PRENATAL CARE:

While observing standard practice, Monica also personalizes care to fit the needs of each client.  Prenatal care serves several purposes.  Its primary purpose is to allow the midwife to check on the mother and growing baby.  Subsequent routine visits allow time to address any questions that may have surfaced.  Another benefit is that children in the family become comfortable with the midwife and her equipment.  Also, time spent together helps the client and midwife develop a trusting bond that will become important during the hard work of labor.

As a "mobile midwife," Monica will travel to you for prenatal visits, bringing any necessary equipment, supplies and a lending library of books and videos.  Early visits include labwork and prenatal testing.  Subsequent routine visits serve the purpose to check that the client's pregnancy is continuing within healthy parameters.

The client will have the opportunity to meet any assistants who will be present to help with the birth.  The midwife will provide a list of supplies to gather for the birth, including some common household items and other items easily purchased at a drug or department store.  As an option, a waterbirth pool can be purchased or rented to have available at the time of the birth.  

LABOR AND BIRTH:

When a client feels that she might be in labor, she calls the midwife.  The midwife and assistants will travel to her home to be with her throughout the labor, birth, and for the first several hours right after the birth.

During labor, the baby's well-being is monitored intermittently with an ultrasonic fetal doppler, which easily picks up the baby's heart rate to let us know how the baby is handling the labor contractions.  The client is helped in finding coping mechanisms with which to handle contractions: rhythmic breathing styles, acupressure, massage, and lower back counterpressure.  Being in the warm water of a shower, bath, or birthing pool takes the edge off contractions and allows the body to relax and work more effectively in dilating the cervix. 

The midwife carries equipment and medications to handle common complications that can occur during labor.  Sometimes it becomes necessary to transfer care to a physician for the remainder of labor.  In this situation, the midwife would accompany the client to the hospital and continue with labor support.

A client should feel free to eat and drink as desired in labor, and to take any comfortable position.  We aim to keep the birth low-key, allowing the woman's body to guide the pushing contractions which bring the baby.  The baby is brought into the world and placed with the mother.  The midwives do an initial newborn assessment while the baby is snuggled into mother's arms for warmth and to initiate breastfeeding. 

The midwife stays with the new mother and newborn for about 4 hours after the birth to make sure that all is well, and remains available to the new family by pager and phone, with the first follow-up visit made the next day.  The home is left in clean condition, with only two bags left to deal with: a bag of laundry and a bag of trash. 

POSTPARTUM CARE:

After the hard work of birth, it's wonderful for the new mother to be able to relax at home and let the midwife come to her.  The midwife will return the next day to check on things.  The state-mandated newborn screening (PKU) test is generally done 1-2 days after the birth.  Home visits are made several times in the first weeks to check on the mother's recovery and baby's adaption to newborn life.  Breastfeeding is evaluated and the baby's weight can be checked using a soft sling scale.  The birth certificate process is initiated, to be completed at the local town clerk's office.  The new baby is seen at a physician's office within the first few days after the birth for an overall checkup.

The new mother should have 24-hour in-home help for at least the first week after the birth.  A woman with other children should have someone lined up to help care for them.  For the new mother, sleep is of the utmost importance.  For well-meaning friends or relatives wondering how to help out, it is especially nice to bring by nourishing meals, do a little housecleaning, or pick up supplies at the store.

The midwife makes a final check at 6 weeks postpartum, where we say our bittersweet goodbyes until we meet again.

PAYMENT:

Payment options include Medicaid insurance, certain health plans that offer out-of-network provider coverage, or budgeted cash payments.  Additional travel fees and the birth assistant fee are generally not covered by insurance.