You have the right to make informed decisions about your own health care. Because of this I offer a free face-to-face consultation visit where you can ask any questions you have about me, midwives, midwifery care, or out of hospital birth. We can also discuss any concerns you might have about your previous pregnancies or personal health history before we decide together if this is the right path for you.
Consultation visits are scheduled for one hour though the actual length may vary greatly depending on your needs. While not all clients feel the need to have a consultation visit, I highly recommend that clients who are new to midwifery care and out of hospital birth schedule a consultation visit before signing on for care.
Prenatal visits are a time to get to know your midwife and for me to get to know you and the people who are important to you. I encourage you to include your partner, your other children, your doula or any other members of your support team in your visits so that they can ask any questions they have and we can all begin to feel like a team.
I offer complete prenatal care for low-risk pregnancies. Prenatal visits are a time to ask any questions you have about your progressing pregnancy and to check in on your health and the health of your pregnancy. During each prenatal visit I take your blood pressure and ask you questions specific to where you are in pregnancy. I will measure the growth of the baby and listen to the fetal heart. Any labs, tests or procedure that you have chosen will also be completed during your visit.
Visits are generally scheduled on the hour for one hour but may only actually take as little as thirty minutes depending on how much we have to talk about.
A typical schedule of visits is as follows:
Initial visit - including complete history, pregnancy dating, labs and a physical exam
Routine prenatal visit are every four weeks until 32 weeks
Routine prenatal visit every 2 weeks from 32 to 36 weeks
The 36 week visit is in your home so that I know how to find it and we have a chance to discuss the use of space for birth.
Routine prenatal visit weekly after 37 weeks until delivery
For pregnancies that continue past 41 weeks and 1 day visits will be scheduled every 2-3 days until delivery.
Most visits will take place in my cozy office in Hoquiam. For those wishing to have all home visits a small travel fee may be added.
Labs & Tests
Most blood and urine tests can be collected during your visits and sent out to a lab for analysis. I refer out for ultrasounds and genetic counseling.
Many different tests and labs are offered during pregnancy. Sometimes these tests can feel overwhelming and confusing. I value shared decision making with my clients and because of this I believe that you have the right to know which tests or labs are available and what the research shows about these tests. Because many tests have a window of time in which they will be useful or valid I will let you know in advance what tests are available and provide ample time for discussion and questions before the window so that you can make well informed decisions.
Routine labs may include:
checking iron levels, blood cell counts, antibodies, and blood type
testing for sexually transmitted infections
screening for an increased risk of chromosomal differences and neural tube defects
screening for gestational diabetes
testing for group b strep
Common times for ultrasounds are:
early in the first trimester to date the pregnancy
late in the first trimester as part of genetic screening
at about 20 weeks of pregnancy to view fetal anatomy
after 41 weeks to check on well being of fetus
Birth at Home
Labor and birth are natural body functions that happen best when they are disturbed as little as possible. Moving from your ‘nest’ and into a hospital can be very disruptive, no matter how nice the hospital. Stress hormones can slow down labor and impede labor’s progress by causing a fight or flight response. By staying home you allow the natural hormonal cocktail, which promotes birth, to lead you toward a natural and euphoric experience.
When the time comes for birth, I come to you! Most births could happen without a midwife (or anyone else) present. However, my job is to safeguard against the occasional emergency and more to help guide you through the rough spots. During your labor I will monitor your wellbeing and the wellbeing of your baby. I do this by regularly listening to the fetal heart (heart rate is the best tool baby has to tell us if they need help), taking your vital signs (blood pressure, temperature, and pulse), and by tracking the progress and making recommendations as needed.
I fully support water birth. I see it work wonders at reducing tension and pain. I also feel it is a gentler transition into the world for baby. Birth tubs are available for home use if you do not have a large soaker tub in your home. Talk to me about your plans to birth in water.
Partners and children are welcome to be as involved in the birth as you would like them to. Homebirth is often less disruptive to family life than a hospital birth. Being home can help make the birth of a sibling a lovely memory for your older children. By being at home they can take a break in their own room, eat familiar foods, and not have to cope with as much parental separation.
Postpartum refers to the time after your baby is born. Immediately following your homebirth I ensure that both you and the baby are transitioning well. In the first three to 4 hours after birth I will remain with you checking in on you and baby frequently. I will help you establish breastfeeding and make sure that you and your support people know what to expect in the next day and what to do if something unexpected happens.
During the postpartum time I am still available to you 24 hours a day by phone and email.
The Postpartum Care Schedule
1st postpartum visit - I will visit you in your home about 24-36 hours after the birth to check on your well being as well as baby's health. Baby will be weighed and measured again and at this visit the blood sample for the Newborn Metabolic Screen is routinely collected. Your baby will also receive a hearing screen at the first postpartum visit.
1 week visit - Your second postpartum visit will be at 7-10 days after birth. This visit is to check in on your physical health and healing from the birth. It is also an excellent time to see how feeding is going. This is my last official visit with baby as midwives are licensed to do newborn care for the first two weeks. After two weeks your baby should get routine care from a pediatrician or family doctor.
3 week visit - The three week visit is all about you and your transition to parenthood or to having a growing family if this is not your first child. We can take some time to debrief your birth in depth and answer any questions that may have come up in the last three weeks.
6 week visit - This is the last routine visit. I will check again on your healing and discuss what your plans are moving forward. We often discuss family planning and child spacing during the final visit. If you need any final lab work, I will also do that at this visit.
*Other postpartum visits may be scheduled as needed.