Care with a Home Birth Midwife
Updated: May 17, 2022
One of the first questions I am asked is, "What does home birth look like?" With this post I would like to paint a clear picture of what care looks like from the first prenatal, through the birth, and all the way to the sixth week postpartum. There can be situations that require a variance from normal, but below you can find an in-depth description of appointments, the schedule, care at the birth, and postpartum.
Prenatal visits are scheduled for one hour each. The first 30-45 minutes of our time together are used to discuss upcoming testing, routine procedures, newborn procedures, and more. You will be provided with information regarding tests or procedures (including risks and benefits) that can be done, so that you may make an informed decision. This way you are in charge of your own care. A list of topics include, but are not limited to:
Glucose Tolerance Testing
Vitamin K supplementing for the newborn
Erythromycin eye ointment for the newborn
Newborn Metabolic Screening
The process of informed decision making is a vital and valued part of your care and with each discussion you will be provided resources to explore.
The remaining 15-30 minutes are spent performing any bloodwork, a full set of vitals, listening to the baby's heart rate, palpating to find the baby's position, and measuring the fundal height of the uterus. The schedule for prenatal appointments is outlined below:
Onset of care through 28 weeks, appointments are every four weeks
28 through 36 weeks, appointments are every 2 weeks
36 weeks through the birth of the baby, appointments are every week
As soon as you think you are in labor we have open communication to determine the best time for me to join you. When I arrive at your house I will slowly begin to integrate myself into your birth environment so that you may get used to having a new presence around. The first thing I will do is ask questions for the admission, including simple things like what you've eaten recently, the last time you've slept, and how you're feeling. Once we get through a few questions and you start to get used to having me around, I will ask permission to feel your belly to assess the baby's position, and listen to their heart rate. A full set of vitals will be done in order to finish the admission. In order to monitor the baby, I will listen to the fetal heart rate every thirty minutes or more. Your vitals would be monitored in four hour increments.
Beyond the clinical aspect of what you can expect from me at your birth, I am also there to support you and your partner emotionally and physically. Throughout your labor I can provide position suggestions, counter pressure/hip squeezes, words of affirmation, and whatever you may find helpful. All women don't want/need support in this way and would prefer to be left alone with their partner to labor in private. This hands off approach is also an option, and you may want a combination of both throughout your labor; it is my job to follow your lead in order to support you in whatever way you need most.
After the baby is born, I will stay at your home for 3 hours after both you and the baby are stable. During this time we will encourage the golden hour for your new family to have precious moments bonding for the first time while my team and I clean up any equipment including the birth pool. This way, it won't look like a birth even happened by the time we leave. Once you get a blissful bonding period, we will reenter your space in order to perform the newborn exam, provide a placenta tour (unless this is not wanted), check your perineum for tears, and get you and your baby cleaned up and tucked in before we leave.
Postpartum visits are scheduled for an hour each. During this time we spend 30-45 minutes discussing anything and everything from nursing and baby's sleep, to postpartum bleeding and cramping. The remainder of the visit is spent doing an exam on the baby from head to toe, as well as taking a set of vitals on mom and baby. In the postpartum period, a Critical Congenital Heart Defect (CCHD) screening is done, as is a hearing test, and the metabolic screening if chosen by the parents.
Postpartum visit scheduling can vary a bit more. At Sol Midwifery, there are three visits in the client's home in the first week postpartum followed by two-three additional postpartum visits back in the office.
At or around 24 hours after the delivery (in the client's home)
At or around 72 hours after the delivery (in the client's home)
1 week postpartum (in the client's home)
2 weeks postpartum (back in the office)
4 weeks postpartum, this visit is not routinely scheduled but can be added in when additional monitoring is necessary
6 weeks postpartum (back in the office)
This season in a woman's life can bring some of life's biggest challenges followed up by the grandest rewards. It is a time to be looked back on like no other as you grow a tiny human inside of you. There will be periods of trial as well as triumph along the way. Each woman experiences the season of childbearing differently and regardless of what it looks like for you, I would be blessed to walk this path alongside you. If you have any further questions about what care at Sol Midwifery looks like, reach out! Interviews are free and the best way to determine if we would be a good fit.