Loading...
FAQ 2017-06-20T20:14:24+00:00

Give Birth Like A Brit!

Union Jack

Call THIS Midwife

Home or Hospital? It’s YOUR choice.

Midwives in all of the developed world, EXCEPT the United States, are educated and credentialed (e.g. licensed or registered) EQUIVALENTLY in their countries (Canada, Britain, Germany, Holland, etc.) In addition, they are prepared to practice in ALL settings (hospital, home, birth center) AND the laws governing their practice typically protect their ability to have access to hospital admitting privileges even while they offer out of hospital birth.

The United States’ tradition of midwifery has not experienced this history of empowerment, resulting in midwives of varying preparation and ability mostly practicing in segregated settings – hospital, home, or birth center.

I have always wished to emulate the model of midwifery care seen in the rest of the developed world as it provides the safest maternity care and it puts the power of choice in childbirth in the woman’s hands.

Home or Hospital? It’s YOUR choice.

I provide the same midwifery care in both settings.

I provide the same midwifery care in both settings. I am with you at your side in your bedroom or in your birthing room at the hospital. I remain at your side to support and guide you. At home, even when you have a doula, I remain with you. In the hospital, where you will have a nurse caring for you, I remain with you.

All hospitals have policies regarding care during labor, birth and postpartum. St. Joseph’s Hospital does allow care for low risk women that is the same as women giving birth at home. This includes eating and drinking in labor, listening to the baby’s heartbeat intermittently in labor rather than continuous electronic fetal monitoring, walking, squatting, lungeing, showering, bathing, use of a birth ball, etc. I encourage you to birth in whatever position works best for you, not necessarily and not typically in the bed. I am skilled at protecting the mother’s vaginal tissues from tearing at birth but am very knowledgeable and experienced at repairing tears that require it. Any needed repair is delayed while breastfeeding takes place. In addition, the newborn is immediately placed in mother’s arms, cord clamping is delayed until it ceases pulsing and you give your approval, and breastfeeding is initiated as soon as baby is ready. Water birth is not currently offered at St. Joseph’s Hospital. Water birth is always an option at home.

In my home birth practice I offer women what is known as “expectant” management of ruptured membranes. That is, if the bag of waters breaks spontaneously at term and the fluid is clear (no meconium in the fluid), we can await the onset of labor, sometimes for days, as long as the fluid remains clear and the mother does not have a fever. I offer this to women who are planning a hospital based birth as well. I have never had a woman who waited for labor to begin, after her bag of waters had broken, get an infection. In addition, I never routinely break the bag of waters. In the rare instance I believe breaking the bag would be helpful, I always discuss this with the mother and gain her approval for this intervention.

In my home birth practice, I do not encourage women to be induced for “post dates” pregnancy before 42 weeks unless tests of fetal well being, the non stress test and amniotic fluid assessment, indicates that the baby would be best protected by an induction of labor. We begin non stress testing (looking for acceleration of the fetal heartbeat accompanied by fetal movement) at 41 weeks gestation. I offer this same care to women in my hospital based practice. I do not treat women who will be 35 years or older at the time of the birth of their baby any differently than younger women.

Pain Relief is available.

Nitrous oxide is available for pain relief at St. Joseph’s Hospital.

Yes I can order an epidural for you.

Yes, I can order an epidural for you. The anesthetist places the epidural.

No.

No, you can decide before OR during labor.

You would call me directly on my cell phone.

You would call me directly on my cell phone. If we weren’t sure it was time to go to the hospital, I would travel to your home to evaluate you and take care of you and then accompany you to the hospital when you’re ready to go.

If you wanted/needed to go to the hospital immediately, I would meet you there when you arrive.

I always have extra supplies.

I always have extra supplies on hand in my car if you haven’t obtained these prior to your labor.

Yes.

Yes. In fact, I facilitate early discharge of the newborn because I will see the newborn at home on the first day and third day of life for follow up newborn care, including the newborn cardiac screen and the newborn metabolic screen (PKU).

I have always remained at the side of the laboring woman

Yes. In fact, philosophically it is the same care I attempted to provide in the hospital. In the hospital, whether it was in the inner city or later, a wealthy suburb, I always remained at the side of the laboring woman as much as possible to provide her with support and reassurance and to shield her from unnecessary interventions.

In the hospital (in many such institutions) I led efforts to change hospital policies so that women could choose intermittent auscultation of fetal heart tones (listening with the fetal doppler) and decline continuous electronic fetal monitoring, walk in labor, eat and drink, have a support person with them and then later their children, and birth in a birthing room first on a birthing bed and later however they chose, rather than in a delivery room on a delivery table. Before birthing beds were widely available I began catching babies with women resting on their sides, first on the delivery table and then in their labor beds. In fact, I was working as a nurse in labor and delivery at Rose Hospital in Denver in 1980 when I saw Rose’s first CNM catch a baby in that way; something I had only read about until then.

Medical supplies, most of which I don’t end up using

I bring many supplies, most of which I don’t end up using. They include among other things, a fetal doppler to listen to fetal heart tones during labor; a blood pressure cuff and stethoscope; a newborn stethoscope and scale; an oxygen tank and equipment to resuscitate a newborn if necessary; medication to control postpartum bleeding including IV fluids; sterile instruments and gloves, local anesthetic, syringes and suture to repair a tear that is bleeding.

When you need me

I am on call 24 hours/7 days a week. In the hospital, I either travel with you from your home to the hospital or I meet you at the hospital when you arrive. I am always available by phone for questions and concerns. I come to your home when you and I agree that my presence is needed and wanted. With first time mothers this is typically early in labor while women who have had a baby before often have me arrive when labor is more active.

A birth assistant

Yes. I always bring a birth assistant with me. This individual is certified in neonatal resuscitation. The birth assistant arrives after I call her. I call the birth assistant when the laboring woman is in active labor and I anticipate that the birth will occur relatively soon.

Always welcome

A doula is always welcome. Her support will be an added benefit to your labor and birth experience wherever and with whomever you give birth.

Routine proceedures are important

I routinely check the mother’s vital signs (blood pressure, temperature, pulse and respirations), I routinely palpate the mother’s abdomen (place my hands on the mother’s belly) to check fetal position and I routinely listen to the fetal heart tones during labor. All other care is individualized to the woman and her labor.

Your comfort is our priority.

Your comfort is our priority, at home or in the hospital.

Waiting for the pulsating to stop is important

No. I wait for the cord to stop pulsating and then clamp and cut the cord. The person of your choosing cuts the cord.

Push

I observe for signs of placental separation from the wall of the uterus and then have the mother squat or sit on the toilet to push her placenta out. I assist the birth of the placenta with what is known as “controlled cord traction” only if the mother is unable to birth the placenta and/or there is an abnormal amount of bleeding. I always explain what is going on and what I wish to do with the mother and her partner.

I have pioneered this experience in my past

Yes. I pioneered that change in a suburban hospital I practiced in over 20 years ago. It’s your birth.

I love water births

Yes. I love water births! I encourage all my clients to have a tub so that soaking in the tub can promote relaxation and comfort in labor and ease birth. Water birth is not currently offered at St. Joseph’s Hospital.

Positioning, Latching, and Trouble Shooting

Yes. I am very experienced in assisting new mothers in correct positioning and latch on and trouble shooting breastfeeding concerns that may arise. In addition, I can evaluate and treat breast infections (mastitis).

As long as needed, at home or in the hospital.

I remain until mother and newborn are stable. That means that the mother’s vital signs – blood pressure, temperature, pulse and respirations, are normal; the mother has been able to eat and drink and urinate; her vaginal bleeding is normal and her uterus is normally contracted; the newborn has had a normal physical exam, including normal temperature, pulse and respirations, and has breastfed successfully. This is typically 2 to 4 hours after the birth.

You would be amazed at how efficient and clean the process is

No. The birth assistant and I keep the birth place quite tidy and clean up after ourselves, associated with the birth.

Continuity of Care

For home births, I return to see mother and newborn on day 1 and day 3 following the birth. In the hospital, I facilitate early discharge (< 24 hours) if desired. I then see mother and newborn on days 1 and 3 at home.  I provide the same care, as described above, as I do for clients who have had a home birth.

If early discharge from the hospital is not desired and/or possible, I see the mother in the hospital for postpartum follow up care.  The newborn is seen by the pediatric care provider.

Finally, I see the mother 6 weeks postpartum for a follow up exam.

Directly

Yes. I fax a summary of the pregnancy, labor and birth as well as the newborn exam to the newborn care provider after the day 3 exam. In addition, if I find anything of concern upon examining the newborn at birth or on day 1 or 3, I communicate directly with the newborn’s care provider regarding this finding and plan for care. The most common finding has been greater than normal jaundice on the day 3 exam. These newborns were treated at home with what is known as a “bili blanket” by the newborn care provider.

I am state licensed

For home births, I file the paper work with the State of Colorado to obtain a birth certificate for the newborn. For hospital births, the hospital files the paper work with the State of Colorado to obtain a birth certificate for the newborn.

6 and 12 weeks of pregnancy

Prenatal care usually begins between 6 and 12 weeks of pregnancy. We meet every 4 weeks until the 28th week of pregnancy, then every 2 weeks until the 36th week of pregnancy, and then weekly until the birth.

Your home

I travel to your home or you come to our office located at 1610 East Girard Place Suite M, Englewood, CO 80113.

Healthy woman

I accept women into my care who are essentially healthy and whose pregnancies are normal.

Routine laboratory work

Yes. I order routine prenatal laboratory work for all my clients. We discuss whether or not you will choose genetic screening tests. I recommend ultrasound evaluation if the date of your last menstrual period is unknown or uncertain or if there is a medical indication for an ultrasound such as unexplained vaginal bleeding in pregnancy. I recommend that my clients have a screening ultrasound at 20 weeks gestation.

Physician consultation is always available

I call a physician with expertise in that area of health care and consult with him or her regarding your care. Most of the time a telephone consultation is all that is needed. Occasionally the client will go to see the physician for further evaluation of the medical problem. If the problem is specifically related to the pregnancy I accompany you to the physician visit.

It’s encouraged

I encourage my clients to see a chiropractor, massage therapist, and/or acupuncturist as needed to treat common discomforts of pregnancy such as sciatica, back pain, or carpal tunnel syndrome. I encourage my clients to see a Women’s Health Care Physical Therapist. I encourage women to incorporate herbal remedies and essential oils.

Safe and effective evidence is important

Yes. For instance, I encourage my pregnant clients to drink a cup of red raspberry leaf tea daily throughout pregnancy. I also use remedies such as papaya for heartburn and ginger for nausea amongst many others. If there is a natural remedy with good evidence that it is safe and effective I will recommend its use.

A cornerstone

Good nutrition is the cornerstone of a healthy pregnancy. I review nutrition at every visit, emphasizing healthy food choices.

I encourage all of my clients to get regular exercise, at a minimum a 30 minute walk 3 days a week and for those who can and wish to do more, a prenatal exercise class.

I also teach my clients how to identify where the baby’s back is positioned once she reaches the 3rd trimester and what exercises and positioning she herself can use to encourage optimal positioning of the baby for labor.

Private

Yes. I request that all first time mothers and partners attend a childbirth education class. I refer to private classes (not hospital based).

Planning, Planning, Planning

I am always aware of what is the closest hospital to your home in the event of an urgent or emergent transfer. Those types of transfers may occur by ambulance or by car. I would remain with you to advocate for you and to support you.

Transfers are not typically urgent or emergent. Typically we would travel by car to St. Joseph’s Hospital where I would admit you and continue to care for you. If you required physician care, I would consult with the attending obstetrician at the hospital.

Slow progression

Slow progression in labor and request for pain relief.

I have many years of experience

Yes. I have many years experience performing annual physical exams including gynecological exams. In addition, I evaluate and treat women for vaginal and urinary tract infections and provide contraception. I also provide routine care for menopausal and postmenopausal women. I consult with and refer to medical providers when necessary.

We Bill For You

I contract with a professional billing service that will bill your health insurance company for my services after the birth. I ask that you pay my fee in full by 34 weeks.

I am humbled by my testimonials

Yes! My former clients are happy to communicate with you by email and/or telephone.

ARE YOU EXPECTING?

We Would Love to Answer Your Questions!

SEND US AN EMAIL