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I prefer that a mother whose baby is imminent keep in close contact during those final days and notify me of any early labor warning signs.
I always bring another midwife or birth assistant and/or apprentice. We think it only prudent to have two experienced caregivers in attendance in the event of a complication with both mother and baby.
On arrival, maternal vital signs are assessed. This is repeated at least every two hours thereafter. Fetal heart tones are checked at least every hour during early labor, and at least every 30 minutes during active labor and more frequently during second stage to ensure there are no signs of fetal distress.
Vaginal exams are done rarely, and then only if there is a specific need for them. The urine is checked initially and then every four hours. Sipping water or juice is highly encouraged throughout the labor, as is emptying the bladder.
Family and sibling participation is encouraged. We ask clients to discuss with us in advance who will be invited to the birth. We like for anyone you plan on having at the birth to plan to attend the home visit at 37 weeks. At this point, a birth supply kit should be assembled and the home should be prepared for it's new arrival!
We have experience with all sorts of delivery positions, including on a birth stool and under water. We are open to suggestions. It is important that the mother feel comfortable and unrestricted during labor and delivery to facilitate the birth process and feel empowered to labor as she desires.
During the crowning of the baby's head we prefer to use hot compresses, perineal support or olive oil massage. We highly recommend prenatal perineal massage and will train you and your husband during your pregnancy. Episiotomy is only done in an emergency. The cord is usually cut after it stops pulsating. The father, mother or a sibling is encouraged to cut the cord.
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I provide care for low risk clients. The first visit, in my home office, includes a complete physical assessment, medical history including a detailed previous birth history, nutritional counseling and the drawing of blood for labs. Subsequent visits occur at monthly intervals until 28 weeks, then bi-monthly until 36 weeks. Weekly prenatal visits the last few weeks ensure close contact leading up to delivery.
and covered with heated blankets. Suctioning of the baby is only performed if deemed necessary to clear mucus. If there is evidence of thick meconium, suctioning with a de-lee suction catheter is done after the birth of the head but before the birth of the baby. Apgar scores are taken at one minute and five minutes after birth. Immediate breast feeding is encouraged to prevent heavy bleeding by the mother and to hasten the birth of the placenta. The family is allowed to privately bond with their new baby and revel in the miracle of birth!
length and weight measurements, reflexes and other assessments. Eye ointment (erythromycin) is introduced to the baby's eyes, a cord blood sample is taken to be tested for RPR, blood group and type, and footprints are taken.
I have experience with water births and gave birth to my youngest in water. Water has proven for many to be a very effective way to reduce pain in labor and keep the laboring mother peaceful, comfortable and able to better handle the intensity of contractions. Water births also provide a more peaceful and less traumatic transition for the infant from the womb to the large, limitless outside environment. Most women who have water births have wonderful experiences and would choose to labor and deliver in water for any subsequent births.
All vital signs are checked, degree of bleeding carefully monitored, the perineum is inspected for proper healing, and the breasts are checked. We also help with breast feeding concerns, proper latch and positioning. The infant's vital signs are checked and the first newborn screening blood test is done on the first visit. Texas has recently updated the the newborn screening testing from 5 tests to 27 tests.