For Mothers

Midwifery prenatal care is different…

Your midwifery care starts with a Meet & Greet early in the first trimester. This is an informal appointment in the office to engage in a conversation about birth with our practice. You and your partner have the opportunity to ask questions and review any individual health concerns.

Once you have decided to hire us as your birth team… the fun really starts!

We hold all our prenatal appointments on Tuesdays in our office location. We have a recommended prenatal schedule that we share with you. We have found that 30-45 minute appointments that progress from monthly to bi-weekly and then weekly are the best to build rapport and trust. The initial appointment gives us time to review documents, complete an in-depth health history, and order prenatal lab work. We also have the opportunity to collaborate with a local functional medicine doctor! This exciting partnership, called “Optimal Prenatal Care” digs deeper into the individual physiological processes with specific lab work, nutrition programs and exercise recommendations. To learn more, please see {Optimal Prenatal Care Page}.

Our prenatals focus on the whole woman, not just the growing baby. It is important for us to check in on all aspects of your health and well-being. We can guide each woman with nutritional upgrades//adjustments, supplementation, and exercises and stretching. All of these are important to secure a low risk birth in your home. It also sets you up for a good postpartum recovery.

The 36 week prenatal appointment is held in your home. This is extremely important so that we can work out any traffic concerns/directions, and become familiar with your home. We love meeting your fur family too!!! This is the time to have all your supplies purchased and organized.

Midwifery labor and birth care is different…

Most births follow a pattern. Some moms have lots of early pre-labor signs; some moms have little to none. But, nonetheless, we love having a heads up. We can be anywhere in the 757. But, we do need time to get to you. We always review when to call your midwife at the 36th week prenatal home appointment.

Once active labor is established, we are by your side. This is typically when contractions are 3-5 minutes part lasting 45-60 seconds for about an hour. We will get our equipment set up and take admission vitals on mom and baby. Then we observe. Observation is key at a home birth. Midwifery looks more hands off (sometimes) than obstetrical birth. This is because we are respecting the physiological process that mom and baby are engaged in together. If a mother is desiring a water birth, the birth tub will be set up by the birth team. This process can take anywhere from 1 hour to 2.5 hours (all depends on hot water tanks). The birth tub is best utilized at the transition stage of labor. We fully support land births or water births.

Throughout labor we are charting and repeating vitals on mom. Fetal heart tones are checked intermittently with this frequency increasing as labor approaches second stage. Vaginal examinations are not a routine procedure in our practice.

Moms are encouraged to push when they feel the urge. Second stage labor positions are mother led and suggestions may be voiced by the midwife if needed. We have found that moms who help receive their baby have less perineal injuries and push more effectively with their babies.

Once baby arrives earth side, moms reach for their babies and bring them to their chests. Immediate skin to skin is supported and highly encouraged. If baby needs any assistance transitioning, most of our techniques can be done on mom’s chest with minimal interruption to bonding.To aid in physiological birth, we want moms to sniff their baby’s heads (no immediate hatting of baby), kiss their baby, and gaze upon their baby. The birth room is generally quiet to not disrupt these first tender moments between mom and baby. Dads are up by mom’s side and encouraged to do the same.

Our practice does very delayed cord clamping and cutting. This is usually done at the 2.5 to 3 hour mark; right before the newborn examination.

The third stage of labor is not rushed. We will be checking for third stage contractions and signs that the placenta has released from the uterine wall. Moms will work with their bodies to birth the placenta. This will be wrapped and placed carefully next to you and baby. Most babies will then latch on the breast for the first time. We encourage a nice long undisturbed first nursing session. A birth team member will prepare a small snack for mom and dad to eat.

The birth team stays at the home for about 3-3.5 hours in the immediate postpartum. We will break down and clean the birth tub, if it was used. Charting of the birth will continue and vitals on both mom and baby are checked every 15 minutes. This is done gently and without interruption of nursing and bonding. The newborn examination will take place at the foot of the bed — baby is checked out from head to foot and all measurements are then recorded. Each baby is blood typed via the placenta. We will clean up the birth space, take out the trash, start the laundry, and tuck the new family into bed.

Midwifery postpartum care is different…

Postpartum care is divided into two sections: Home Postpartum Care and 6 Week Postpartum Appointment

Home postpartum care consists of 3 visits within the first 10 days. The first home visit is done within 24-36 hours of baby’s birth. Between the departure of the midwives from the birth until this visit are several phone/text check-ins for updates. This postpartum visit consists of a full newborn examination and several optional newborn tests. The Critical Congenital Heart Defect Screening and the Newborn Metabolic Screening can be performed at this visit. Mom is also checked out and vitals performed. We will review postpartum care and expectations for healing. 

As licensed midwives by the state of Virginia, we are required to electronically file a Certificate of Live Birth. We have 7-10 days to file this and cannot do it until a full legal name has been chosen for the baby. We will bring all documents to a home postpartum visit for signing. Parents can opt for the Social Security Card to be issued with this paperwork, if desired. Two copies of the state issued birth certificate are included in the cost of midwifery care with our practice.

The second home postpartum visit is done between 3-5 days after birth. The baby and mother are checked out completely and all vitals repeated and charted. Nursing is assessed to determine the need for lactation consultation. We will review postpartum care and expectations of healing. The Newborn Hearing Screen can be performed at this visit.

The third home postpartum visit is done between 6-10 days after birth. The baby and mother are checked out completely and all vitals repeated and charted. Nursing is once again assessed to ensure milk is in and baby is gaining weight. At this time, the medical chart for the baby may be faxed to the pediatrician/family doctor of your choice.

The birth team will check in via text/phone each week between the last home postpartum visit and the in office 6 week postpartum appointment.

Each client and baby are brought into the office at 6 weeks postpartum. We have time to talk about your labor and birth, hear concerns and successes during your postpartum experience. We are more than happy to make referrals to Pelvic Floor Therapists and order any additional lab work. This visit closes our midwifery journey together for this pregnancy and baby. We always enjoy the hugs and baby snuggles.