Our first prenatal visit will last about two hours. During that time we will fill out paperwork, I will assign you some homework to do regarding your medical history and your current diet, and I will check on you and the baby to be sure you are both healthy and well.
Subsequent prenatal visits usually last about an hour, but could be longer if needed. We will spend time on the routine things like urine testing, weigh-in, blood pressure and pulse. I also get to do fun things like playing with the baby by palpating your abdomen to determine fetal position, and listening to the heartbeat to determine the rate and check for any abnormalities. Most of the time at prenatal visits is spent chatting about your diet, your exercise, the vitamins and supplements you are taking, what your dreams are like, how life is going, what your plans for the next month may be. One of the cornerstones of homebirth midwifery is a close relationship between the midwife and the client; in my practice this relationship is developed during the pleasant social times we spend together at our prenatal visits.
I will see you routinely every four weeks until you are 28 weeks along, then every two weeks until you are 36 weeks pregnant. The 36 week visit takes place at your home so that I and my team can get a good idea of where you live, see what the space will be like when the birth happens, and meet everyone who will be present for the big event.
After the home visit, you will return to the office weekly until you give birth.
I will order routine lab work for you at our initial visit and then do in-office hemoglobin and glucose testing at 28 and 36 weeks.
Throughout the entire pregnancy, I am available by phone for any kind of question or concern. If we need to have additional appointments, they will happen and will not increase the cost of my services. My goal is for you to feel informed and comfortable with every decision that is made and every procedure that is performed. Our time together will be a partnership, working towards a happy birth experience and a healthy mom and baby.
Labor and Birth
In labor, I will join you when you need me. That may be at the first sign of a contraction, or it could be later when labor is getting more active. Usually, my midwifery assistant accompanies me when I come to your house. I will monitor your well-being and that of your baby regularly through labor, and I will inform you of my findings. When you get close to transition, I will call the second midwife in to help assist in the birth. During the birth, I will coach you on positions and practices for a safe, non-traumatic experience, with the goal of an intact perineum and a healthy baby. Once the baby is born, I will do my best to allow the placenta to deliver peacefully on its own, assuming all signs of the situation are normal. After the birth, I will gently perform a complete newborn exam on the baby and a thorough perineal exam on you to look for tears. I will stay as long as needed after the birth. Generally this is at least 3 hours, and can be more if necessary.
Following the birth, I will return to your home on day 1, day 3, day 7 and day 14. At these visits, I will do a complete assessment of you and the baby to be sure you are recovering well from the birth and the baby is making a good transition to life outside the womb. The six-week postpartum visit takes place back in the office.
If you wish, I can perform the newborn metabolic screen on the baby at the one week postpartum visit.
I will file a birth certificate for the baby and request a Social Security Card if you wish.
You should be aware that I feel very strongly that mothers and babies should stay home for the first two weeks after the birth. In particular, I like my clients to stay in bed for a solid week in order to rest, recuperate, establish a good milk supply, and bond with the baby. Most people think this is an impossible demand, but I assure you that it will be the best two weeks you've ever had if you follow my instructions during this very special period of your life.