Updated: Feb 8, 2022
So, you are thinking about midwifery care...but...you aren't quite sure what to expect from an appointment. Will it be like an appointment with an obstetrician? Will we be burning incense and drumming in a drum circle? Can I still get all the testing I want done? What will we talk about?
Well, you're in the right place...
Quick answers to the questions above: A bit, but not really. No, well...we won't at least. Yes. And...all the things.
When you come into care with a home birth midwife you are looking at longer, more intentional appointments. In our practice, Tiffany and I (Kelly) do our appointments together as much as possible, and we set aside an hour per appointment, allowing a lot of time for emotional check-ins, physical check-ins, education, laughing, crying, getting to know one another, and space for you to ask all the questions you would like. This is in stark contrast to the quick physical check ins and checklist type appointments that most obstetrician offices make time for. We see fewer clients, we invest in their physical, emotional, and spiritual health, and we recognize that these appointments can sometimes parallel counseling sessions - so we plan them as intentionally as possible. We sometimes have kids playing on the floor, and sometimes moms want their own time - we honor and love both!
Your very first appointment with us is usually the longest one, about an hour and a half. We get to know each other a bit, go over health history, take any labs and exams that are needed/wanted, provide any referrals that are needed/wanted, perform a physical, and do a prenatal check-in where we do things like measure your fundal height (the top of your uterus), listen to heart tones of your baby, check the position of baby (if you are far along enough), and check your blood pressure and pulse. We chat about your diet and supplementation regimen and continue to have those conversations throughout your pregnancy.
Our practice doesn't do routine urine dips like the obstetrician's office, but we will if there is reason to do so (research shows doing it routinely doesn't really help). We also leave it up to you if you would like to weigh yourself or not. Again, if there are reasons we feel like we need to follow it more closely, we will discuss that...but otherwise you are free to be scale-free if that's what you'd prefer.
We can draw labwork in our office ourselves and bill to your insurance, and we refer out for ultrasounds - including dating ultrasounds, anatomy scans, and biophysical profiles.
At each visit, usually lasting around an hour, we do some mix of the following:
Physical Check-In for Mom: Blood Pressure, pulse, discussing any physical symptoms you may be feeling, and best ways to alleviate the uncomfortable ones.
Physical Check-In for Baby: We listen to your baby's heart rate at each appointment, and also ask about fetal movement. You have the option to listen with the Doppler, a Pinard horn, or a fetoscope (which is basically like a stethoscope specifically made to listen to babies in the womb). We are happy to follow your preference. We will also be checking your fundal height, which is done with a measuring tape from the top of your pubic bone to the top of your uterus. Amazingly enough, that measurement in centimeters usually coincides with how far along you are (If you are 34 weeks, oftentimes your fundal height is 34), this is usually true +/- a cm or 2. This is a helpful measurement to follow along in the growth of your baby. As you get further along, we begin to check on the positioning of your baby. We can feel for baby's head, back, butt, extremities, and can help you feel as well. Lots of times older siblings really like helping with this!
Emotional Check-In: How are you doing, really? Not just aches and pains, but in the midst of this season of growth and change and stretching (literally and figuratively) there can be a lot happening emotionally, and we are here to talk about it, process it, and encourage you along the way. How do you feel about the upcoming birth? How are you feeling about the relationships in your life? All of these things matter - your mental health matters. Not only does it impact your day-to-day, but it can impact your birth and your transition into mothering this baby, and we want you to be as supported as possible throughout it. This aspect is often woven through everything we do with you- and sometimes everything is smooth sailing, and sometimes it's not...and we are here for you for all of it. We never push our clients to share more than they are willing, but we always leave that space open for you to utilize as you feel comfortable.
Education: We are allllll about informed consent. But not the type of "informed consent" that basically informs you to consent, but the type of informed consent that puts you in the driver's seat of your care. We give you an overview of the research, the pros and cons of just about everything we can offer you, and you get to say yes or no. We give you information about tests available to you, referrals we can offer, choices you have for interventions...and then we get to discuss it and you get to make the final call. If there is something that clinically we deem to be necessary, we have that conversation as well. We love when our clients feel in control of their options - and while sometimes making these decisions can feel uncomfortable because it is so different than most of our medical system... it is a journey of empowerment for sure.
So, now you can see how our hour is spent together. It's a sweet, sacred time that can be filled with laughter, tears, or a combo of both. We find this aspect of midwifery care to be so important and such an impactful way to keep your pregnancy low risk while forming life-long relationships at the same time.
Also, check out this podcast episode we did on interviewing a care provider HERE.
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