What is a midwife

From MANA (Midwives Alliance of North America):

"Midwives are the traditional care providers for mothers and infants. Midwives are trained professionals with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide women with individualized care uniquely suited to their physical, mental, emotional, spiritual and cultural needs. Midwifery is a woman-centered empowering model of maternity care that is utilized in all of the countries of the world with the best maternal and infant outcomes such as The Netherlands, United Kingdom and Canada."

https://mana.org/about-midwives/what-is-a-midwife

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Midwives Model of Care

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The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.

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The Midwives Model of Care includes:

• Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle

• Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support

• Minimizing technological interventions

• Identifying and referring women who require obstetrical attention

 

The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

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http://cfmidwifery.org/PDF/mmoc_brochure.pdf

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Safety of home birth

Studies have shown that planned home birth for low risk women leads to lower interventions in labor and birth without an increase in risks for mom or baby. 

https://mana.org/pdfs/DOR-Outcomes-Paper-Fact-Sheet-on-Risk.pdf
https://mana.org/blog/new-studies-confirm-safety-of-home-birth-with-midwives-in-the-us

https://www.citizensformidwifery.org/resources

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Safety of water birth

Click the link below for information on the safety of water birth:

https://evidencebasedbirth.com/waterbirth/

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Areas Served

I serve Tuolumne County and parts of Calaveras and Stanislaus county. Please contact me with your location to see if I serve your area. Some areas may be too remote for a home birth but we can discuss options. 

 

Medications

I do not offer pain medications. We use movement, massage, water and other non-pharmaceutical forms of pain relief in labor. I do carry medications and herbs for postpartum hemorrhage, oxygen, numbing medications to use for suturing, and medications for your newborn. 

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Newborn Medications & Testing

At home we offer most of the same medications offered to newborns at the hospital. We have erythromycin eye ointment and Vitamin K (either oral or injectable), see links below for more information on these. We perform the Newborn Screen Test and the Screening for Critical Congenital Heart Defects at home during one of the postpartum home visits. We are trained in neonatal resuscitation to assist your newborn if they do need help after the delivery. We will discuss all testing and medications with you so you can make an informed decision for your newborn. 

 

I do not offer the Hepatitis B vaccine that is standardly given at birth at the hospital or the newborn hearing screening.  You can get the Hepatitis B vaccine through your pediatrician or the health department if you would like it. The hearing screening is done at the hospital and you will need a prescription from your pediatrician. 

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Links to more information on newborn medications and procedures:

https://evidencebasedbirth.com/evidence-for-the-vitamin-k-shot-in-newborns/

https://www.healthychildren.org/English/ages-stages/baby/Pages/Purpose-of-Newborn-Hearing-Screening.aspx

https://archive.cdph.ca.gov/programs/nbs/Documents/Newborn-Screening-Brochure-EN-SP-2016-Web.pdf

https://www.cdc.gov/ncbddd/heartdefects/cchd-facts.html

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Prenatal tests and ultrasounds

I am able to order standard prenatal testing, genetic screening, and ultrasounds. All testing options will be discussed at your appointments so you can make informed decisions on what testing you would like. 

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Genetic Screening Information:

https://www.youtube.com/watch?v=-vIJGFWJquk&t=7s&index=1&list=PL82Z-swK0-4lq6SaKF_lCRquP15gJ3VG0

https://www.cdph.ca.gov/Programs/CFH/DGDS/Pages/pns/default.aspx

https://www.sequenom.com/tests/genetic-counseling

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Care schedule

Prenatal care schedule:

• Monthly appointments until you are 28 weeks pregnant

• Appointments every 2 weeks from 28-36 weeks

• Weekly appointments from 36 weeks until you give birth

Visits usually last about one hour and are at my office

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Postpartum care schedule:

• 1 day home or office visit (depending on location of your home)

• 3 day home or office visit

• 5-7 day home or office visit

• 2 week office visit

• 6 week office visit

Visits usually last about one hour. Care schedule may vary slightly depending on your location and any issues that come up postpartum. 

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Breech and Twins

Legally in California I am not allowed to attend breech or twin births at home. I am happy to help you to find the best option for the birth of your breech baby or twins and may be able to provide doula care for a hospital birth. 

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VBAC

I do attend VBAC births at home or will work with you to find the best hospital birth option if a hospital birth is desired. I will need the hospital records from your cesarean to review. 

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Some resources for more information on VBAC:

http://www.ican-online.org/

https://consensus.nih.gov/2010/images/vbac/vbac_statement.pdf

http://www.childbirthconnection.org/giving-birth/vbac/basics/vbac_basics/vbac-future.html

https://evidencebasedbirth.com/ebb-113-the-evidence-on-vbac/

https://www.thevbaclink.com/

https://vbacfacts.com/

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Cost and insurance

I do accept most insurance and I also have cash pay options. The out of pocket cost to you will vary depending on what type of insurance you have, your deductible, and your co-pays. Please contact me for more information. We can review your insurance together and I can estimate the out of pocket costs. Estimates should be paid by 36 weeks or a payment plan should be agreed upon. I do not currently accept Medi-Cal or any Medi-Cal managed care plans. 

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Children at birth

Your other children are always welcome at your birth. I do

suggest, especially for younger children, that you have another

adult that is there just to care for your children. 

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