Home births rise in Madera as services disappear, increasing risks for moms and babies

Madera County resident Glory Warner was born at home in the 1990s. Now, she’s nearing her due date and wants to do the same with her baby.

Warner says that she romanticized the idea of a home birth from stories her family members shared. She has a midwife and doulas ready for the call but, in present-day Madera, it’s not so simple.

In the case of an emergency where Warner has to be transferred to a hospital, she could be left with nothing but hope, and too-long of a drive to the nearest hospital maternity ward.

In the case of childbirth, many Madera County residents must make the nearly 30-minute drive from Madera to a Fresno hospital to receive proper reproductive care.

From the time the Madera Community Hospital closed it doors in January 2023 and then reopened in March this year, there were 45 live births in the county, 42 of those home births.

2022 data from the California Health Care Foundation found that in California, 46,000 women aged 18-44 lived in counties without hospitals containing birth centers or obstetric care.

Lacy Lisbon, a licensed midwife with Fresno Birth Midwifery that serves expectant mothers throughout the region, said multiple counties in the Central Valley lack available maternity care.

“I feel like the Central Valley in general is a birth desert,” she says.

To receive treatment by a midwife, Lisbon says it typically costs around $5,000. But with the Madera County poverty rate at 26%, this can be a problem. And, she says insurance doesn’t want to cover their services.

Like Warner, Lisbon assumes that the number of unassisted home births in Madera is much higher than what one might expect, due to factors like finances and accessibility.

To qualify for a midwife-assisted home birth, a pregnancy must be deemed risk-free.

“That makes me think that a lot of the home births in Madera are then done kind of unofficially,” Warner says.

The increased risk for mothers and unborn children is particularly acute in Madera County, with no maternity ward or Planned Parenthood office nearby.

After reopening its doors in March 2025, the Madera Community Hospital is still without a maternity ward, and as a result of funding cuts from the “Big Beautiful Bill,” the only Mar Monte Planned Parenthood in Madera closed in August. The Madera County Department of Health also does not provide labor care, a representative there told The Bee..

The closest hospital to where Warner lives is Kaiser Permanente Fresno Medical Center in North Fresno, which is normally a 15-minute drive. But with the new housing developments in Madera, traffic has been even worse, adding as many as 15 minutes just to get out of Madera, Warner says.

“In an emergency situation, a 15-minute difference could be a big deal,” she said.

In her case, Warner’s midwife and doulas are traveling from Fresno and Oakhurst to get to her place.

Home birthing resources have been slim for some time in the county.

Warner’s long-time family friend, Jacque Moschella, was once one of the only practicing midwives in Madera County until she retired.

“She was like the only option for a home birth situation,” Warner says.

Warner says traveling to a hospital can be stressful, especially for first-time moms who aren’t sure what they’re walking into.

And, midwives are only trained for minor emergency situations. If anything major happens, the hospital could be the only chance at treatment.

Home births are not for everyone

Lisbon, the midwife, says that she typically arrives at a home birth when the mother is in active labor. Then, they do a physical assessment of the mom and baby, and if the pregnancy is still deemed low-risk, they proceed with the plan.

“The main benefit is that the anxiety level and the comfort level of the birthing person is maintained because they’re birthing in their own environment,” Lisbon says.

On the flip side, Lisbon says that a large downside of home birthing is that midwives are not capable of prescribing life-saving medication or epidurals.

“We also obviously don’t have the ability to provide, you know, C-sections,” she says.

If a mother requests or requires any of these options, she must be transferred to a hospital.

The midwife team monitors the mother carefully, Lisbon says, which usually allows them to allocate plenty of time to get to a hospital in the case of an emergency. She says it’s never ideal to rush to a hospital, especially from Madera to Fresno.

Warner says she’s not surprised that reproductive healthcare is essentially absent in Madera.

“There’s a huge discrepancy between male and female medical care and the understanding of male and female bodies,” she says. “I feel ashamed to live in a county that doesn’t serve women better.”

This story was originally published November 23, 2025 at 5:00 AM with the headline "Home births rise in Madera as services disappear, increasing risks for moms and babies."