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Frequently Asked Qeustions
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WHEN SHOULD I BEGIN PRENATAL CARE?If you are newly pregnant, congratulations!!! You should try to schedule your first prenatal visit no later than the 6th – 12th week of pregnancy. That is about two to eight weeks after your first missed period. Optimally you should begin your care immediately for planned pregnancies, even before you conceive. Remember, we provide preconception counseling, nutritional counseling, and lab work important to a healthy beginning.
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I AM PREGNANT AND STARTED PRENATAL CARE WITH ANOTHER PRACTITIONER. CAN I STILL CHOOSE YOUR MIDWIFErRY SERVICES?Absolutely! I would love to have you as a client. I typically accept a transfer of care from the beginning of your pregnancy until about 36 – 37 weeks of pregnancy (or even later in some cases). You will fill out a ‘records request’ form that allows your previous provider to send us your medical records.
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WHY SHOULD I GO TO A MIDWIFE?Midwives provide excellent care! For example, midwives know that a normal pregnancy in a healthy woman is a reliable indicator of a birth that will be normal and will occur as a healthy normal physiological event. I will not consent to deliver your baby outside of a hospital unless we are satisfied that you are healthy and that your pregnancy is progressing normally. If your pregnancy exhibits any of the risk factors that make a home birth unsafe, we will consult with a physician and in some rare cases, transfer your care. However, even with the presence of some common risk factors, women are not necessarily automatically excluded from homebirth care. Midwives usually consider risk case by case, taking into account the history and entire health of a woman rather than simply relying on risk labels. Only a relative few high-risk factors lead to appropriate and selective transfer from home to hospital. It is important to remember that childbirth is inherently safe when the laboring and birthing processes are left undisturbed to progress naturally under the skilled attendance of a CPM. Statistically, if your pregnancy proceeds without complication, the chance that you or your baby would encounter difficulty during birth that required hospital care is extremely low. ADDITIONALLY, CONSIDER THE FOLLOWING ADVANTAGES As a midwife, I consider pregnancy to be a normal healthy event; most women can have a safe birth at home. I spend much time with you getting to know your body, your baby, your lifestyle and therefore it is easier for me to detect when something is not going well Your visits are typically 30 – 45 minutes long. I view you and treat you as an equal partner in your care. I trust in the power of your body to give birth and will work to help instill this confidence in you. Instead of treating pregnancy as a ‘disease,’ I will work on creating a healthy mom and baby. I have extensive experience in dealing with complications. Your place of birth is never as important as the safety of yourself and your baby. I have training in dealing with many types of emergencies and have worked in one of the most dangerous countries in the world for a woman to have a baby, such as Haiti. A recent large landmark study shows that CPM midwife-attended home births are as safe (if not safer) as physician attended hospital births for low-risk women. For more information on this study, see the NARM 2000 Study.
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HOW IS A HOMEBIRTH DIFFERENT FROM A HOSPITAL BIRTH?The dynamics of each of these places is so very different than the two can hardly be compared! YOU and I are in charge of your birthing process...TOGETHER. Using informed consent and educated thinking you will determine your needs in labor, eating drinking, walking around, people present at the birth, these things are all your decision. Midwives recognize birth as a normal process, which means that many things that hospitals do as an intervention are just not necessary UNTIL THEY ARE. Midwives do not do many of the routine birth procedures that are talked about when referring to hospital birth, until and unless they become necessary. NO I.V.s, no being confined to bed, no catheter and eating and drinking are certainly encouraged!
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IF I CHOOSE YOUR MIDWIFE SERVICES FOR MY PRENATAL CARE, CAN I STILL GET AN ULTRASOUND?"Yes, we can discuss your desire for an ultrasound. I rarely recommend ultrasounds/sonograms unless there is a medical need. Many parents want to know the very important gender, so we can accommodate this if it is your desire.
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IS HOMEBIRTH MESSY?People often worry that home birth will be messy – midwives hear this a lot! Your birth kit and instructions will provide much of the necessary protection for your birthing spot. After birth, when it’s time for your me to leave, you can expect to be tucked into a clean bed with the majority of the cleaning and laundry are done. What’s more, you will receive practical instructions on how to care for your laundry, put your garbage out and safely store and/or dispose of your placenta.
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WHO CAN BE AT MY BIRTHWhen you plan a home birth, it is up to you to decide how many (or how few) birth companions, family members, and/or friends are there with you. We will discuss this towards the end of your pregnancy, just be aware that the birthing space is sacred, you only want those that fully support your choice to birth where and with whom you wish. Fear is not welcome at any birth; it slows down the process. You and I will have a relationship where, if the laboring mom is feeling fearful, I can assist her because of our relationship. Others may not understand that negative statements or feelings can truly hurt the birthing woman.
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WHAT ABOUT GERMS?Birth is not an illness. Having a vaginal birth does not require a spotlessly clean setting, the birth itself is not free of germs. Unless you give birth by C-section, you do not need a sterile environment to have your baby in! You do not need to clean your home using the same infection prevention measures they do in the hospital to avoid getting an infection. There is something known as the microbiome (read more here). This microbiome is critical to your new baby, developing a precision machine... his/her immune system! Research shows that babies born via c-sections are more likely to have certain types of immune issue like food allergies, or frequent ear infections. This is one of the main reasons I ask you not to wash your baby for several days. If I feel a cleaner environment is needed, we will discuss this. I will come equipped with the supplies required to help prevent infection. At first glance, a hospital may look cleaner than your home, but research shows that people get infections from being treated in hospitals every year. Even with strict cleaning and disinfection protocols, it is very difficult for hospitals to control infection risks because of the large number of sick people who pass through them every day. That doesn’t mean that you or your baby will get an infection if you go to the hospital. Healthy people are at lower risk of infection than sick people in hospitals. It does mean, however, that you are less likely to come into contact with infection in your home than in a hospital and so is your baby.
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WHAT ARE MY PAIN RELIEF OPTIONS AT HOME?Midwives are skilled in providing comfort measures to support you in labor. Giving birth at home does not mean you are without pain relief options. Having a peaceful environment that is safe and supportive is very important. Comfort measures available to you at home may include: Massage Position changes Relaxation and breathing techniques Hydrotherapy (using warm water like taking a deep warm bath or shower for comfort and pain relief) Transcutaneous electrical nerve stimulation* (TENS) Sterile water injections
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IS HOMEBIRTH SAFE?Homebirth has been shown to be a safe option for healthy women and healthy babies whose normal pregnancies are full-term at the start of labor, and who are monitored and attended by professional midwives. You can get more information here, and check out these studies on homebirth safety: Outcomes of planned homebirth with CPMs in North America, and Outcomes of planned homebirth after regulation in British Columbia.
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DO I NEED TO SEE A DOCTOR DURING MY CARE?I offer comprehensive care during pregnancy, birth, and the first weeks after the baby is born. Prenatal care in the midwifery model includes all the same clinical components as obstetric care, such as listening to the baby with a doppler or fetoscope and taking your blood pressure and also includes time getting to know you and your health, and addressing all your questions. Postpartum care is also included, with at least three visits. Midwives also provide weight and color checks for your newborn for the first two weeks, and most families see the pediatrician at a few days to two to four weeks of age. My care includes recognizing clinical situations requiring the attention of an obstetrician or pediatrician and referring you to one if necessary.
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WHAT ARE THE BENEFITS OF HOMEBIRTH?There are many benefits to having a homebirth. Some of the ones most commonly reported by families are: Individualized care: All decisions about your care are made together with you, in detailed discussions of your needs and desires, your individual health, and the evidence regarding the options available to you. I respect you as your own - and your baby's - primary care provider. Evidence-based care: i stay current on the research around pregnancy, birth, postpartum, and breastfeeding, so that I can provide the best evidence possible for your decision-making and my skills and knowledge. Your own environment: You choose who attends your birth and who cares for you. You choose what to eat and drink. Walk, dance, or sleep uninterrupted if you want to! Bonding with your baby: I believe in holding the scared space for the mother-baby connection as it makes the transition from the womb to the mama's arms, to the breast, and beyond.
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WAHT HAPPENS IF SOMETHING GOES WRONG?Midwives are trained to handle certain complications at home and to recognize complications that means a hospital birth is advisable and to transport in those circumstances. One of the most common complications we handle at home is excessive bleeding immediately after the baby is born, I carry medications to stop this bleeding and use them the same way they are used in the hospital. The other, which is rare but still one of the more common complications, is a baby who needs some help to take his or her first breaths. I am certified in neonatal resuscitation and have experienced this scenario. Most babies in this scenario receive a couple of breaths from me and then start breathing on their own very quickly. Again, in this scenario, I follow the same standards as the hospital. My most common transport to hospital happens for first-time labor that lasts a long time, and mom nears clinical exhaustion; we go to the hospital for an epidural so that mom can have several hours of sleep and get her uterus the rest it needs - often she wakes up pushing her baby out! I also listen to the baby with a doppler during labor so that the baby can let us know that he or she is doing well; babies usually give us plenty of advance warning with a change in their heart rate if they need us to go to the hospital for their birth.
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WHAT HAPPENS AFTER THE BABY IS BORN?Every midwife has a little different approach, but at a typical birth I will put the baby up on mama's chest/belly, and for about the first fifteen minutes keep an eye on your bleeding and your baby's adjustment to life outside the womb. After the placenta is born and the baby's cord is done pulsing, I ask you if you are ready to cut the cord and who is going to be the one to do it, and I help clamp and cut the cord. Then I give you some space for family time, staying close by with an ear out for your needs and checking on you periodically. Whenever your baby is interested in nursing, we offer help with positioning and latch if you would like it. When you are comfortable and ready for a nap with your baby, and I am satisfied that you and baby are healthy and stable, I will do a newborn exam, give you a shower and bathroom break and then leave. I will usually see you in about 24 hours for your first postpartum visit.
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