Prenatal Care

BirthWays follows the Midwives Model of Care which is a fundamentally different approach to childbirth. The Midwives Model is based on the fact that pregnancy and birth are normal, healthy events in a woman’s life. It recognizes that women have the right to seek care that is safe and addresses individual needs. Midwifery care emphasizes education providing women with the information they need to make informed decisions about their health care. It has been proven that this model of care results in less complications, fewer interventions, and healthier births for mothers and babies.

Midwives have been attending women during pregnancy and birth since the beginning of time. Traditionally, the midwife was another mother within the community who not only tended to childbirth, but also tended to all aspects of health care. My great-great grandmother was a midwife in West Virginia who did everything from baking bread and attending birth to mending broken bones.

One of the most significant aspects of midwifery care is the relationship that forms between the mother and midwife. All visits are at least a 1/2 hour long which gives us time to talk about your questions and to discuss your concerns and desires. Your children and family are an integral part of your life and they are encouraged and welcome to be at your visits to ask their own questions and to witness the miracle of your baby's growth.

Your first two appointments will include a medical history, a physical exam, and a nutritional analysis. These first two visits are thorough and usually take 1-2 hours. All future prenatal exams will last 30-45 minutes and includes checking your blood pressure, urinalysis, fundal height measurement (measuring the growth of your baby), gently feeling your baby's position through your tummy, and listening to your baby's heartbeat.

Your prenatal care will be monthly until 28 weeks of pregnancy, then every two weeks until the 36th week ( the midwife comes to your home for this visit if you're planning a homebirth) followed by weekly visits until your baby is born. Having a baby is a very special time in a family's life, I feel privileged to be a part of this special event!

• You will have the option of having all the same tests that are available with a physician or nurse-midwife. The initial tests are a Pap smear, a screening for Chlamydia and Gonorrhea, and a blood test called a Prenatal Profile, which includes: blood type, Rh Factor, Complete Blood Count (CBC) including hemoglobin and hematocrit (to identify possible anemia), antibody screen, rubella titer (German measles), Hepatitis B, Syphilis, HIV and Hepatitis C.
• At 28 and 36 weeks, tests are again offered to assess for the presence of anemia. At 28 weeks you will also have your blood< checked for sugar levels to screen for the presence of diabetes or hypoglycemia, and if you are Rh-negative, for antibodies to Rh- positive blood.
• At 35-37 weeks you will be offered a vaginal culture for Group B Strep.
• AFP (tetra screen) testing, ultrasound and amniocentesis are optional.
• Prior to any test or procedure you will be informed of the risks and benefits to you & your baby and given time to make an informed decision. You are in charge of your care. We are here to provide you with the guidance & support you need to make the best decisions for you and your baby!

If you think your in labor, you should call me. It doesn't matter if it's late at night or if you're not sure if you're really in labor. We will decide together when you'll come into the Birth Center or when I should come to your home. Once you're in active labor I will remain with you, providing support and assessing you and your baby throughout labor until a few hours after the birth. During your labor I can be as involved as you need me to be. I can actively provide support, encouragement and guidance. Or, if you prefer to labor alone with your husband or partner I will provide you with as much privacy as possible. Of course I will make sure that you and your baby are doing well throughout labor by quietly listening to your baby's heartbeat and assessing your vital signs at regular intervals.

All interventions are kept to a minimum when possible. Birth is a normal process and it works best when not interfered with. Cervical checks are kept to a minimum, IV's are not routine, and you are supported in listening to your body during labor, taking whatever positions you find most comfortable. I'll encourage you to walk around, eat and drink, use the shower or tub if desired, and generally do what works best for you during your labor. You can rest assured that interventions will only be done when needed and with your consent. If a hospital birth becomes necessary I will remain with you as your doula providing support, comfort, and information to assist you in making important decisions.

When it's time for your baby to be born I'll encourage you to follow your body for pushing. Changing positions during this time in labor is often helpful and I can suggest positions if needed. When your baby is being born you or your husband (or partner) may receive (deliver/catch) the baby if you chose. Your baby will be assessed in your arms. After the cord stops pulsing it can be cut by whomever you choose. Most often Dads or siblings get this honor. Each mother, baby, and family is unique and special and so is each birth experience!

After your baby is born at I will remain with you for the first several hours until you and your baby have eaten. If you've given birth at the Birth Center you will go home approximately 4-6 hours after the birth. If you've had your baby at home, I remain with you at home for 3-6 hours. During those first few hours the Midwife and/or Midwife Assistant will be assessing you and your baby for continued health and the Midwife will have completed a full physical exam on your baby. Vitamin K and erythromycin eye ointment are available for your baby if you desire. It is recommended that you have a Pediatrician available to see your baby within 48 hours of the birth. We will contact your chosen pediatrician after the birth to let them know that your baby has been born and fax the birth records to them. You will schedule your baby's visit with the pediatrician at your convenience.

We will visit 24-48 hrs after the birth to ensure that all is well with you and your baby, to assist you with breastfeeding if needed, and to answer any question that you may have. During this visit you will sign the birth certificate and we'll collect a small sample of blood from your baby's heel for the Infant Metabolic Screening (PKU) that is required by the State of Florida.

You will come back to the office again at 2-3 weeks postpartum. Usually by 2 weeks breastfeeding is going well and your baby is back to his or her birth weight (babies will normally lose 10% of their birth weight in the first week).

Your six-week postpartum visit is the last of our visits together surrounding this pregnancy. I will perform a physical exam and we can discuss your birth and your family planning options. This visit is done either at the Birth Center or at your home.

One of our home visiting nurses/assistants is also available for additional visits if they're needed for assistance with breastfeeding. Although these visits and phone calls are set at particular times during your postpartum weeks we are always available to you for any questions or concerns you may have.