By signing below, you are acknowledging that you are informed of the benefits and risks associated with homebirth. In addition to the information I have provided, you have researched homebirth and midwifery from alternative sources as well. You are choosing the type of prenatal care and birth that is right for your family. You agree that the primary responsibility for your pregnancy, birth, and postpartum and newborn care is yours. You agree to communicate with your midwife/assistants by demanding informed consent and by clarifying any situations, procedures, or recommendations that you do not fully understand. You also agree to do your own research, so that you can make a truly informed decision. You acknowledge that you have received and thoroughly read this document that outlines my education, philosophy, care practices, privacy practices, financial agreement, transfer protocols, emergency care plan, and a copy of my statistics. You agree that should a complication requiring transport occur, as deemed necessary by your midwife or yourself, you will consent to transfer to a medical facility.
Your midwife will use her experience, training, and knowledge to prevent and treat complications to the best of her ability. You understand that a midwife, like any human, is not perfect. Midwives and practitioners of all types can and do make mistakes. Regardless of practitioner or place of birth, complications sometimes arise. No provider (including midwives) can guarantee any intended outcome. Homebirth is suited for low-risk pregnancy and birth. Low risk is not equivalent to ZERO risk. There are unforeseen complications (ie: cord prolapse, placental abruption, asymptomatic infection, etc.) that could be better handled in the hospital. You agree to hold Crystal Fink CPM, LM (and/or her apprentices/assistants) harmless for a negative or unintended outcome.