Basic Midwifery Care:

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1.     When should I start prenatal care? 

You can start your care whenever you feel ready to start care.  I always encourage people to start care when they begin thinking about having a baby.  There are so many things you can do to help encourage a healthy pregnancy prior to a positive pregnancy test.  If you are already pregnant, the sooner the better.  Boosting your health and helping to combat possible pregnancy discomforts will help you gain knowledge, confidence, and a great respect for your body and all it is doing to help your baby grow.

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2.     How often will I visit with my midwife?

You will see your midwife every month at the beginning, from your first visit until 28 weeks.  After 28 weeks you will see your midwife every two weeks until 36 weeks.  After 36 weeks, you will see your midwife every week until your baby is born.  

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3.     Do you require specific tests during pregnancy?

You will be able to fully participate in your care! I am able to offer all of the same testing you would receive at a doctor's office.  The risks and benefits will be discussed along with the type of results that each test will provide.  You will have the ability and opportunity to do some research, discuss it over with your loved ones, ask questions, and then make your own decision.  Summit Maternity Care Center does require one ultrasound around 20 weeks, blood work, and all vitals done at each visit.

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4.     Will you use a fetal scope in place of a Doppler if requested?

Absolutely, in fact I prefer to use a fetal scope.  Doppler carries the same kinds of risks to the baby as ultrasound does.

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5.     What is your experience with herbs, homeopathy & alternative medicine?

I have had a formal introduction and education in herbs, homeopathy, and alternative medicine.  I have received several classes throughout my educational experience in midwifery school and had three years' experience with them throughout my preceptorship with my instructors. I will generally offer this route of treatment before offering any routine pharmaceuticals.

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6.     Do I have to plan to have my baby at the birth center to use your services?

No.  I also provide prenatal care and support to women exploring hospital birth options.  There are three ways to receive care when deciding if a hospital birth is the right option for you.

• Receive prenatal care and postpartum care: You will receive all routine prenatal care, testing, and support up until labor ensues. Once in labor, you can head to the hospital and assume care with the on-call physician.  The on-call physician will provide all care at the hospital.  Once discharged, your midwife would provide the remainder of your postpartum care.

• Receive prenatal care with assistance of a doula: This option would allow you the ability to receive all routine prenatal care, testing and support up until labor ensues.  Once in labor, the birth center would provide a doula to join you.  Once at the hospital, the on-call physician will provide all care at the hospital.  Once discharged, your midwife would provide the remainder of your postpartum care.

• Receive prenatal care: You will receive all routine prenatal care, testing, and support up until labor ensues. Once in labor, you will have the option to labor at home with or without a doula (separate fee applies for the use of a doula) and once ready can head to the hospital.  Once there you will assume care with the on-call physician.  The on-call physician will provide all care at the hospital.  Once discharged, you would follow up with the physician on-call that delivered your baby in their office.

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7.     Do you require a childbirth preparation class to prepare for a birth center birth?

Yes, childbirth education is required for first time mother and families.  Families who participate in childbirth education are more successful in their birthing experience and are less likely to transfer to the hospital.  It is great information and sometimes a nice refresher, so we also offer classes for families who have already had a baby looking to do a mini course.  It is also encouraging to connect with other families in the community.

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8.     Do I need to hire a doula for labor support or do you provide that also?

First time mothers are required to have the use of a doula during labor.  This team will support you throughout your labor and in the event of a transfer, your doula will go with you to the hospital to continue support.  Your doula can be present with you in your home until it is time for you to come to the center.  There is a fee for the doula co-op.

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9.  I am an abuse survivor and this may affect my experience. Do you have training in counseling or other trauma-healing work?

I am not a psychiatrist nor psychologist, but I have received a formal education and have clinical experience in counseling and support for women who are victims of sexual, physical, or emotional violence and trauma.  I offer and specialize in birth restoration and healing. 

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10.  How many clients do you typically have in a month and what is your plan if you have two clients laboring/giving birth at the same time?

I prefer to take on four clients per month but no more than five.  There are local midwives that are able and willing to attend a mother in labor if more than three woman are in labor at the center at one time.  Two women can labor at the center at one time with one midwife.

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11.  Can I go past 42 weeks and still have a birth center birth?

The option to go past 42 weeks is discussed along with testing that is offered to reassure the baby's well-being.  As long as testing comes back positively along with a doctors consult has occurred and the pregnancy has been healthy without complication, going past 42 weeks can be an option.

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12.  I have attended an open house and I am ready to be apart of the Summit Maternity Care Center Family, what is next?
Each family is considered for care through an application process reviewed by a committee of midwives. This application process helps us to ensure that each family who receives care is low risk, healthy, and qualified to have a birth outside of the hospital. We limit our care to four families a month, this ensures optimal and personal care to each family we have the privilege to serve.

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Intrapartum Care:

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1.     At what point in my labor will I come to the birth center?

When you are ready and this timing is different for everyone.  A common question I ask is "Do you feel the need to have your midwife?"  If the answer is yes, then we talk about meeting at the birth center.  During prenatal visits we do discuss optimal timing in contractions, but everyone's labor is so different with everyone.  Our goal is to be in active labor when admitted to the birth center.  If you are not in active labor, you will be sent home to labor some more.

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2.     What is your role during a birth?

Your midwife will help support you in giving birth in the way that you would like to give birth.  Your midwife will monitor your health and the well-being of your baby.  Your midwife will help you to progress in your labor through position changes, movement and rotation of the baby, hydration, nutrition, physical and emotional support.  Your midwife will support the natural progression of labor and encourage you to trust the process.  Your midwife is present to guard the health of mom and baby medically. Though your midwife may provide some physical support and pain management techniques, her primary role is the medical health of mother and baby. If you feel you will need more support, your doula will be available to you.

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3.     What equipment and supplies are available at the birth center?

The birth center has the majority of the items you would find in a hospital. There will be a birth supply fee that covers all your birthing needs such as: cord clamp, amnihook, sterile gloves, sterilization and provision of instruments to detach the cord, catheter, chucks pads, gauze, tape, suture material.  We also have emergency equipment such as IV equipment, Delee, surgical instruments, Ambu for mother and baby, we have oxygen per FL state law, however new guidelines state oxygen should no longer be used for neonatal resuscitation and can cause harm.

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4.     How long do I stay after the birth? 

You will stay at least three hours postpartum and upwards of six hours.  We monitor the health and well being of you and your baby.  We assure that you are able to get up, use the toilet, take a shower, eat, and have breastfed before you return home.

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5.     Are you able to suture the perineum if necessary?

Yes.  I am able to repair a first and second-degree laceration.  Lacerations that involve the rectum require the extensive knowledge of an OB/GYN and would require transport to the hospital.  

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6.     What is your standard for cord clamping and cutting?

It is your option, you are the boss.  In standard practice I do not usually use a cord clamp on the cord until after the placenta has detached, delivered, and has stopped pulsing.  In rare lifesaving instances, the cord may be clamped and cut just before baby is born.  In the event that cord banking is being used, the process is different and requires the cord to be cut shortly after birth.

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7.     How many assistants do you typically have during my birth?

I will generally have only one assistant, at times possibly two if I have someone training.  No more than two assistants will attend your birth. Students may be present at your birth, in this case, two people would be available to you.

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Basic Postpartum Care:

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1.     Do you provide postpartum visits in the days after birth?

Once your baby is born, you will see your midwife 24-48 hours after the birth at the birth center.  Postpartum appointments after the 24-48 hour appointment are unlimited.  You may see your midwife as often as you feel you need to up to 6 weeks postpartum.  You can schedule a postpartum at any point past 6 weeks postpartum until your child's first birthday at a reduced fee and your midwife is always able to schedule a phone appointment at no charge.

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2.     Do you do placenta encapsulation? Is there an extra charge?

Yes, I do offer placenta encapsulation, placental tincture, placental prints, and placental creams.  I can also create a smoothie.    All placental products are delivered by your follow up postpartum visit and are stored in glass along with dosage instructions.  The charge for placental products is $350.

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3.     Do you have experience breastfeeding? Will you be able to help me with any breastfeeding problems?

Yes, I have over 5 years of experience as a Certified Lactation Counselor.  I am able to identify breastfeeding complications, provide counseling, support, and will continue to be available for service until your child is finished with breastfeeding.

 

Transfer of Care and Complications:

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1.     What are some reasons for transfer?

There are many reasons for transfer throughout pregnancy, labor, delivery, and postpartum.  Anything that would cause the need for a higher level of care would be a reason for transfer.  Here are some examples, they are not limited to this list, but may include: abnormal progression of labor, abnormal fetal heart rate, hemorrhage, unresponsive infant, third or fourth degree laceration, etc.

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2.     How would we transfer if it was needed?

There are two types of transfer, non-emergent and emergent.  For non-emergent transfers, the transfer may be made by car to the hospital of your choice within proper distance.  For emergent transfers, transfer will be made by ambulance to the nearest hospital with a labor and delivery unit.

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3.     What care would you provide to me if a transfer were necessary?

Your midwife will call the hospital and provide a report to the team that will be receiving you for care.  Due to changes in protocol with Charlotte County EMS and Shore Point Medical Center, your midwife will not be transferring to the hospital. She will be in communication by telephone.  Your doula will be available to you, pending hospital protocol, to provide emotional and physical support. 

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4.     Have you ever handled a postpartum hemorrhage? What protocol do you use to stop excessive bleeding after delivery?

Yes, I have handled several postpartum hemorrhages.  I use a cocktail of herbs at delivery to help prevent the chance of postpartum bleeding.  If a hemorrhage occurs, I will use medicinal products to help control bleeding and fundal massage.  In the event that bleeding becomes emergent, we will transfer to the hospital by ambulance for further care.

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5.     Have you had any bad outcomes with a mother/baby? Please explain them.

I have not had a mother nor a baby die.  I have dealt with unforeseen complications that include: shoulder dystocia, unresponsive infant, placenta accreta, hemorrhage, cord prolapse, placental abruption, abnormal fetal heart rate, etc. All care in emergent conditions have resolved in care at a hospital.  I would prefer to prevent a complication rather than cause one, my management approach is centered around this philosophy.

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I would love to meet with you and your family to further explore your options