pittsburghmidwife@zoominternet.net        © 2016 Jennifer Nelson         724-968-2264

Care Options Throughout the Child-bearing Year

Home Birth Midwifery Care Services

This complete package provides the family with comprehensive traditional midwifery services for prenatal care, home birth, and postpartum care. 

Prenatally, we will

  • Conduct an initial interview to discuss our philosophies and your desires for your pregnancy and birth.  This will be a time to discuss how we practice and to answer any questions.

  • Provide my Informed Disclosure to discuss and have signed.

  • Schedule an initial prenatal visit and subsequent visits, one visit per month until 33 weeks, then every 2 weeks until 37 weeks, then weekly until your birth.  Visits will include assessment of blood pressure, fundal height, fetal heart tones, intermittent urine dip, nutrition and diet, questions and discussions, education and information for each stage of pregnancy. 

  • Provide routine prenatal evaluation and refer any findings that are outside of my scope of practice. 

  • Document and maintain accurate records of care, history, visits and tests, and any referrals or suggestions.  Clients will have access to copies of pertinent records as needed. 

  • Provide physical, mental, and emotional support to couple when possible, referring any serious conditions. 

  • Be available by phone, text, or email for questions or concerns.

During your birthing time and immediately postpartum, we will

  • Be available by phone 24 hours a day from 37 weeks on.  I will stay in close communication with you throughout early labor and will come to check on you and baby if warranted.  I will arrive at your house after active labor has begun and will bring all necessary midwifery equipment with me with the exception of your birth kit.

  • Monitor labor, assess vital signs of mom and baby, and provide labor support and suggestions as much as possible.  We will respect and support your desires for the birth with you but will let you know if we are seeing any signs that your baby’s well-being may be compromised.

  • Provide a newborn exam on baby, notify you of any abnormal findings, and recommend referral to a higher level of care if necessary.  We will provide initial breastfeeding support and help you to clean up or shower as desired. 

  • Assess your perineum for any tearing that may have occurred.  We will provide instructions for care of this if necessary.  We will recommend referral for sutures beyond my scope of practice.

  • Stay about 2-3 hours after the birth, monitoring vital signs of mother and baby, and longer if continued observation is required.  We will also try to clean up the birth room and take all laundry to your requested area once you are resting and comfortable.  Before leaving, we will review postpartum instructions with you and your family. 

  • Be available by phone for any questions or concerns.

  • If I am not able to be at your birth due to extenuating circumstances, I will arrange for a back-up midwife.

  • If a situation arises that cannot be resolved at your home, we will recommend transport to the hospital.  If circumstances allow, I will go with you to the hospital to help with transfer to medical staff, and may remain longer for labor support, depending on the situation.  All care will be transferred to the physician.

  • In the event of an emergency where help is needed immediately, I will call 911 and you will be transported by EMS.  It is my policy to call 911 and transfer care to the EMS crew if you refuse to transport in the event of a life-threatening situation for you or your baby.

During your postpartum period, we will

  • Visit you in your home around 24 hours after birth and again at around 2 weeks postpartum. 

During these visits I will assess: maternal well-being; bleeding and vaginal discharge; fundal height and firmness; breastfeeding problems or concerns; perineal exam if necessary; psychological or emotional concerns; baby’s color, vital signs, breathing, cord healing, and sleeping.  We will also discuss family planning options and cycle tracking.  I will complete registering your birth with the state and requesting a social security number, if desired.  Your birth certificate will be directly mailed to you as will your social security card.

  • Be available by phone and text for any needs that may arise.

  • Provide a 6 week appointment if requested or if further assessment is necessary.

Due to the nature of home birth and the relationship we will be forming, we also have reasonable expectations of our clients as well. We expect our families to... 

Prenatally:

  • Secure all birth supplies from birth supply list and have them gathered and accessible by 37 weeks.

  • Accept responsibility for making decisions about your care and provide honest feedback to your midwife about your condition and concerns.  Also, communicate to my midwife about what is or is not working in our relationship.

  • Maintain appropriate nutrition and hydration throughout my pregnancy to promote the health of my baby and myself.

For labor, birth & postpartum:

  • Provide an environment for mother and baby that is restful and helpful to their recovery. 

  • Provide time for maternal-infant bonding and family adjustment.

  • Line up help, family, friends, or professional help for the first week or two to help with household chores and meals and siblings if applicable.

  • Call immediately with any concerns.  Schedule a follow up visit with chiropractor, naturopath, family physician or pediatrician for the newborn within the first 2 weeks of life.

Monitrice

The word "monitrice" is French for one who monitors, coaches, and instructs.

For various reasons, home birth may not be the best option available for some families.  We understand and support these families as well to have options available to them for labor and birth.

A monitrice provides physical, emotional and informational support to the expectant family during labor, delivery & postpartum similar to a doula. A monitrice differs from a doula in that she also provides limited clinical expertise. This includes monitoring of the vital signs of the laboring mother, intermittently assessing fetal heart tones, and providing cervical exams as requested.  As a monitrice,  we help you to monitor your progress during labor and share that information with you so that you can make the best, most informed decisions during your labor and birth. We are not hired as a medical care providers and we assume no responsibility for your personal choices in labor and birth.  If you may be planning to stay home longer before moving to your place of birth, hiring a monitrice can provide an important bridge between the benefits of laboring in the comfort of your own home without interruption and the resources of the hospital. As a monitrice our goal is always empowerment with information and comprehensive support of your decisions. I purpose to include your partner and family during this once in a lifetime event to strengthen your relationship, not be a wedge or hero. 
 

There are not many paths of study for monitrices, and I am not familiar with any widely recognized certification for this type of service.   Most monitrices are either midwives who do some doula work (like myself), or apprentice midwives who have learned some clinical skills. You will want to ask VERY specific questions about where your (potential) monitrice gained her clinical skills and what her practice guidelines are. For instance, many could say that they monitors fetal heart tones during labor, but do they know how to do it properly and what they're listening for?

I am fully aware that some women may seek out a monitrice who is also a midwife with the intention to downplay how far along in labor she is and get a midwife for a doula’s or monitrice's fee. My contract is very specific: if, as your monitrice, I am forced to assume the role of midwife due to a quick birth, you will be charged my full midwifery fee. While I am fully capable and skilled as a midwife to provide care should this situation arise, I have no intention of doing homebirths in this way without appropriate planning and preparation.  I am honest and transparent and expect the exact same courtesy from the families that request my services. 

Prenatally we will

  • Meet 2-5 times prior to birth if possible.  During this time, we will have an opportunity to get to know one another, and prepare for your birth.  

  • Provide you with education to prepare for your upcoming birth experience, birth planning, anticipating for your postpartum period, newborn care options, and tools for successful breastfeeding.  I will then be present for your birthing time, and for approximately an hour after birth to attend to the families needs. 

During labor and birth, I will

  • Provide physical, emotional and informational support at your home and your birthing location.

  • Monitor vital signs of mother, assess fetal heart tones, and provide cervical exams upon request while at your home.

  • Transition to your birthing location with you.

  • Explain and interpret information and requests from your care provider to be sure your understand both the pros and the cons of the decisions to be made.

  • Serve at your advocate and help your family navigate the new environment.

 

During your postpartum time, I will

  • Typically visit once in person and once by phone to be a continued support as needed during the first few weeks of your newborn's life. I very careful to not intrude and let your needs guide the scheduling of the visits.

Preconception Counseling & Planning

Start your pregnancy journey off on the right foot!

There are so many ways to plan and prepare BEFORE conception ever occurs.  Some couples find conception to be a challenge and then where do you turn for help? Who can you trust with such a private, sensitive subject?  How can you be sure you are mothering your baby literally from day 1?  

At Pittsburgh Midwife, you can trust us to provide you with information and counseling in a transparent, kind, and professional manner without being sterile.  We are happy to discuss nutrition, supplementation, herbal and homeopathic fertility support, natural family planning, and fully informed consent to more mainstream birth control methods. 

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