— any questions? —

I expect you to take responsibility for your care. This includes coming to your prenatal visits,prepared to learn about your pregnancy and birth. You need to take an active role in preparing for your birth; learn skills to work through labor. You need to be honest with me about your history and what is happening as your pregnancy progresses. This is important to keep you safe during your pregnancy and birth.

each visit includes updating history, evaluating growth of the uterus, maternal blood pressure,listening to baby’s heartbeat and working through a teaching checklist appropriate to the point in pregnancy. We talk about childbirth education options, ways to improve comfort in pregnancy, preparing for the birth.

All pregnancy visits, care in labor/birth, postpartum visits. You would be responsible for outside lab fees, outside ultrasound and some supplies for birth (a small supply box costing approx. $40) If you are self-pay or have a large deductible, we are able to find you less expensive lab and ultrasound costs.

we draw most labs during your regular office visits.

We evaluate how you and your support persons are coping with labor- physically and emotionally. Baby’s heart rate is evaluated every 30 min during active labor and every 15 min during the second stage. Cervix is evaluated only as needed- not on a routine basis. If Cervix evaluation helps with plan of care or deciding how to best care for you, then that exam is

Soon after birth our birth assistant and midwife begin to clean up your birth space, tubs are emptied and cleaned out all garbage is discarded and laundry is begun the only usual hint of a baby being born is the BABY!

In the immediate time after birth, the birth team stays with you about 2.5-3 hr., ensuring that mom and baby are both recovering well. Once we are sure that you have both eaten, bleeding is normal, baby is weighed and examined, we tuck you in for a good rest. We return to your home at 24-36 hr. and again on day 7 to do full evaluations on mom and baby. Then office visits at week 3 and week 6 to finish up the official pregnancy/ birth care. There are 3 baby screenings mandated by the state that include: oximetry testing to evaluate for severe heart defect, newborn blood screening to evaluate to metabolic blood disorders, and hearing screening. We offer all 3 of these screenings to you in the postpartum period.

37 weeks is considered full term. An experienced mother may be able to remain at home after 36weeks, but this also depends on other risk factors

Every member of our staff is NRP Certified, BLS Certified and trained in pregnancy/birth/postpartum emergencies.  We carry medication to help prevent and manage postpartum bleeding, oxygen for mom or baby and all of the other basic life saving equipment.

Terrie has attended about 2000 births. The first 1500 were while working as a CNM in hospital practices for 13 years before beginning home birth

hospitals in our practice area have treated our clients very well. Once transfer is decided, the midwife calls the hospital and lets them know the situation of the transfer and when to expect the client’s arrival. The midwife usually accompanies the family to the hospital to ensure complete communication to the accepting care team. Also ensure that the family understands the care options and is supported through this transition. Since the midwife cannot care for the client in hospital, we often leave once this transition has occurred.

About 15% for all reasons:  in pregnancy, during labor or immediately after the birth (for mom or baby).   Most transfers are non-emergent and can be accomplished by private car. Transfers in labor are typically for first time moms that may have long exhausting labor and need help with rest or improving labor’s effectiveness.  Another reason in labor may be for a mom with more bleeding than expected or fetal heart rate concerns that warrant closer watching.  After the birth, the mother may experience more bleeding than expected.   The bleeding is usually managed with medication or massage, but the mom may require more support or evaluation.   Baby may need extra assistance or evaluation that can be accomplished at home.   Midwives and the assistants all are certified in neonatal resuscitation and most babies that need help are doing well in just a few min.   But if they require more help, transfer to hospital may be needed.

No hospital privileges It is rare in the United states for homebirth midwives to also have hospital privileges. Sometimes this is dictated by the political environment, some by the malpractice insurance company that insures a specific hospital