How I Assist
I take on a limited number of clients at any one time to make sure I can give you the full care and attention you deserve.
The Licensed Midwife will
1. Maintain a normal obstetric schedule of prenatal visits -- monthly till 32 weeks, biweekly till 36 weeks, and weekly till birth. Evaluation for problems may require additional visits.
2. At prenatal visits, check mother's vital signs, urine for protein and glucose, measure fundal height, listen to fetal heart tones, and evaluate the baby's presentation and position.
3. Advise and / or administer 28 week Rhogam to Rh- mothers.
4. Advise the mother on other testings and screenings as necessary and advise where
they can be done or provide testing, if able (e.g prenatal labs, ultrasounds, blood sugar screening, and hemoglobin checks.)
4. Consult with or transfer care to other health professionals as the health of the mother and child dictate.
5. Give information related to pregnancy and birth, refer to other birth professionals and educators, and advise on healthy pregnancy and birth practices.
6. Be available from 37 weeks till birth or assure that another midwife from the birth
team is readily available.
Midwifery services for birth include
1. Attend birth whenever active labor is underway.
2. Assess maternal vital signs and fetal heart rate in relation to contraction pattern,
3. Evaluate contraction pattern and signs of progress in the areas of cervical effacement and dilation and descent of the baby's head through the pelvis.
4. Evaluate baby's presentation and positioning and provide suggestions for position changes to encourage baby’s continued progress to birth.
5. Provide for emotional and physical comfort, allowing the parents‘ privacy to allow for the normal hormonal processes to establish a good labor pattern.
6. Provide for energy needs by encouraging fluids and food, as desired.
7. Provide support for perineal tissues in second stage. Warm compresses, massage, and oil may be used if birth is occurring out of water for the mother’s comfort and to encourage perineal elasticity. A slow delivery of the head is encouraged to allow the tissues to stretch.
8. Deliver baby and placenta by natural methods, encouraging position changes as
needed. Place baby in mother‘s arms unless newborn resuscitation is required. Cord clamping is delayed till cord pulsing is done.
9. Assist baby with respiration and effective heart rate as needed, maintaining warmth, and helping with the initiation of breastfeeding.
10. Perform newborn exam, providing medications as mandated by state regulation and per parental consent.
11. Assess immediate postpartum status of mother, provide for safety and comfort
measures, and administering medications, if needed, for the control of postpartum
I visit with mother and baby in the mother's home at 24-36 hours postpartum for mother and newborn exams, pulse ox screening, and administration of Rhogam, if needed, for Rh- mothers.
I advise the mother on other testings and screenings as necessary and advise where
they can be done or provide testing, if able (e.g. metabolic screening, pulse ox screening, hearing screening)
After birth, I gather information from the parents for completion of the birth certificate and submit information to the Department of Vital Statistics. Parents may request a copy in 6 weeks from that department.
I support and assist the parents, when needed, with breastfeeding needs and well baby care. Referrals for more advanced lactation support or newborn care can be provided.
I advise the parents to see the baby's care provider within the first 2 weeks, preferably
by the end of the first week of life.
I provide a 6 weeks postpartum visit. Other visits are scheduled in the interim to
assess mother and baby health and well being.