birth partner can participate and share in the birth experience at a more comfortable level. We share techniques to allow your partner to be able to deliver effective comfort measures throughout your labor.  And the best part is that we find the birth partner often feels more confident and equipped, with less partner fatigue, than couples going it alone.  We provide support and TLC for them, too, because we know how important this experience is for both of you! And since a doula is with you until you deliver, you have the comfort of knowing you will never be alone when your birth partner needs to grab a bite to eat or catch a quick nap. 

However, your Doula and your entire birthing team, are very sensitive to your personal space as a couple, so during a quieter time in labor, we may step out for a few moments to allow you two to share some private time together as you await the arrival of your baby.

Will my Midwife (or Doctor) mind that I want to use a Doula?

Doulas have built great relationships with physicians and midwives in San Diego and are seen as an integral part of the birth team. We have the ability to provide continuity of care, without shift changes, unlike any other member of the birth team. We are regularly praised for our outstanding commitment to our laboring clients, not only for being by their side until they deliver (plus 1.5 – 2 hrs after birth), but also for the amount of time we spend in advance preparing our parents and teaching them how to work with their bodies in an efficient way. This makes the labor and deliveries easier on all, leading to a more satisfying birth experience for our clients and their midwives or physicians. 

What about my family and friends?

Many women choose to have family, friends or their other children attend their birth, and that’s great. It’s your birth…it’s your choice! 

What about the pain? Can I get an epidural?

The same as with home birth, when women feel safe and comfortable, in a nurturing, loving setting, with the warmth and support family or friends, and with a Midwife they have built a trusting relationship with, women rarely need pain relief. But we don’t believe in suffering. If a woman needs to transfer for an epidural, we support her choice all the way. However, only about 8-10% of women chose to do so.

They know what to expect, and have taking our special classes, “Removing the Fear of the Unknown,” the preparation, combined with the relaxation that this environment provides, allows women to take their labor one contraction, or surge, at a time. 

We also utilize Integrative Medicine options and complementary modalities, including aromatherapy, massage, hydrotherapy, acupressure and homeopathic remedies in labor. A woman may also ask her Acupuncturist to come for a visit while in labor.

No epidural? How does this work?

Knowing that the body is designed to respond to pleasure much more than pain, we utilize the varied senses to “run interference” for a woman in labor. Add that to the natural pain killers (endorphins) her body will produce in labor, it is completely do-able. And from the hands-on skills she learns in our class, she will already know this to be the case, not just have to take us at our word. She will have already experienced this first-hand, and that knowledge and confidence allow her to move forward toward calmly birthing her baby.

From sinking into our deep soaking tubs, enjoying in a nice massaging shower, or standing out doors on her own private terrace while relaxing on a birth ball or leaning on a birth swing, these combined with the emotional support that surrounds her, enables a woman to know “I can do this. I AM doing this!”

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