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Summary of Services

Prenatal Care:

Prenatal visits begin around 10 weeks and are scheduled every 4 weeks until 28 weeks gestation, every 2 weeks from 28-36 weeks, and weekly from 36 weeks until your birth. These visits are usually 30 minutes long with face to face time with your provider. Partners, siblings, other relatives, and friends are welcome to attend, as long as you are comfortable.

 

Visits will include regular physical and gestational assessments such as:

  • blood pressure and pulse

  • urinalysis 

  • fundal height

  • position of baby

  • fetal heart tones 

  • medical and obstetrical history

 

Lab work will be done at the following visits:

  • The first trimester OB Panel

  • 28-32 weeks: hemoglobin and random blood sugar tests will be repeated

  • 28 weeks (and at 34 weeks, if needed): antibody screen

We will cover the following topics of interest over the course of your pregnancy:

  • informed choice agreement. 

  • financial contract

  • exercise

  • emergency action plan 

  • parent education

  • sibling preparation

  • nutritional counseling, including vitamins 

  • birth expectations and preparation

  • childbirth education class referrals

  • breastfeeding preparation 

  • breech remedies, if applicable

 

Please keep track of questions you want to ask at your next prenatal visit. Some women find it helpful to keep a pregnancy journal for this purpose.


Birth Care:
When you start labor, I and my assistant(s) will come as soon as necessary or when you, as parents, feel you need us. There are at least two attendants in case mother and baby need care simultaneously. If I am not available when you begin labor (at another birth, for instance), I will provide you with a qualified midwife as my backup.

 

Before your home visit I will give you a birth supply list which you should fulfill. I will bring all other supplies to the birth at no additional charge.


Among other responsibilities during your labor, I will monitor your vital signs and general condition, cervical dilation, fetal position, and intermittent fetal heart tones with a Doppler instrument. 

 

In the unlikely event of an emergency, I come prepared with resuscitation equipment, oxygen, and anti-hemorrhagic knowledge, practical skills and natural remedies. I will make every effort to avoid perineal lacerations by using warm compresses for perineal support during second stage. I bring healing herbs and homeopathic remedies. I want to do whatever I can to facilitate your birth plan. Therefore, if you have a concern, please communicate that to me.

 

Immediate Postpartum Care:
Immediate postpartum care will last for a minimum of two hours, or longer if needed or desired by you, or determined by us.


Maternal care will include:

  • monitoring of blood pressure and pulse monitoring bleeding

  • uterine checks 

  • shower, bath, or sponge bath

  • establishing breastfeeding

  • check that mom is urinating within 3 hours

  • leaving the birth place clean and tidy

  • postpartum care instructions, written and oral, for mother and baby

 

Newborn care will include:

  • neurological and gestational age exam

  • weight and length measurements

  • prophylactic eye care as needed or desired

  • Vitamin K administration, if desired

  • cord care instructions

  • cord blood typing, if mom is Rh negative

 

Six-Week Postpartum Care:

Postpartum visits are scheduled at the following times and locations:

 

  • Day one (within 72 hours of the birth) at your home 

  • Two weeks postpartum at my office

  • Six weeks postpartum at my office

 

Postpartum visits will include the following:

  • complete newborn assessment 

  • checking your vital signs, lochia (bleeding), uterus, and perineum 

  • counseling in breastfeeding 

  • attention to nutrition 

  • questions and concerns 

  • Newborn Screen (PKU) 

  • newborn weight checks and measurements 

  • birth certificate information which I file with the state 

  • information regarding immunizations, circumcision, hearing screen, and natural family planning, if appropriate 

 

The following may be needed and are not included in our fee for services: diagnostic ultrasounds, RhoGam, lab work, newborn screen. I highly encourage you to phone me for any concerns that you have during the immediate and six-week postpartum period and beyond.

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