Today we’d like to introduce you to P Fadwah Halaby.
Hi Fadwah, it’s an honor to have you on the platform. Thanks for taking the time to share your story with us – to start maybe you can share some of your backstories with our readers.
Thank you VoyageMIA for providing this opportunity to share my story with your audience!
I am a nurse practitioner, certified nurse midwife with extensive experience in both home and hospital birth. Becoming a mother was a big part of my personal journey with birth, and I was fortunate to birth all 6 of my children in the comfort of my home. This enabled me to experience firsthand why women and families choose this option for a normal human function that some believe should only take place in the hospital – a place specifically for sick people. Birth is a rite of passage for the person giving birth and the one getting born. Birth is also sacred and deeply personal. Unfortunately, we have made the terminal mistake of discounting the relevance of those aspects of birth when it comes to providing birth services within the medical model. Our despicable rate of harm to mothers and babies compared to other countries is proof of this. The American medical system is not the ideal place for low-risk birthing. Many informed and aware consumers of birth services know this and demand better from their providers. They turn to out-of-hospital venues, like their homes or birth centers, and providers like me to facilitate a better birth experience.
During my childbearing years, I went to nursing school and trained as a licensed or lay midwife in rural Colorado. I was fortunate to work in various areas of nursing including end-of-life care, emergency room, and labor and delivery. I then completed my advanced nursing degree through Frontier School of Midwifery and Family Nursing Community Nurse-midwifery Education Program (CNEP) (now known as Frontier Nursing University). I relocated in Florida to work for a very busy OB/GYN doctor-owned practice for nearly 8 years, assisting slightly over 1600 vaginal births in the hospital in a practice with about a 40% cesarean rate. Eight years ago, I left them to open a home birth practice and have not looked back since. While we mostly provide a birth experience in the comfort and safety of home, we also have relationships with two local birth centers. We look forward to a time when we can freely transfer to the hospital if needed and continue providing personalized care and advocacy there.
Can you talk to us a bit about the challenges and lessons you’ve learned along the way? Looking back would you say it’s been easy or smooth in retrospect?
Midwife360 has struggled along the way… looking back, my first mistake was to join the insurance game. I spent hours trying to get into insurance networks as well as finding the right billing service to file claims and work on denials and appeals. This resulted in large sums of uncollected money and wasted time and energy in an effort to play the game! Whew! I recently decided to separate the practice from insurance reimbursement in an effort to focus our energies more on client care and less on business activities. As of spring 2023, we will be working under a new model of care. We are a niche practice providing concierge care that cannot be adequately reimbursed within the standard global maternity scenario required by insurance billing.
It was also a struggle to find like-minded midwives to join me as I grew the practice. There are pros and cons to working in a home birth vs hospital-based practice. Finding midwives willing to accept a lower salary compared with a hospital-based practice was not easy. On the plus side, home birth is more laid back, intimate, and personal. We develop a relationship with our clients and become a part of the family for a bit. These are the things that attract midwives to this paradigm of birth. We now have a wonderful team of midwives who have been instrumental in working to provide 24/7 coverage and midwifery expertise to our clientele. It would be nearly impossible for one midwife to provide care to the number of clients that seek our services. For example, since COVID the rates of out-of-hospital births in some areas have increased 20%; Midwife360 business has tripled since 2020.
Finding the right location for our practice was also a challenge. We moved from Boca Raton to Boynton Beach to West Palm Beach in the span of 6 years. We and our clients love the current location of our practice on Antique Row in West Palm, and we plan to be there indefinitely. Our range for home birth is 30 miles from the office so every move has impacted our practice by shifting our range for home visits.
Not having a solid transfer arrangement with any hospital has been an inconvenience but not a major obstacle. This is because there are laws in place and personnel on hand at every hospital that provide birth services for anyone who comes through the door without a doctor. In every scenario that has required a transfer, Midwife360 has been able to facilitate a positive experience by sharing the preferences of our clients with the nursing and physician staff. Hospitals have recently allowed us to accompany our clients when they transfer (this was not allowed during the COVID lockdown). This helps provide a better hospital experience for our clients.
We’ve been impressed with Midwife360, LLC, but for folks who might not be as familiar, what can you share with them about what you do and what sets you apart from others?
Midwife360 is a full-scope nurse practitioner-owned and operated Women’s health practice. We provide both GYN and Pregnancy related services with birth either at home or in a birth center. We currently take most insurance plans but will be no longer billing claims to insurance by April 30, 2023. We have 4 Certified Nurse Midwives who see clients in the office and provide home visits before and after birth at home. Our range is 30 miles from our West Palm Beach office, but with the option of the Birth Center, we can care for folks who live outside our range.
We are known for providing respectful, evidence-based care and have the privilege of helping many families have their 2nd, 3rd, and even 4th repeat birth experiences with us. Fadwah has extended experience with more complex birthing scenarios and has assisted many women to birth at home with high-order VBAC history, twins, and breech babies. This expertise coupled with trust in birth and women’s bodies allows for working with people who have unusual circumstances and preferences, including those with a desire to birth in an unconventional location or with a complex history. We would be happy to assist the more complex scenarios in the hospital, however, vaginal birth is often not a true option for folks with those scenarios.
Midwife360 brand is strongly client-centered. We have a firm foundation in evidence-based care – which is a combination of best evidence, provider experience, and client preference. Our clients value our culture of no waiting for client appointments, transparent billing practices, extensive education at every client visit, in-office phlebotomy, and billing of labs to insurance.
What are your plans for the future?
The biggest future shift will be dropping the insurance contracts. This has been the desire for several years, but it has seemed too complicated and scary in the past. I now accept it as a necessary step in order to remain a thriving business. It is difficult to describe the extent of time, money, and energy it takes to work the insurance system. It also contributes to the burnout of medical business owners. We are looking forward to a new paradigm of business without the constraints of the insurance system.
We are also discussing the possibility of merging with a birth center recently opened in the area. This carries the promise of hospital privileges. Our hope is to bring on more midwives, gain hospital privileges, and offer full 360-degree care for families who are building their families and opting for home birth, birthing center birth, or hospital birth.
Serving as the Chair of the Home and Birth Center Committee of the American College of Nurse-Midwives (ACNM) has given me the opportunity to recognize the universal need for smooth transfers for out-of-hospital birthing situations. I would like to establish a legacy of seamless service between home or birth center and hospital care that can be implemented in any locale. There has already been seminal efforts on the part of a large cohort of interested players, which were never implemented. I believe we should build on their efforts and continue to pursue seamless service as part of the overarching mission of Midwife360.
Pricing:
- Full Journey Home Birth $7000
- 60 min CNM Office Visit $150
- 60 min Home Visit $250
- 60 min Lactation Office Visit $100
- 60 min Lactation Visit Home $150
Contact Info:
- Website: midwife360.com
- Instagram: @midwife360.com
- Facebook: https://m.facebook.com/midwife360/
- Youtube: http://www.youtube.com/channel/UC8VH3jMPueE3ymr10tYmUQg
Image Credits
marybelize_birthphotography
Argon Agency Marketing team
