"There is a secret in our culture, and it's not that birth is painful. It's that women are strong."
Prenatal care is offered at the same care schedule as an obstetrician: once a month until 28 weeks, bi-weekly until 36 weeks and then once a week until birth. Midwifery care differs from obstetric care for it includes hour long prenatal visits, continuity of care with the same provider, herbal medicine, diet and nutrition counseling, alternative therapies, emotional birth preparation support and optional childbirth education classes. A typical prenatal visit includes blood pressure, weight, urine analysis, belly palpation with fundal height measurement to check on fetal growth, listening to the baby’s heartbeat, and discussion of current questions and concerns.
Initial visit @ 6-8 weeks
At the initial prenatal visit your personal, gynecological and family health history is reviewed. Discussion of health, lifestyle, nutrition, and exercise for a healthy pregnancy. A blood draw for the initial prenatal panel is usually performed at this time. The option for the first trimester genetic screening is offered and to be performed between 10-14 weeks.
Fun fact: your baby's heartbeats for the first time around 6 weeks and we can hear it at 10-12 weeks!
A physical exam if indicated, diet diary and prenatal lab work are reviewed. The option for second trimester genetic QUAD screening and Cystic Fibrosis testing are offered and to be performed between 15-18 weeks. The option for a dating ultrasound is given and most accurate between 6-10 weeks. Belly is palpated and fundal measurements are taken after 12 weeks. The option is given to hear the baby's heartbeat as early as 10 weeks, but it's more common to hear it at 12 weeks with a doppler. How early the sound can be picked up depends on the baby's position in the uterus, maternal build, and due date accuracy.
We require a fetal anatomy scan which looks for possible fetal anomalies, health and function of the placenta. The option is given to listen to baby's heartbeat with a fetoscope is possible from 18-20 weeks.
Prenatal Exam Screening for gestational diabetes and anemia tests are offered. Blood is checked for appropriate levels of blood volume expansion. Antibody titer and Rhogam are offered to Rh negative people. Childbirth education classes are suggested and options are given.
Prenatal exam and home visit! All birth attendants, doulas or family members attending the birth are encouraged to attend the home visit. Discussion regarding labor and delivery, becoming parents and a time for questions and concerns. Birth kit should be ordered and a labor supply list are given to parents. The Group Beta Strep (GBS) vaginal culture is performed. Rh antibody titer may be repeated on Rh negative people. Anemia is checked again if indicated. All birth fees are to be completely paid by this time. The birth plan is reviewed.
Weekly from 37 weeks until birth
Prenatal exams continue weekly until the birth. If no labor by 41 weeks a biophysical profile and non-stress test is discussed and offered. We offer home birth from 37-42 weeks.
Two licensed and trained midwives will be present at every birth. The midwife and assistant midwife will remain in the home for 3-6 hours after the birth to ensure that you and baby are stable and healthy. A thorough newborn exam is completed where the baby is weighed, measured, and evaluated. Vitamin K and an antibiotic eye ointment are offered for the baby. We offer help with breastfeeding / chestfeeding as needed. Postpartum assistance and instructions are given including suturing with numbing medication if needed.
Home visit assessment of the health and well-being of you and baby. The Birth Certificate paperwork is given. The baby is screened for Critical Congential Heart Disease. Newborn exam and day 1 postpartum newborn assessment are sent to pediatrician. Newborn Metabolic Blood Spot Screening test is offered/ performed.
Home visit assessment of the health and well-being of you and baby. Lactation support and normal newborn transition is monitored.
Home visit assessment of the health and well-being of you and baby. Weight check for baby.
Office visit assessment of the health and well-being of you and baby. We offer a Well body exam / gyn exam with a Pap smear as needed. Family planning options discussed.