PRENATAL CARE

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, 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 10+ weeks 
At your first visit we review your health history and discuss health, lifestyle, nutrition, and exercise for a healthy pregnancy. The option for an ultrasound, genetic screening and blood work is performed. Fun fact: your baby's heartbeats for the first time around 5-6 weeks and we can hear it at 10-12 weeks!

15 weeks-20 weeks
A physical exam, diet diary and prenatal lab work are performed and reviewed. The option for second trimester genetic screening and Cystic Fibrosis testing are performed between 15-18 weeks. Your belly is palpated and fundal measurements are taken after 12 weeks. Your baby's heartbeat can be heard depending on your baby's position, physical build, and due date accuracy. 

20 weeks-27 weeks
We require a anatomical ultrasound which looks for possible fetal abnormalities as well as the health and function of the placenta. You have the option to listen with the fetoscope to your baby's heartbeat.

28 weeks-35 weeks
Prenatal screening for gestational diabetes and anemia tests are offered. Your 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 resources are given.

36 weeks 
Prenatal exam and home visit! We invite anyone who is planning on attending your birth including doulas and family members to attend this appointment. We will discuss what to expect in labor, your birth desires, how and when to call and answer any 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. 
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37 weeks until birth
Prenatal exams continue weekly until the birth. If no labor by 41 weeks a biophysical profile and non-stress test are offered. We can attend births at home from 37-42 weeks.

birth

Two Licensed Midwives will be present at every birth. The Midwives will remain for 2-3 hours after the birth to ensure that you and baby are stable and healthy. A thorough newborn exam is performed where the baby is weighed, measured, and evaluated. Vitamin K and antibiotic eye ointment are offered for the baby. We assist with breastfeeding / chestfeeding. Postpartum instructions are given and suturing is performed with numbing medication if needed. 

postpartum care

Day 1
Home visit well-being check on you and your baby.  The Birth Certificate paperwork is given. The baby is tested for Critical Congential Heart Disease and the Newborn Metabolic Blood Spot Screening.

Day 3
Home visit assessment of the health and well-being of you and baby. Lactation support and normal newborn transition is monitored. Newborn records are sent to pediatrician. 

Week 2
Home visit assessment of the health and well-being of you and baby. Lactation support offered. Weight check for baby.
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Week 6-8
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 and pelvic floor is checked.