Home birth in MD with CPM - How to get birth certificate

[sunsalutations]

I am planning a home birth in Maryland (Montgomery County) with a CPM and wondered about the process for getting a birth certificate. I found a couple of threads about this but none specifically about MoCo. Any advice out there?

[BirthWithFaith]

Unfortunately, until Maryland legalizes CPMs (stupid, I know!) then we have to file with the health dept to get our birth cert and not name our midwife but say we basically had an unassisted birth so that the CPM doesn't get "on the radar" of the nursing board who oddly enough oversees our midwives.

Otherwise, you need another type of practitioner that has the authority to sign birth certificates to do so for you like a doctor who is willing to vouge for your birth at home. It isn't likely you be able to find someone willing though.

If you file yourself, expect a visit by the Mont Co nurse who will come ask you questions in your home in order to verify you gave birth and your baby exists. Some have pleasant and not so pleasant experiences with this.

I wish you luck!

[lotusdebi]

I recommend nursing during the home visit. The nurse I dealt with seemed to dismiss any concerns she had over the child not being mine when he started nursing, and quickly moved on to the brief physical exam and finishing the paperwork.

[sunsalutations]

Thanks!

Thanks Lotus and Jeska! This is very helpful information.

[Awaken]

I had a very pleasant home visit with the home health nurse. Im sure that varies, though. I happened to have previously seen a CNM practice before switching to a CPM so had "proof" of prenatal care to show her. We named my husband as the birth attendant and left the mw out of the equation. After the home visit, it was quite a simple process.

[homewithtwinsmama]

I registered a home birth in Montgomery and have worked with many mothers who did. You do NOT need to lie and say you did an unassisted birth. You simply say, "I am declining to name my midwife because her credential is not licensed in the state". And move on. It really is no trouble. Now Howard County is much more hostile. I had to go to them at the healthy dept. and had to tell them that there was no way in hell they were doing an invasive vaginal exam on me to prove I had given birth and that I would bring a lawyer with me if necessary. I still never named my midwife, did not lie about what I did, but they were more ignorant about it. They can only mess with you if you let them. Confidently tell them about your birth and give all the basic info.

In the case of the Mont. Cty. nurse that came out she started trying to get into vaccinations and homeschooling and the like and I said, "respectfully, if that question is not on the birth certificate form, I am declining to answer it. Please contact my pediatrician if you have any concerns about my baby's well-being."

Don't worry, it will be fine. Just project confidence and certainty.

[homewithtwinsmama]

Originally Posted by lotusdebi

I recommend nursing during the home visit. The nurse I dealt with seemed to dismiss any concerns she had over the child not being mine when he started nursing, and quickly moved on to the brief physical exam and finishing the paperwork.

I just want to add that they have no legal authority to physically examine you. I got two homebirth certificates without doing so. One county tried to say I would have to have a vaginal exam and I said, "what day do I bring my lawyer with me to explain to you that you have no right to do so?" and it was never brought up again.

[lotusdebi]

Originally Posted by homewithtwinsmama

I just want to add that they have no legal authority to physically examine you. I got two homebirth certificates without doing so. One county tried to say I would have to have a vaginal exam and I said, "what day do I bring my lawyer with me to explain to you that you have no right to do so?" and it was never brought up again.

She didn't examine me - she just checked over my son. I think she was primarily verifying that he was male. I never would have consented to a vaginal exam by a stranger! Sorry I wasn't more clear.

[sattygirl99]

Originally Posted by JeskaMW2B

Unfortunately, until Maryland legalizes CPMs (stupid, I know!) then we have to file with the health dept to get our birth cert and not name our midwife but say we basically had an unassisted birth so that the CPM doesn't get "on the radar" of the nursing board who oddly enough oversees our midwives.

Otherwise, you need another type of practitioner that has the authority to sign birth certificates to do so for you like a doctor who is willing to vouge for your birth at home. It isn't likely you be able to find someone willing though.

If you file yourself, expect a visit by the Mont Co nurse who will come ask you questions in your home in order to verify you gave birth and your baby exists. Some have pleasant and not so pleasant experiences with this.

I wish you luck!

Does that mean my Pedi can sign the BC form? I've asked her and she said she thinks she can... She'll do a home visit within the first 48 hours (I think she'll come shortly after if it's possible)... She's supportive of my HB, I just don't know if she is authorized to sign the BC form...

[homewithtwinsmama]

Originally Posted by sattygirl99

Does that mean my Pedi can sign the BC form? I've asked her and she said she thinks she can... She'll do a home visit within the first 48 hours (I think she'll come shortly after if it's possible)... She's supportive of my HB, I just don't know if she is authorized to sign the BC form...

If your ped will do this, then yes it will work. Many peds will not so consider yourself blessed. This will make it easier.

[sattygirl99]

yay! I love our pedi and was really surprised when she said she was pretty sure she could sign the birth certificate form! That makes me happy as I was REALLY not thrilled about dealing with the county and a home visit and all.

[PlumBlossom]

Here is a link to the MD state vital records on what you need to register for a home birth certificate: http://dhmh.maryland.gov/vsa/SitePages/home-birth.aspx

I am in Howard County, planning on a home birth, and have been in touch with the local Health Officer (named Beth Amstad -- she is very friendly and helpful) the reqs for HoCo are the same, however in HoCo they don't do public health nurse visits, so you HAVE to find a physician to sign off on the "fact of live birth", which as I am finding out, finding a pediatrician willing to see a HB infant around here is a battle. 

Hope this helps!

[boobfairy]

FYI the board of nursing tends not to review certified professional midwives because they are not claiming to be nurses,the board of physicians tend to take those cases as they are deemed as "practicing medicine without a license".Maryland needs to look at other states to see how all midwives work together,for example the west coast seems more open .Just my 2 cents.

[IdentityCrisisMama]

When we got all the paper work from Baltimore City, I found it all a little confusing to be honest and I did feel a little underprepared having not really started the procedure until after my LO was born. What I remember was not having the required proof of pregnancy ("Fact of pregnancy" in the link above). Fortunately I did have a blood test early in my pregnancy (can't remember why? RH maybe?) but that ended up being good enough for the nurse BUT my MW was a little reluctant to provide that form because it had her name on it and with the legal climate in MD I can understand. I think we ended up blacking her name out. I suggest that you get some of these requirements clear with your local health nurse/department and your MW before the birth because it's just a PIA to work out after the fact. 

I *think* I recall that the baby was proof of a live birth.  

For the record, the health nurse who handled our paperwork in Baltimore City was really helpful both in making sure our paperwork was complete before filing and in her flexibility in her visit. I did get the impression (perhaps wrongly) that the nurse visit was just one form of proof of live birth and that it was just the most common way of getting things done -- not the way it had to be done and that the parent could compile the paperwork without the help of a nurse if they felt confident in the system and requirements. I didn't feel the nurse visit was an invasion so I was happy to go that route but I don't think it's required. 

Good luck! 

[IdentityCrisisMama]

Originally Posted by PlumBlossom 

I am in Howard County, planning on a home birth, and have been in touch with the local Health Officer (named Beth Amstad -- she is very friendly and helpful) the reqs for HoCo are the same, however in HoCo they don't do public health nurse visits, so you HAVE to find a physician to sign off on the "fact of live birth", which as I am finding out, finding a pediatrician willing to see a HB infant around here is a battle. 

Hope this helps!

Yes, this is the impression I got in Baltimore - that the home visit was just one way to prove the live birth. For us the trick was proof of pregnancy. How terrible that in Howard Co. one has trouble finding a pediatrician willing to see homebirth families. If you are allowed to see someone outside your county I can recommend a HB friendly pediatrician in Baltimore. 

[imnottelling]

If you have ultrasounds, that works too for proof of pregnancy.

I don't, but I can't remember what I showed, if anything -- I had been using a CNM who didn't deliver my baby so perhaps I had some records from that? I don't think so, though.

Take some digital pics of you while pregnant, dated, and perhaps that helps.

Prescriptions for prenatals? (I always buy OTC though).

I don't remember showing anything though...lab work from gestational diabetes -- a bill from that would be easy to keep a hold of.

So many ideas I'm coming up with, but I doubt there is official criteria of what they care about. It seemed to me it was quite arbitrary and at the mercy of who your visitor is. Mine was sweet, but I don't remember her name.

[IdentityCrisisMama]

From what I remember the nurse isn't the one granting your the BC though -- she is just the one verifying "live birth" (in many cases) and has been tasked with making sure all the paperwork is in order/acceptable. That's the impression I got from my nurse. I specifically remember her saying, "I just want to be sure that the paperwork you submit is acceptable because I'd hate for you to get declined."  That's when we decided to go back to the MW and request the only proof of pregnancy we had available to us (some really early paper work I think from testing for RH). It's worth looking into while still pregnant!