Comprehensive Homebirth Midwifery Care

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:


Prenatal Care


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,
    • pulse,
    • weight,
    • fundal height,
    • fetal position,
    • fetal heart tones,
    • urinalysis,
    • 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.






Postpartum Care

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:
    • vitals
    • body systems
    • umbilical healing
    • output
    • and nursing
  • Assessing the postpartum client:
    • vitals
    • uterine size
    • bleeding
    • perineal condition and healing
    • pain
    • breastfeeding
    • bonding
    • 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.