This is the meeting set up for us to get to know each other. Unlike many client/business relationships, both parties have a decision to make in whether or not we are the right fit for each other. The reason why we both need to feel right about it is because it is such a big decision. You are adding a new member to your family and looking for the right person to guide you through the pregnancy and birth and transition to being new parents for the first time or new parents to another baby.
That being said, although all our prenatals are family/kid friendly, (see below) we do ask that for the consultation parents find a babysitter (if at all possible) due to the nature of the appointment. It is hard for the questions the parents have to be asked and the paperwork I have to be discussed properly when trying to keep their children entertained. It is important to get to know each other at this visit to know if we are the right fit for each other.
This appointment should take about one to one-and-a-half hours depending on where you are in the process of choosing your midwife and birth site. If you are just starting out, it may take longer because you may have more questions, but if you have already had a homebirth, or interviewed other midwives everything will be familiar and you won’t have as many questions.
This appointment takes place in our home office, and we do ask that, if possible, both mom and dad attend, because together they need to feel comfortable with their choice in a care provider. We generally start off with us answering your questions that you bring along, and then we go through our paperwork answering any other questions that come up as well. We then send the paperwork home with you to read over in greater detail and should you choose New Birth as your care provider you can call or email us, and then send us the completed health history form so that we have a chance to look over it to be sure there are no surprises.
One thing that can be helpful but not necessary is for you to bring copies of your medical records to go over at the consultation. Especially records including previous pregnancies and births.
Prenatal appointments are held at our home office except for the 36 week home visit when we come to the client’s home, we go through her gathered birth supplies and tour her home and talk more in depth about her birth plans. Also, we ask that anyone that the parents want to have at their birth attend this prenatal if at all possible, or at least send in any questions so that we can talk through them and have them cleared up before the birth.
Appointments are always family friendly, if parents already have children, they are welcome to come to the prenatal, just plan for the appointment to take a bit longer due to possible distractions I do have a few toys in my office, but if your child has favorites, I recommend bringing them.
At the appointment we sit down and talk about what has happened since the last time we saw each other. We talk about how you are feeling, have you step on the scale, and we check vitals. Then we do the fun part which is feeling the baby and listening to the heartbeat.
After that we are usually done unless there are more significant things to talk about – concerns or questions that the parents might have etc. We always recommend that both mom and dad keep a piece of paper that is easily accessible (on the fridge for example) to write down questions they come up with during the week since it is easy to forget what they are especially in the beginning when we don’t meet as often.
Some appointments are slightly more involved – the first one where we need to do more paperwork and do lab work, transfer medical records etc, then the 28 week appointment where there are extra labs that need to be taken and education that needs to be done and then the 36 week appointment when we come to your house to do the home visit and see the space (even if you live in a small space, don’t worry, we have tricks up our sleeve to make it work) so that we know the lay of the land when you are in labor.
Appointments can be brief – as short as 20 minutes if time is of the essence on the clients’ part, or they can be longer (normal is usually between 45 minutes to one hour).
Actually, we’ve found home birth to be less messy in most cases. First of all, there are not tons of drapes used, and in hospitals, women are generally covered “nipples to knees” in antiseptic. At a home birth that isn’t necessary, so this cuts down on the amount of mess.
Since episiotomy is rarely used, it can also cut down on the amount of blood loss. As for the fluids and water that are expelled during the birth, if the mom delivers in the water (which is highly recommended) the mess stays in the tub, the mom gets out and either goes to the bathroom to clean up (with the midwife helping her) or gets wiped down with warm water and a towel if she isn’t quite feeling up to a shower yet and goes to bed. Then, the midwives use the pump they brought to flush the water/mess into the toilet and it magically disappears!
As your midwife we will also ask that you order a home birth box – it has disposable chux pads – the blue, plastic backed cloths that are very handy in catching the majority of these fluids. We will also recommend using old sheets for the bed and having a layer of plastic under the old sheets.
After we fully inspect it (and offer the parents the chance to see where their baby lived for the last 9 months) we put it in a double ziplock bag, clearly label it and put it in your freezer. Then you have some choices—you can save it for planting in your garden (it makes a wonderful fertilizer,) or you take it out and put it in the garbage on garbage day (we freeze it so it doesn’t smell) or some people choose to encapsulate the placenta and the mom can take it as supplements since it is so full of nutrients. There are studies that have shown it to help with lactation and postpartum depression. As your midwife, we support that and are happy to help you connect with someone who will encapsulate your placenta.
As your midwife, we will check on you and your baby’s well being at every prenatal visit and if you are healthy during your pregnancy, you should be able to have a normal, uncomplicated birth. As midwives, we are trained to recognize signs of complications as they arise, and we carry supplies and equipment for handling the most common complications of childbirth, including but not limited to: hemorrhage, cord around the neck of the baby, shoulder dystocia, etc.
Together with our clients, we will also make a transport plan before birth so should a complication arise that cannot be managed at home so we are prepared. Should we have to go to the hospital, we will absolutely stay with you and advocate for you at the hospital, we become your doula in the hospital instead of your midwife. Most of the time, when a transport is necessary, it isn’t an emergency situation, and we go in private cars (your midwife with you, and the assistant following in another car) and we go to the hospital of your choice. Of course if it is an emergency, we will call 911 and go to the nearest hospital in an ambulance.
Home birth is only for low-risk women. However, the definition of low-risk varies among care providers. For example, some practitioners may consider a woman with a previous cesarean to be high risk, and some might not. Because this is a personal subject, we would like to speak with you in person about it. If you think you may not be able to have a home birth because of medical complications, please call us, and together we will talk about whether or not home birth can be an option for you. We also go over this topic more in detail at the consultation.
YES! Everything about midwifery care is family friendly—the appointments as well as the birth. The only thing we ask about children being at the birth is that parents prepare them for it by watching videos and talking through the process and that they have a care provider specifically present for the kids if they need to leave the birth or need anything (since mom and dad will be busy!). It is important that the kids know they are allowed to leave if they want to and that the person caring for them knows that.
Family and friends are very welcome as long as they attend the 36 week home visit (if at all possible, obviously if they live out of state, we will work something else out). All must be in support of the choice the parents are making for a home birth and it will be the birthing parents’ choice who comes and doesn’t come – as your midwife we will support the birthing parents’ decision.
We LOVE doulas! And doulas love home birth! This is the kind of birth where they can really do what they love to do – support natural birth at it’s best, they are more free to do labor support than in the hospital. That being said, however, we would like to mention that because you will already be in a supportive environment, a doula might not be as necessary as she would be in a hospital setting where you are needing to fight for the kind of birth you want, so her help as your advocate is wonderful to have.
We would like to put a plug in here for birth photographers. Most people are taken aback by that idea – thinking that the photos that would be taken would be weird and gross, but in fact, it is the complete opposite. 98% of the photos taken are beautiful and emotionally stirring – helping you to remember the wonder that was and helping you to share your story with friends and family (a book would be a great coffee table adornment!) and only 2% are private, but because it’s all digital now, those are easily kept private on a CD that can be tucked away. If you want a place to find several different photographers that also support natural birth go to www.mnbirthphotographers.com.
We specialize in the care of normal, healthy newborns and provide regular care for the first few weeks of your baby’s life. However, It is a good idea to have a care provider (family practice or pediatrician) set up ahead of time in case your baby needs some additional assessment or care in those first few weeks. We are able to do the newborn screening (parents need to buy the card, with my help for $106) but do not have the necessary equipment to do the hearing screening which is highly recommended to be done as soon as possible, but at least before 6 months of age. If parents want the newborn screening to be covered by insurance, the dad will need to take the baby to a clinic or hospital to be tested which we can discuss further in person.
There are two broad categories of midwives in the US:
- Nurse midwives with the letters CNM who receive their training primarily in the hospital and mostly attend hospital births
- Direct-entry midwives who primarily practice in out-of-hospital settings
Among direct-entry midwives, some are certified (Certified Professional Midwives or CPMs) and some are licensed by their state (LMs or LTMs) and some choose not to be certified or licensed (in the state of MN licensure is optional at this time). We are both certified and licensed in the state of MN & WI.
Absolutely! We are all for an involved dad in the birth process, so if this is something the birthing parents would like to explore, we will do so during prenatals. There will be babies that need a little extra help coming out, so it may need to be a team effort, but we are happy to have the dad be as involved as he wants to be. Of course, if he isn’t quite ready to catch, but wants to cut the umbilical cord after birth, that is a great place to start too!
This depends on the specific midwife, so this is a good question to ask each midwife that you interview. We specifically carry oxygen for both mom and baby, medications/herbs for hemorrhage, suctioning equipment, catheter, suturing equipment (for 1st and 2nd-degree tears only) and numbing agents if suturing is necessary. We also have a water-proof doppler and other equipment necessary to monitor mom and baby’s well being during labor and birth and for several hours after. If you have questions about this, please call us.
We highly recommend renting or buying a birthing tub that we can set up in your home. Water immersion is highly effective in reducing pain and helping moms to relax during labor and birth. Otherwise, walking, staying upright and touch are all very helpful as well. The support that comes from being surrounded by people who love you and support your choice for natural birth is also very comforting and can help with pain management.
We also recommend that parents (especially first-time parents) attend natural birthing classes so they prepare themselves as much as possible. Because midwives never induce labor using Pitocin (which can cause unnaturally long and painful contractions that are much closer together than normal) the need for medicine (like epidurals) is greatly reduced.
The freedom a woman has in her own home to do whatever works for her (whether it’s moaning or reciting poems, scripture etc), makes it easier for her to deal with the pain of childbirth. In hospitals, women too often feel they must conform to some unwritten code of acceptable behavior.
Most likely, yes. The type of housing available for the birth is usually not a concern and there are a few things you can do to make sure there won’t be any problems when you are in labor. We do ask that there be electricity and running water, the place be relatively picked up and clean, but we can go over that in more detail as you approach your due date. Some things you can do to prep for a home birth:
- Tell your neighbors (both sides and across the hall) that you are planning a home birth, and when your due date is. Explain that there will be more people around during that time, there might be more noise, and it might be at weird hours of the night, but not to worry because you have a trained birth attendant at your birth.
- You might also want to think about posting a note by the mailboxes and/or on the front door to let people know that a “birthing party” is in progress.