As midwives, we are committed to using our training and life experiences to promote health in the birthing family through comprehensive and individualized care during the prenatal period, labor, birth, and postpartum.
As part of your comprehensive care package, Sierra Homebirth offers:
Our care includes an in-depth initial visit and phone and email contact throughout care. Prenatal appointments are scheduled once a month until 28 weeks, every other week until 36 weeks, and once a week until the birth. At 36 weeks we make a home visit to familiarize ourselves with the birth environment and the route to your house, to make sure all needed supplies are present, and for you to have the opportunity to have us in your space.
Prenatal care is thorough and will include:
- Risk assessment
- Health history and physical exam intake
- Regular physical assessment, including
- assessment of blood pressure,
- fundal height,
- fetal position,
- fetal heart tones,
- physical conditions and complaints,
- vaginal exams when desired or indicated
- Nutritional discussion and analysis
- Some diagnostic testing, including
- Blood work
- Urine cultre
- Gestational diabetes screening
- STI screening
- GBS screening
- Birth education and preparation
- Newborn care education
- Resources and referrals
- Spinning babies demonstration and teaching for optimal pelvic and fetal alignment in the last trimester
- Plenty of time to answer all your questions and check in on your experience of pregnancy, whether that be physical, emotional, social, or spiritual.
We will explain procedures and answer any questions so you understand the childbearing process and the care you are receiving. We will monitor for signs of impending complications and offer suggestions when needed. Lab work including blood draws, Pap Smears, and STI screening will be gathered on site and sent out to a laboratory. All appointments are one hour long with the exception of the initial appointment and home visit, which may last longer.
Care During Labor and Birth
We will support you in creating the kind of birth experience you desire. We will attend the birth once active labor begins or earlier, if needed. Prior to active labor we will be in touch with you by phone. At the birth, we will monitor the health of the client and baby by checking vital signs, fetal heart tones, confirming fetal position, monitoring nourishment, hydration, and output, and cervical dilation checks when necessary or desired. To the extent that it is deemed safe, you may give birth in the position and place of your choice, and may determine the level of our involvement in the birth.
Although most births can occur spontaneously and proceed best without interference, we will be there to offer assistance if needed, such as preventing perineal tears or managing a shoulder dystocia. Because complications can arise even in low-risk situations, we carry emergency equipment including oxygen and resuscitation equipment, hemorrhage medications, and IV supplies. If needed, we can start an IV, suture a tear, and perform resuscitation. If a complication develops that would be most safely managed within a hospital setting, we will recommend transport and accompany you throughout the birth as planned.
After the baby is born, we will be responsible for checking the newborn’s condition, monitoring you and the birth of the placenta, amount of blood loss, and checking the placenta. Delayed cord camping is our standard of care. In the early postpartum, we will perform a newborn exam and procedures if desired, and continue monitoring the health of you and baby. We will stay at least 2 to 3 hours following the birth, until both you and baby have eaten and breastfed and are settled and stable, and the house is in order.
We offer three home postpartum visits: the first at 1 day postpartum, the second on day 3 or 4, and the third between days 7 and 10 postpartum. Two in-office postpartum visits will also be scheduled at three and six weeks. Additional visits will be provided if there is any problems that need additional monitoring or assessment.
Basic postpartum care consists of
- Assessing the newborn:
- body systems
- umbilical healing
- and nursing
- Assessing the postpartum client:
- uterine size
- perineal condition and healing
- emotional well-being
- Special attention and support will be offered to help establish successful breastfeeding.
- A newborn screen and critical congenital heart disease screen will be performed if desired.
- Pap Smears and contraception counseling will be offered at the final postpartum visit for the price of lab work with no additional charge.
Our care does not include fees for lab work, birth kit, birth tub rental, physician consultation, hospital care or ultrasounds. You have the right to be accompanied by the persons of your choice to any visit. You have the right to a copy of any of your records and to additional medical opinions. Most importantly, you have the right to ask questions and to express your needs.
Planning a hospital birth but want additional postpartum care for you and your baby in the home? Sierra Homebirth offers home postpartum visits for full maternal and newborn assessment.
Postpartum Visits include:
- Breastfeeding support and guidance
- Baby care
- Newborn Assessment: vital signs, weight, input/output, umbilical healing
- Maternal Assessment: vital signs, uterus and bleeding, perineal healing, breast health
- Maternal emotional assessment
- Answering any questions you have about your postpartum recovery and adjustment and caring for your baby
A monitrice is a care provider who offers all the services that doulas offer, such as physical, informational, and emotional support during labor, but who also has medical training and experience in pregnancy, birth and postpartum. Often a monitrice is a trained midwife or nurse. Because of this training, a monitrice can perform clinical tasks in labor such as assessing fetal heart tones, maternal vital signs, and performing vaginal exams. Monitrices work with clients who are receiving prenatal care from another provider and who are planning a hospital birth. With the additional skills and experience of a monitrice, a laboring woman can potentially stay home deeper into the labor process before going to the hospital.
A monitrice is a perfect choice if you desire to safely labor longer at home or want an advocate and guide for a natural and vaginal birth.
Monitrice Services Include
I offer 2 one-hour and a half hour prenatal visits so we can get to know one another, discuss your birth hopes and priorities, answer questions, and discuss the labor and birth process. Additional prenatal visits at available if desired.
I come to you in labor when you are in or approaching active labor (~4cm). I stay with you at your house and monitor fetal heart tones and can perform vaginal exams when needed. I am here to help you navigate the labor process, to help you find your rhythm and relax into the labor process. I will offer support in whatever ways you are needing. When appropriate for the individual woman, I will help you transfer care to the hospital (no later than 8cm). At this point I stay with you, but in the role of a doula only. I do not have hospital privileges to continue any kind of clinical care. I will stay with you until birth and the first hour postpartum. One exception is if a woman decides to get an epidural and sleep, I will go home to rest and return closer to birth.
I offer two home postpartum visits where we provide full postpartum assessment of the client and baby, including breastfeeding assessment and support, well baby care, and postpartum recovery assessment.
Are you thinking of getting pregnant during the next year? Do you have questions you want to ask a care provider? We specialize in helping clients and families prepare for the life changing event of pregnancy and birth. Preparing in advance helps ensure you enter this next phase of your life in optimal health and well-being. We offer one hour visits to help you plan and prepare for your little one’s arrival.
Preconception Counseling topics include:
• Review of personal and family medical history
• Nutrition and exercise
• Genetic considerations and testing options
• STI screening (if needed)
• Medical assessment
• Social and lifestyle considerations
• Vitamins and supplements
Sierra Homebirth offers Well Person Gyn Care that is personal, compassionate, and gentle. Visits are one hour long so you will not be rushed. We want you to feel safe in our office. There is plenty of time to talk and answer any questions you have. And we will always tell you what to expect so you understand all procedures and consent before being touched.
Well Person Gyn Care includes:
• Pap Smear and HPV testing
• STI and vaginal health screens: blood, urine, culture (if needed)
• Review of medical and gyn history
• Breast exam
• Contraception counseling