Sections:
     •Why "Open Arms"?
​     •General Questions
     •Midwifery Questions
     •Massage Therapy Questions

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Question: Why "Open Arms"?
Answer: I thought for a long time about what I wanted to be known for and call my business. I knew I wanted people to feel welcome, seen, and cared for, no matter their background or beliefs. I love Jesus and I want to share my gifts of midwifery, massage, and teaching with my community. He has blessed me so that I can bless others. I'm not here to judge or criticize anyone. I'm here to serve. I'm here with Open Arms.

​"Whatever you do in word or deed, do everything in the name of the Lord Jesus, giving thanks through Him to God the Father." (Colossians 3:17)

I also just enjoy the parallels with open hands/arms in massage therapy, yoga, and birth. When you see me for massage, my hands provide the safe and healing touch of therapy. When you practice yoga, your open hands ground you on the mat (even if you fall over during that handstand!) When your baby is on their way, loving hands catch them and loving arms hold them. But ultimately, I'm constantly grateful that the Lord welcomes us back over and over, every time we fail, just like the loving parent He is. I am not perfect, but He is. He's always waiting with open arms!
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General Questions:

Q: How to I book a) an interview for midwifery care or b) a massage session?
A: Text/call Rebecka directly, at 540.693.0405. You can also email her at [email protected] if needed. Either way, please include your name and which type of appointment you're seeking. She'll respond as quickly as possible.

Q: What forms of payment do you accept?
A: All of them! Specifically:

• cash
• debit/credit
• FSH/HSA
• check
• Zelle
• Venmo
• CashApp
• PayPal

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Midwifery Questions:

Q: Is homebirth with a midwife safe?
A: Certified Professional Midwives (CPMs) are specifically trained in physiological, out-of-hospital (OOH) birth. We're the "experts of normal". In Virginia, we are both nationally certified (through the North American Registry of Midwives) and state licensed (through the Virginia Board of Medicine). We stay up to date with resuscitation trainings, including NRP (specific to newborns) and CPR (specific to adults). We are uniquely qualified to help you stay low-risk before, during, and after delivery. If there is any indication for concern, we can help you find a solution or refer you for further testing. At any point, if you become high-risk, we stay with you and safely transfer your care to a hospital setting. Rebecka has an excellent rate of about 7% transfer to hospital care and about 3% cesarean delivery. Approximately 93% of moms are able to stay low-risk and deliver at home!
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This mom is using a birth ball to get comfortable and help her baby move down more.

Q: What are the benefits of homebirth?
A: There are many benefits to homebirth, too many to list! Some of the main ones are:

1. ​Safety: low-risk moms have fewer complications and interventions at home under the care of a midwife. To read more about this, check out this study.
2. Comfort: you're in the familiar surroundings of your own home. Sights, sounds, smells, ambience--all of these contribute to avoiding unnecessary distractions, instead letting your body focus on relaxing and progressing in labor.
3. Privacy: you know the people in your birth space. Your partner, your midwife, her assistant, and perhaps a friend/family member. As truly wonderful as the staff in the hospital can be, they're usually still strangers, which can be a distraction and slow your progress.
4. Cleanliness: believe it or not, hospitals are pretty germy places! They do their best to sanitize, but there are still many more pathogens floating around the place than your own home. Bonus: any germs in your home are ones your baby has already been exposed to through you and the same ones they'd come right back to after a hospital birth.
5. Flexibility: your midwife's main goal is to provide you with information so you can make the best choices for your baby and yourself. She wants to help you reach your goals and is flexible when it comes to the things you care about, like movement in labor, water birth, who catches the baby (in fact, she'll probably try to talk you into it!), and pushing positions.
6. Evidence-based care: a midwife has a passion for listening to the body. Data shows that the more we let a low-risk mom's body perform the natural process of birth without intervening, the better the outcomes. There are many things that you don't have to advocate for with a midwife because they're already her evidence-based standard practice, like delayed cord clamping, eating and drinking in labor, and honoring your bodily autonomy.

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Q: Is midwifery care affordable? What does the fee include?
A: The price for a no-frills, straightforward vaginal delivery in local hospitals is around $14,000. That number jumps above $30,000 if you need interventions like a cesarean (surgical) delivery. That's not including the prenatal, postpartum, or newborn care with an obstetrician, which are a few thousand more. Insurance usually covers a lot of that, but you still have deductibles and copays to consider.

Rebecka's fee is $6,000. That includes:

• prenatal care
• 24/7 availability from Rebecka for emergencies, business hours availability for non-emergencies
• birth attendance
• postpartum care, both mental and physical aspects
• newborn care
• breastfeeding support
• in-house labs (like iron and blood sugar) for mom and baby
• birth classes
• other educational resources
• hiring a birth assistant
• one 60-minute prenatal massage, plus 15% off any additional massages you may want (see the ​Massage Therapy tab for details)

 It does not include:

• *send-off labs (basic ones for everyone, plus any extras if we're concerned about a specific complication)
• birth kit that you order from supply website (about $100, with option for nice-to-have extras like a footprint kit)
• optional birth pool rental ($100)
• *ultrasound(s)

*your Insurance will pay for these!

Rebecka is passionate about moms having access to high-quality maternity care, so she's happy to discuss payment options with you and come up with a plan that won't overwhelm your budget. She can also help you learn how your insurance company might work with your homebirth plan, typically via their gap exception option. Lastly, check out the "Affording a Homebirth" link (in the Resources section) for lots of ideas that can help with the cost.
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Q: What is the point of a water birth? Is it safe? Can I have one with Rebecka?
A: Water birth is an excellent option for labor, mainly to help manage the intensity of contractions. The main ways that being in water helps you are:

1. Moist heat: the not-too-hot water penetrates deeply into your tissues, helping them to relax. This means that you can more easily work with your body instead of fighting against yourself, wasting energy and increasing pain.
2. Buoyancy: since your body is mostly comprised of water, when you're sitting in the birth pool, your belly feels lighter because you're partially floating. But since the water is also pressing in on you, your body perceives it kind of like a big hug, which communicates with your nervous system to relax further.
3. Relaxation: we're hard-wired to relax in water (unless we've been through some sort of trauma involving water, in which case you can always choose a "dry land" birth!) We were all in our mother's womb for the first nine months of our life, so we associate it with safety and comfort-- like taking a bubble bath at the end of a stressful day.

Some people say that water births aren't safe*, which isn't true if you follow very basic guidelines. There is a misconception that babies need to breathe air as soon as they're outside the womb. Most babies actually take a minute to make the transition, whether born in the birth pool or not; water birth does not impact this. As mentioned in #3 above, we are in a bubble of amniotic fluid while growing inside mom, so it doesn't hurt to be in water for the first few seconds after birth. The basic guidelines to follow are measures like having a clean birth pool, waiting to fill it with clean water until shortly before you need it, and keeping the water at about body temperature. Fetal heart tones can still be monitored while in the pool, so you don't have to sacrifice safety or comfort if you choose a water birth!

Rebecka sees about 75% of her mamas choose water birth and she highly recommends them.

*If you or your baby have any high-risk factors that would mean you need to deliver in the hospital, water birth may not be a safe option. Discuss this with your care provider.
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This mom and dad just worked together to have a lovely waterbirth.

Q: What area in Virginia does Rebecka serve?
A: Fredericksburg and the surrounding area, up to 75 minutes of driving time outside of city limits. Surrounding Virginia cities in this radius include Ashburn, Callao, Culpeper, Goochland, Richmond, Tappahannock, Warrenton, Washington, and Woodbridge. If you live a few minutes past the radius, exceptions may be made based on how busy Rebecka will be around the time your baby is due. Just ask!

Q: Does my home need to be a certain size to have a homebirth? How do I need to prepare my home? "And what about the mess?!"
A: Any size home will work! Tiny house to mansion, we can create a lovely birthing space together. You don't need to do anything complicated to prepare your home for the birth-- just have it clean-ish and gather a few things that you think will help you feel cozy. Your favorite robe, slippers, and soft music, for example. You order a kit that Rebecka specifically designed for your homebirth needs, which has all the disposable items in it, and then she carries all the monitoring equipment and "just in case gear" (like for resuscitation or stitches) with her. Now the most common question: "What about the mess afterward?" A lot of people think that your home will look like a gory mess when you deliver there (thanks for nothin', TV dramas!) Good news: this is just plain wrong! In fact, you'd never know a baby had been born there by the time we pack up and leave.
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Parents showing big sister who the new addition is, just a few minutes after birth.

Q: Can I have my older kids at my homebirth? Or family/friends?
A: Yes. You know your kids better than anybody and it's your birth, so the decision is yours! Some kids' temperament isn't as conducive to hanging out with you during labor, so they can end up being a distraction to you. A lot of the time, it seems to be the best of both worlds to have someone at your birth who is a dedicated "older kid watcher" to entertain siblings outside or in their own room, then have them rejoin you when the baby is about to be born or right after. This is especially wise in case they start to get scared when they notice you sounding and looking differently than they're used to, as you experience contractions. We want them to see birth as a challenging but amazing process, not a scary thing their mom suffered through. Depending on the individual child, they may even want to catch their newest sibling! But most of the time, babies come in the middle of the night and older kids sleep right through it.

As for other adults, it's still your birth and your choice! Rebecka will discuss with you how to make the decision about who you want at your birth. Anyone there should be there 100% for you, not for their own curiosity. Just like sex or having a bowel movement (stay with me here!), birth is a very private body function and needs the right environment to allow you to relax and get the job done. So that means anyone at your birth needs to be there in a support capacity.

Q: What's the difference between a midwife and a doula?
A: A midwife is a healthcare provider who is the primary caregiver for your baby and you. She is licensed and follows professional protocols to give thorough and thoughtful care to you both. She sees you for regular checkups throughout pregnancy, with visits getting closer as you go along. In these visits, she does things like take your health history, draw blood for labs, take your blood pressure, check your urine, listen to and measure the baby, teach you about healthy habits and exercises, answer your questions, and just get to know you. Then she attends your birth, doing everything she can to follow your unique wishes, helps you begin your breastfeeding journey, and examines your sweet baby. She continues to check on you and baby until about six weeks after delivery.

​A doula is a support person during your birth and/or postpartum period. Much of the time, doulas help moms who are having hospital births and make a seriously huge difference in not only your experience, but your safety. Statistics show the massive impact doulas have on hospital births, like fewer interventions and healthier moms and babies. Doulas may provide educational resources, physically support you in labor with comfort measures, help you understand hospital protocols, help you advocate for your baby and yourself, support you in breastfeeding, and assist during postpartum recovery. They're usually moms themselves and know just how you feel. Doulas are attending more homebirths in recent years and are a lovely part of the birth team.
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Both midwives and doulas want you to have the birth of your dreams!
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Q: I have a low pain tolerance. Could I manage without pain medications? What can I use/do instead?
A: Yes, you can! Your body was designed for this, with a million little things working in beautiful symphony to grow, birth, and nourish your baby. Modern life has fooled us into thinking we need to try to control the process of birth. But you're no less capable than those throughout human history to work with your body and deliver your baby. Rebecka likes to tell people, "We don't have magically strong women who are uniquely able to handle the intensity of labor and choose homebirth. We just have women who are determined and intentionally prepare themselves. They set themselves up for success with time-tested breathing exercises and healthy habits like yoga and good nutrition." You don't have control over everything, but you do have control over a bunch of things that can really steer your pregnancy in the best direction for a smooth birth. Your endocrine (hormonal) and nervous systems work in concert to release powerful pain-reducing chemicals, called endorphins, when you have a contraction. This is your body's way of responding to the intensity. Then you can further influence how you feel by using breathing and relaxation techniques.

This is because of Gate Theory, which explains the super cool fact that your brain can only process so much information at once, so if you flood your senses with non-painful stimuli then your brain won't get flooded with pain signals. That's why things like

• breathing deeply and slowly,
• being in water,
• squeezing a spiky ball against your palm (Rebecka keeps some in her gear bag for you to borrow!),
• moving your body,
• having someone massage your back or squeeze your hips,
• and holding a low-pitched hum that reverberates in your chest

​actually mask the intensity of the contractions. It all adds up to make a real difference!
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Dad giving a "hip squeeze" to mom in labor to help ease the intensity of a contraction.

Q: What exactly is the Bradley method for childbirth?
A: This is a natural approach that utilizes relaxation techniques which work with your nervous system to decrease the intensity you feel from contractions AND help you make progress toward delivery. People use the term "natural childbirth" with vastly different definitions. Some people say it to mean vaginal delivery (as opposed to surgical). Others say it to mean no use of an epidural (whether or not you use other pain medications). When we talk about natural birth as homebirth midwives, we generally mean that we-- you and your midwife as a team-- support your body's ability to perform its natural body function of delivering your own child, by providing support and resources to set you up for success. Your body conceives and grows your baby; it knows what to do next, too! Just as sex, conception, and pregnancy are natural processes, birth and breastfeeding are, too. They take determination and effort, but you can do it! The Bradley method of childbirth integrates breathing and relaxation techniques to support these processes. Stress is the enemy of a smooth, safe birth. Working with your body by practicing natural techniques helps you secrete the hormones that drive labor and manage pain: oxytocin, serotonin, melatonin, and endorphins. This also keeps adrenaline levels down, further decreasing your pain in labor.
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Q: Who are Rebecka's childbirth classes for?
A: Everyone! Whether you're hiring Rebecka for your homebirth OR you intend to deliver at the hospital, these classes are perfect for you! Even if you plan to have medications or a cesarean delivery, you will still learn so much. And they're not just for first-time parents. Rebecka recommends them for first-timers (home or hospital) AND for first-time homebirthers. But some parents enjoy jumping in for a refresher round of classes during each of their pregnancies!
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Q: When is the next childbirth class series?
A: Rebecka teaches her series several times a year, depending on demand. She prefers a small group size of just a few couples, so that you can ask questions and have a personalized experience. So whenever she has a group of couples who are ready to start learning, she picks a start date that works for everyone!

If you're interested, please text/call Rebecka!
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One lovely couple in class with Rebecka, practicing an excellent position for the pushing phase.

​Q: How much do childbirth classes cost?
A: They are included in the fee for midwifery care, when hiring Rebecka for your birth. Otherwise, they are $500* for the full series.

​*Full or partial scholarships are available, based on individual need. Please contact Rebecka if you'd like to receive one.
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Massage Therapy Questions:

Q: What's the difference between medical/orthopedic massage and therapeutic massage?
A: Medical massage is a fairly new term, being talked about more and more, with a lot of unnecessary confusion. First, let me explain the difference between orthopedic and medical. It comes down to who's recommending and paying for it. Orthopedic massage is goal-oriented, where we're focusing on a specific medical condition and carefully monitoring progress, and it doesn't require a physician referral. All medical massage means is that we're doing orthopedic that has been prescribed by a doctor and thus is being paid for by your health insurance. Now, back to the main question. The difference between orthopedic and therapeutic is that the latter is for less critical, more chronic issues. Therapeutic massage is great for things like headaches/migraines, sore/weak/tight muscles, poor circulation, insomnia, poor range of motion, mental health issues like anxiety/depression/PTSD, arthritis, etc. Orthopedic massage is more for acute conditions, like injured muscles/tendons, rehab after surgery (even if it was 20 years ago), restrictions in fascia or scar tissue, carpal tunnel syndrome (a.k.a. wrist pain), TMJ dysfunction (a.k.a. jaw pain), tendonitis, infertility, etc. Also, in orthopedic we use a slightly more systematic approach, starting with a full evaluation and monitoring/charting progress throughout the course of treatment. If you have any questions about which kind of session you need, just ask Rebecka!

 Q: What should I expect at my massage therapy session?
A: Rebecka will need you to fill out an intake form before your first visit, which asks about your health history and preferences. When you're done with that, she will show you where the restroom is because it's always a good idea to empty your bladder before you'll be on the massage table for a while. Next, she will show you the massage room. She'll point out where you should place your belongings so you don't lose them and so she can easily move around the table during your session. She'll explain exactly how to situate yourself on the table to begin the session, depending on which type of massage you've chosen. She'll do an evaluation of your range of motion, if needed, so that she knows which areas need more time during the session. She'll ask if you have any questions, then she'll give you a few minutes of privacy while you get onto the table and under the sheet. Then she'll knock on the door and ask if you're ready for her to enter the room and begin the session. Finally, she'll remind you that this is your session and that you can always speak up if you need less pressure (although she always carefully eases into more pressure in order to help your muscles acclimate comfortably) or if you have any concerns.
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Q: What should I wear to my massage therapy appointment?
A: For most types of sessions, you will be undressed but covered by the sheet on the table. (The exception is the CranioSacral session, where you remain fully clothed.) After working your head and shoulders, she uncovers your arm, leg, or back to massage it, then recovers it and moves on to the next area. It is perfectly fine if you feel more comfortable keeping on your underwear, but most people choose to remove it so that the hips can be reached for issues like sciatica. Don't worry-- Rebecka is extremely careful to keep you modest as she works.
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Q: Will the massage hurt?
A: Any experienced massage therapist will work with your muscles and your feedback, not fight them. First, we do lighter movements to warm up and prepare the tissues (muscle, fascia, tendons, ligaments). Next, we gradually work more and more deeply, and lighten back up if it's causing you actual pain or to tense up. That being said, sometimes after a massage, you're sore for a day or two, just like after a workout. While some people say, "No pain, no gain", Rebecka would perhaps say, "No intensity, no gain". Real pain is a sign that we're working your tissues too aggressively and breaking them down more than they're ready for, but intensity is fine (think "it hurts so good"). You get to be the judge of where that line is and when we need to back off. If you have chronic pain from any number of reasons, it's usually moderately intense during the first session. But Rebecka will always listen to your feedback.
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Q: How often should I get massage therapy?
A: That's up to you. Factors to think about are your therapy goals, typical level of demand on your body, and your budget. Most of Rebecka's clients have appointments every other week, but some schedule weekly, monthly, or randomly/as needed. Rebecka doesn't like "cookie cutter" recommendations because everyBODY is different, so your scheduling will be, too.

Q: Is a tip expected for a massage?
A: Not expected, but appreciated! Most people who tip think of it like when you eat at a restaurant with waitstaff, and want to show gratitude for the service rather than just the cost of the food. Typically, this is somewhere in the range of 15-25% of the non-discounted price for your massage session.
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Q: Do you offer massage therapy for men and non-pregnant women?
A: Yes! I'm a midwife, but I was a massage therapist first and I believe EVERYBODY benefits from therapeutic massage. I am happy to schedule sessions for anyone!
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Q: I'm in a wheelchair. Will I be able to get on the table easily?
A: Rebecka has an ADA-compliant hydraulic massage table that lowers to a height of 18 inches for wheelchair-friendly access. If you have any condition that means you need further help, please feel free to ask!