A mother's health is crucial for the safe birth of a healthy baby. You will receive regular check-ups throughout your pregnancy. Your first prenatal visit occurs as soon as you want to begin. It includes a complete medical history, blood work and nutritional counseling. In the second trimester, we can listen to your baby's heartbeat. At your second prenatal visit, I conduct a thorough physical exam and explain the results of your blood work. Your routine, prenatal visits last about an hour and occur monthly through the seventh month. I will see you every two weeks starting at 28 weeks, followed by weekly visits in your last month of pregnancy. We'll do one of your later prenatal check-ups in your home to help you get ready for the birth.
The 30-60 minutes we spend at each visit gives us plenty of time to monitor and discuss these important indicators:
- Fetal movement
- Fetal heart beat
- Uterine growth
- Infant position
- Blood pressure
- Social support
Through a holistic approach, we can identify any areas that need extra attention before your birth. At each visit you will learn something new about your pregnancy, childbirth or newborn care. Be sure to raise your questions and concerns during these visits. This is your time.
To have an extra pair of caring hands, a second midwife or a midwife apprentice will also attend your birth. During labor we will encourage you to walk around your home and change positions. This increases your comfort and advances your labor. You will not be hooked to machines or confined to bed, as is common during hospital labors. I believe that the excessive use of high-tech equipment shifts the focus from the laboring mother to machines. Overemphasis on technology mystifies birth for many couples, and has not been shown to increase safety for healthy, low-risk mothers and babies. Your comfort will not prevent us from closely monitoring vital signs to ensure that you and your baby are progressing safely through labor.
We will stay with you throughout active labor, offering encouragement, massage and guidance. To boost energy, most women prefer water, juice and snacks to the traditional hospital fare of ice chips and IVs. Many women find that a shower or warm bath are the most comfortable places to labor. We have helped women give birth standing, squatting, reclining, lying on their side, seated on a birthing stool, supported on their hands and knees and submerged in water. You will find whatever position works best for you.
When your baby is born, we will place him or her on your chest for you to cuddle and nurse. We do newborn examinations beside you in bed. Afterwards, we will clean up, assist with nursing and ensure that mother and baby are stable and adjusting well. This is usually completed within 2-3 hours of the birth.
Because we serve only healthy, birth-educated women, we encounter few complications. Nonetheless, we are fully trained to evaluate labor and birth and to carry out emergency medical procedures as needed. I never delay necessary medical care. The vast majority of our hospital transfers are not urgent, but are due to drawn out labors in which the mother decides it's time to try some of what the hospital has to offer. When a woman transfers to the hospital in labor, we accompany her there to brief the doctors and nurses and to serve as her doulas throughout labor and birth.
Postpartum & Newborn Care
Most women who deliver in the hospital stay 24-48 hours after the birth. After discharge, they typically do not see their practitioner again for six weeks.
I have a different approach. Though my assistant and I typically leave your home within three hours after the birth, we will check up on you by phone the next day. Two days after birth, we visit your home to fully examine you and your baby. At 1-2 weeks postpartum, you and your baby get thorough exams at my office. We give significant breastfeeding support and arrange additional visits in your home or my office as needed.
I will see you both back in my office for your final postpartum visit when your baby is 6-8 weeks old. This exam includes family planning counseling and a pap smear, if needed.