To qualify for out-of-hospital birth coverage under OHP, the following criteria must be met:

• Enrollment in OHP: You must have active Oregon Health Plan coverage. If you’re not yet enrolled, we can help guide you through the process. 

• Low-Risk Pregnancy: OHP permits out-of-hospital births for pregnancies that meet the following conditions:

  • A single baby (no multiples).

  • Baby positioned head-down at the time of labor.

  • No significant medical conditions that could complicate labor or birth.

• Prior Authorization Approval: A Prior Authorization (PA) is required for OHP to approve out-of-hospital birth services. This process includes:

  • A review of your medical history.

  • Ongoing risk assessment conducted by your midwives.

  • Submission of necessary documentation to OHP.

• Ongoing Risk Monitoring: Your midwives will continue to monitor your pregnancy to ensure it remains low-risk. Should complications arise, a transfer to hospital-based care may be necessary. These measures ensure your care remains safe and meets OHP’s requirements for community birth.

• Compliance with OHP Guidelines: To qualify for home birth coverage under OHP, your care plan must meet specific requirements outlined in their community birth guidelines. This includes providing evidence of the following:

  • Gestational Diabetes Screening: Completion of a gestational diabetes screening using a 1-hour or 2-3 hour OGTT is required. Other methods, such as Hemoglobin A1c or home glucose monitoring, do not meet this requirement.

  • Anatomy Scan Ultrasound: A second-trimester anatomy scan is required to assess for placental, uterine, or fetal anomalies.

  • Routine Prenatal Assessments: Documentation of weight checks, fundal height, blood pressure, fetal heart rate, and urine glucose/protein must be recorded at each prenatal visit and included in a comprehensive flowchart format.

  • STI Screening: Original laboratory results for syphilis, HIV, and hepatitis B are required. Patients who decline these screenings do not meet OHP’s criteria for community birth.

If you have any questions or concerns about meeting these requirements, please reach out to us for clarification. We’re here to guide you through every step of the process.

If your pregnancy doesn’t meet OHP’s criteria for community birth, you may still be eligible for OHP-covered prenatal and postpartum care as well as doula care. We can help coordinate hospital-based care while continuing to provide support as part of your team.

In some cases, OHP may deny your PA request for an out-of-hospital birth, but it may still be safe to plan a community birth paid out of pocket. If this applies to you, let’s talk about your options and how we can best support your family.

Our team will work closely with you to explore all options and ensure you feel supported, no matter the path forward.

Yes! We accept transfers into care up to 36 weeks of pregnancy, provided you meet eligibility criteria.

1. Book a Consultation:
   Schedule a meeting with our team to discuss your options and learn about our midwifery services.

2. Submit Prior Authorization:
   We’ll handle the paperwork and submit your PA request to OHP.

3. Approval Process:
   Once approved, we’ll develop a personalized care plan tailored to your needs.

4. Receive Comprehensive Care:
   Begin your journey with us, including prenatal visits, labor and birth support, and postpartum care.Book a Consultation:
   Schedule a meeting with our team to discuss your options and learn about our midwifery services.

5. Submit Prior Authorization:
   We’ll handle the paperwork and submit your PA request to OHP.

6. Approval Process:
   Once approved, we’ll develop a personalized care plan tailored to your needs.

7. Receive Comprehensive Care:
   Begin your journey with us, including prenatal visits, labor and birth support, and postpartum care.