Prenatal & Postpartum Care
Prenatal Care
A free consultation can be scheduled with me either by phone or in person at your home. Once you have made the decision to hire me as your midwife, the schedule of prenatal visits is as follows: once every 4 weeks until your 28th week of pregnancy, once every 2 weeks until you are 36 weeks pregnant, then weekly until the birth of your baby. The initial visit will take place either at your home (unless the face-to-face consultation was conducted in your home) or at my office and the 36 week prenatal visit will be in the home. All other visits will take place at my office.
Pursuant of SC Regulation 61-24, all mothers who are receiving care from a Licensed Midwife and planning a home birth must schedule 2 visits with a medical provider (CNM, Ob, Family Practice, General Practice, etc) in addition to the above visits with her midwife. One of these two visits must be within the first two trimesters and the second visit has to be within the last 6 weeks of pregnancy.
During the prenatal visits, expect to spend about an hour with me as you will discuss many topics and (hopefully) have several questions at each visit. Your partner is not required to attend all visits, but is encouraged to attend whenever possible. I would appreciate the presence of your birth partner at the 36 week home visit, so that your birth team can thoroughly discuss the labor and birth day. Children are invited to attend prenatal visits as well, they should know that this is a healthy, normal part of life and should be involved.
What do the prenatal visits entail?
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At the initial visit, a complete health history discussed, physical performed and prenatal panel lab work drawn, if needed
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Weigh-in
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Blood pressure reading
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Urinalysis
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Answer any questions you may have
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Assess nutrition and sleep habits
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Lay hands on the belly and assess the position of the baby (after 20 weeks)
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Measure the growth of the uterus
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Using a hand-held Doppler or fetoscope, auscultate the baby’s heart tones
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Discuss baby’s development and mama’s changing body
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Between 24-28 weeks, hemoglobin (iron) level is checked and glucose tolerance test is offered
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Between 35-37 weeks, a sample to culture for group B strep is obtained
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36 week visit in home visit includes: all of the routine prenatal assessments as above as well as discussing what to do when labor starts, when to call your midwife, and how to prepare for birth and the postpartum period
Postpartum Care
Immediately following the birth of your baby, assessment has begun. While you are meeting your baby, I will be checking out your baby and you to ensure that everything is starting of smoothly. The Apgar score is an assessment that is done while you are holding your baby at 1 minute and 5 minutes after the birth.
I will observe for seamless transition from pregnant woman to mother and from baby's life in utero to adaptation to the outside. I will be as unobtrusive as possible and only intervene when the situation calls. After the initial meeting period- the Golden Hour (which may actually last more than an hour)- I will weigh the baby and do a thorough head-to-toe exam for the baby, right beside you while you eat a good meal. Once that is complete, it will be time for the new family to snuggle down into the bed and rest. My assistant and I will then exit leaving no trace, except that you now are holding your baby in your arms.
You and I will be in close contact over the next 24 hours by phone and I will visit you in your home within 24-36 hours after the birth. At this first postpartum visit, the baby will be weighed and assessed. While the baby is at the breast, I will perform the Newborn Metabolic Screening. (learn more about that here). I will answer any questions that you have, assist with breastfeeding and examine you, mama, to make sure that you are healing well.
Over the next 6 weeks, we will remain in contact. Just as during your prenatal care, I will be available to you. You will schedule a 1 week postpartum visit in your home, a 3 week visit either at my office or in your home, and a 6 week visit in my office. If there are questions or concerns during that postpartum period, do not hesitate to contact your midwife.
