“There came a time when the risk to remain tight in the bud was more painful than the risk it took to blossom.” -Anais Nin
During your childbearing year, my services to you include complete prenatal care, support during labor and birth, and comprehensive postpartum care for both mother and baby.
Thorough prenatal care is a cornerstone for a healthy pregnancy. In addition to the importance of monitoring the physiological aspects of the developing fetus and your changing body, it is a special time in which the emotional aspects of your experience can be explored, and we develop our connection so that I may personalize your care, particularly at the time of labor and birth.
We see each other for prenatal home visits once every four weeks until 28 weeks, then twice a month until the 36th week, and then weekly until your baby is born.
I schedule prenatal appointments to allow for at least an hour together, in order to include plenty of time for physical exams, such as palpation (to determine the position of your baby), listening to the fetal heart beat, blood pressure checks, urine analysis, weight checks, and diet review, as well as discussions about how things have been going. I answer any questions you may have, and provide education about your options, and all aspects of the childbearing year. Your care includes options for prenatal genetic testing and/ or ultrasounds, and I provide all essential lab work, such as blood-draws.
Care During Labor and Birth
Supplies: During your pregnancy I will show you how to order a birth kit, and what supplies you will need to assemble, in order to prepare for your home birth. I carry oxygen and resuscitative equipment, drugs to control hemorrhage, IV fluids, and antibiotics if necessary/desired for treatment of Group Beta Strep. I also provide injectable Vitamin K and Erythromycin Opthalmic ointment for the baby, if you choose those for your newborn’s care.
When you think you are in labor, we talk by phone to determine what is going on, and I come over when you are ready for me, set up my supplies, and begin the process of preparing for the arrival of your baby. I carefully, but quietly, monitor your vital signs, and your baby’s heart beat, to assess your health and safety during labor, birth, and immediate postpartum period. I minimize internal exams, and always involve you in decision making for any such exam or intervention. I encourage mothers to eat, drink, and remain ambulatory during labor, and make recommendations for position changes, resting, walking, etc. based on my assessment of the circumstance at the time.
At some point during your labor, when it seems that birth is imminent, I will call for my assistant. This “second set of hands” is another midwife who can help me to handle any unexpected challenges in which two people are needed, or simply provide me with support by charting, etc. so that I can give you and your baby my fullest attention.
Immediate Postpartum Care
Once your bundle of joy arrives, I stay for at least three hours to monitor vital signs, help in establishing breastfeeding, and do a complete newborn exam right next to you, on your bed. I give you and the baby “the bath of your life” in a healing herbal bath, make sure you get a meal, and then tuck you in for a nap.
Postpartum Care and Well-Baby Visits
In order to support your healing process, I return to your home for postpartum visits one day, three days, and one week after your birth. I see you at two weeks, four weeks, and six weeks as well. (Sometimes these later appointments are home visits, if travel to my office is a hardship.)
During these visits I help you file for your baby’s birth certificate and social security number, I provide the Newborn Metabolic Screen, and take foot-prints of the baby. At each visit I review your breastfeeding experience, provide tips and suggestions, and hands-on support. We weigh the baby, take vital signs on both of you, keep track of your healing progress, and your baby’s transition to extra-uterine life. If I see anything that appears to be of concern, or which falls outside of the range of “normal,” I make appropriate recommendations/ referrals.
In the event of the unexpected…
Sometimes during the course of labor, or immediately after birth, it becomes clear that home is no longer the safest place to be. There are emergent and non-emergent reasons to transport to the hospital, and it is always a decision that you will be involved in making. It could be that, for whatever reason, the baby’s heart-tones indicate distress, or the labor is not progressing, or something arises that causes concern, which is not easily resolved with the tools available to us at home. Usually, a transport can happen by private car, but occasionally (rarely) 911 must be called for an ambulance. In the case of a transport, my role shifts, as responsibility for your care is transferred to a medical professional, but I remain with you, and become your doula/ support person, in order for you to experience continuity of care. In the event of a true emergency, I am trained to provide the necessary, life-sustaining support needed while we wait for emergency personnel to take over.