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Use the form on the right to contact Karen Ruby Brown directly! If you have a special case or prefer to speak over the phone, please don't hesitate to contact us by calling  (858) 707-5765

San Diego and Riverside Counties

(858) 707-5765

Aerie Midwifery provides full-scope, out-of-hospital midwifery care in the greater San Diego area. We offer a personable, competent, and commonsensical approach to your care before, during, and after your birth, as well as well-woman care throughout the lifespan.
You can expect clinical excellence meeting the highest, evidence-based standards, grounded in solid experience, and inclusive of the fully informed consent of women and their families.
Contact us today for more information, or to schedule a complimentary consultation!


Frequently Asked Questions

Who is involved?

Karen Ruby Brown CNM, MSN.

There will always be at least two people at your birth-- myself and an assistant. All of my assistants are birth professionals (midwives or nurses) and hold current certification in neonatal resuscitation.

What services do you specialize in?

Complete Prenatal Care
Birth Services (home or birth center)
Well-Woman Care

When is best to make a decision about home birthing?  

It is best to start care in early pregnancy. There is so much that goes on in the first trimester, and a lot to talk about. Prenatal visits, which can last up to an hour depending on your needs, are monthly until your 3rd trimester, then every 2 weeks and, in your last month, every week. By the time you go into labor we will know each other well, and have that foundation of trust so essential to optimal childbirth.

That said, many women decide upon home birth after starting care elsewhere, and I am happy to meet with you at any time during your pregnancy and to facilitate transfer of care.

Where will be see each other?

I will see you for visits at my office in Vista.
You will birth at home or at Babies in Bloom Birth Center.

How do we get started?

You make a complimentary appointment to meet with me. We decide together if home birth is right for you and if we are a good fit. Should you decide to work with me, I will see you regularly throughout your pregnancy. You will have complete access to your records online, through a secure HIPAA-compliant website.

You may call me, email me, or send a message here.

How much does it cost? 

I do not work directly with insurance companies, but am happy to provide clients with a Superbill during the postpartum period. Clients may elect to submit this Superbill to their insurances to seek reimbursement. CNM services are often reimbursable by insurance. 

Out-of hospital-birth costs but a fraction of birth in a hospital. Nevertheless, it is a significant out-of-pocket investment. If cost prohibits you from having an out-of-hospital birth, please talk to me. I do not want cost to be the one thing prohibiting your options.

What does "Aerie" mean? 

Aerie means eagle's nest.

What equipment do you bring to birth? 

  • Doppler to hear fetal heart tones.
  • Stethoscope and blood pressure cuff.
  • IV supplies.
  • Antibiotics for women who are GBS-positive.
  • Medications to stop excessive bleeding.
  • Oxygen and neonatal resuscitation equipment.
  • Newborn medications.
  • Suturing supplies and equipment, including lidocaine.
  • A baby scale.

In addition, clients are responsible for providing some low-cost items. A list and instructions will be made available during the course of prenatal care.

How do you address complications? 

It depends, of course, on the complication. It is important to note that there are ‘complications,’ and there are ‘emergencies.’ Most complications of home birth are not emergencies and, if recognized early in the process, can be corrected using a variety of at-home measures. Should these fail to work, we will together consider transfer to the hospital.

I am equipped to handle and the most common obstetrical complications and emergencies, such as hemorrhage, shoulder dystocia and neonatal resuscitation.

It is true that there are some extreme and acute emergencies that cannot be managed at home. Such emergencies are rare. Part of being an informed home birth consumer is accepting that very small––though not absent––risk.

How often are clients transferred to the hospital? 

From the largest contemporary prospective study of home births in the US and Canada, involving 5418 women, 12.1 percent of patients were transferred to a hospital intrapartally or postpartally. Five out of every six women transferred (83.4 percent) were transferred before delivery; half of these transfers were for failure to progress, pain relief or exhaustion. After delivery, 1.3 percent of mothers and 0.7 percent of newborns were transferred to a hospital, usually because of maternal hemorrhage (0.6 percent of births), retained placenta (0.5 percent of births), or newborn respiratory problems (0.6 percent of births).  (BMJ. Jun 18, 2005; 330(7505): 1416)
It is more common for mothers giving birth for the first time to require transfer.

What if you have two women in labor at once? 

Life being what it is, this may sometimes happen for any and all midwives, indeed for any birth attendant regardless of birth setting (it even happens in the hospital!). Fortunately, the San Diego has a robust and supportive. I have relationships with several other midwives whom I trust and respect to back me up on those rare occasions when I am at another birth, just as I am available to back them up in the same situation. Sustainable home and birth center birth practice depends on such community! 

Don't see the answer to your questions? Ask me!

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