The Beginning of Labor
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Throughout your pregnancy, we will review signs of labor and when to call us. When you think you are in labor or your water breaks, you can call us no matter what time of day or night it is. Your midwife will discuss what signs and symptoms you are experiencing. If you are unsure, sometimes we will head over to do a quick assessment. When you're ready for us to come, we will let you know we are on our way and head to your home.
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Initial Assessment
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When we first get to your home, we will ask how you are doing , make sure you are comfortable and all your needs are met. Next, we will set up all our medical supplies and emergency equipment. We'll check your vital signs including blood pressure, pulse rate, and temperature and offer the option of a cervical exam to determine your approximate dilation. We will also check baby's position with Leopold's maneuvers and listen to their heart rate.
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Support Measures
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We love having experienced doulas attend births with us and we offer referrals to ones we recommend during your pregnancy. When you are in labor, we will suggest various comfort measures, positions, and ways your partner may support you. Once you are in active labor, hydrotherapy such as the birth pool or shower is often relieving. We provide continuous support and create the ideal space for you to labor down your baby, whether that is surrounded by family and friends or with just your partner.
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Vital Signs
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During labor, we will monitor your blood pressure, pulse rate, temperature. We will also listen to baby with the Doppler intermittently throughout labor and birth. If you are GBS positive, we also offer the option of intravenous (IV) antibiotics. We may also offer cervical checks intermittently to determine approximate dilation and station.
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Pushing and Birth
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When you are fully dilated and feel the urge, you can push however you like, in whatever position is comfortable for you. Our clients often find that squatting or being on their hands and knees is the best position for them. We may encourage you to take deep breathes and help you relax in between contractions. When your little one is born, they will go immediately on your chest. In the rare instance that a baby needs a bit of help breathing, we are fully equipped and trained with oxygen and other emergency equipment. Our team is certified in CPR (Cardiopulmonary Resuscitation), BLS (Basic Life Support), and NRP (Neonatal Resuscitation Program).
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After You Give Birth
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Immediately following birth, we place baby skin to skin with you and make sure you both are stable. When you begin to feel cramping again, we will see if your placenta is ready to be delivered. When it is, we will encourage you to give one more push for the placental delivery. After the placenta is delivered, we examine it to make sure it and the membranes are complete. Next, we examine the umbilical cord. If it is opaque and white it indicates it is ready to be clamped. The partner or whoever else the birthing person wishes may cut the cord. If there is any excessive blood loss, we may administer herbal tinctures or medication to help your uterus go down more quickly and slow bleeding. We will also examine your vagina and perineum for any tears and do any necessary suturing on first or second degree tears with local anesthesia.
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Postpartum Care
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Next, the birthing person and baby are settled down comfortably to rest for the first hour to promote bonding. We will take your blood pressure and pulse rate, listen to baby's lungs intermittently and monitor breathing while we tidy the birthing space.an hour from the time of birth, we see if you would like to get up, shower, and use the bathroom. Meanwhile, one our team will set up equipment for the newborn exam and replace any bed sheets or blankets that may have birth products on them with clean ones. Once you are settled back in your bed and comfortable, we begin the newborn exam in front of you.
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The Newborn Exam
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During the newborn exam, we will weigh and measure your little one. We will then do a quick physical exam to assess gestational age and make sure that your baby is doing well. Partners or family members often enjoy participating in the exam and taking guesses about how much the little one will weigh.
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Before We Leave
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A few hours after birth, we will do one last set of vitals on you and your baby. We'll make sure you have all your needs met and that both you and the little one are doing well. Once you feel like you are comfortable and have all your needs met, we will pack up our supplies and discuss scheduling for the 48 hour postpartum home visit before we leave.
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Image credits: Kristen Dunn Photography
