Services

Prenatal Care Childbirth Classes
Laboratory Services Herbs
Referrals Labor and Delivery Care
Post Delivery and Newborn Care Equipment at Births
Water Birth Post Partum Care
Backup

Prenatal Care

Prenatal care is an  important part of any birth. I provide care for low risk clients. The first visit, in my home office, includes a complete physical assessment, medical history including a detailed previous birth history, nutritional counseling and the drawing of blood  for labs. Subsequent visits occur at monthly intervals until 28 weeks, then  bi-monthly until 36 weeks. Weekly prenatal visits the last few weeks ensure close contact leading up to delivery.


The initial visit usually will last at least an hour and a half, subsequent visits are one hour. The visits after 36 weeks are usually 30 minutes. Any concerns, whether they be physical, emotional or psychological may be addressed and discussed, in addition to the routine prenatal assessments and concerns.

These include;
Fetal Heart Tones Blood Pressure
Position of Fetus Fundal Height
Emotional Status Urine Dip
Weight Nutrition
Pulse Movement of the Fetus
Edema Discomforts/Remedies
A home visit is scheduled for the 37th week, to go over the birth plan, to ensure that the home is ready and the address can be reached easily.
Childbirth Classes

Classes are  required of first time mothers and highly recommended for those having their  first home birth. Classes are taught by a certified instructor who specializes in preparing home birth couples. Some classes have a Christian base. There are several options and locations available. All clients are encouraged to use their prenatal visits to bring up concerns and questions.

Laboratory Services

A full service lab in Houston and/or San Antonio is utilized throughout the prenatal period. The following tests make up what is termed a "prenatal profile" and are required of all pregnant mothers:

Antibody Titer Rubella Titer
RPR (syphilis screening) Hepatitis B Screening
Blood type and RH Urine Culture
CBC-Complete Blood count HIV screening
TSH (Thyroid Stimulating Hormone)

In addition to these initial tests, we also perform the following:

Diabetes screening if indicated at 28 weeks.
Antibody screening at 28 weeks for Rh negative moms.
Repeat CBC at 28 weeks.
CBC if indicated at 36 weeks.
Group B Strep screen at 36-38 weeks.
Sure Path Pap Test at 6-8 weeks postpartum.
Blood group and type on cord blood.

New state laws require testing for HIV, Hep. B and RPR in 3rd trimester

Herbs

To ensure a  naturally healthy pregnancy, labor and delivery, I recommend the use of several herbs, especially Red Raspberry Leaf and Nettles. Other herbs are often used as  the need arises. These herbs and others are available at many whole food and nutrition stores or can be purchased through New Life Birth Services from a  reputable supplier.

Referrals

Referrals are available to another midwife, or to a chiropractor,  pediatrician, massage therapist, ultrasound technician, lactation consultant,  family practitioner, obstetrician or hospital.  Contact Cathy for more information.

Labor and Delivery Care

I prefer that a  mother whose baby is imminent keep in close contact during those final days and notify me of any early labor warning signs.

I always bring another midwife or birth assistant and/or apprentice.  We think it only prudent to have two  experienced caregivers in attendance in the event of a complication with both mother and baby.

On arrival, maternal vital signs are assessed. This is repeated at least every two hours thereafter.  Fetal heart tones are checked at least every hour during early labor, and at least every 30 minutes during active labor and more frequently during second  stage to ensure there are no signs of fetal distress.
Vaginal exams are done rarely, and then only if there is a specific need for them. The urine is checked initially and then every four hours. Sipping water or juice is highly encouraged throughout the labor, as is emptying the bladder.

Family and sibling participation is encouraged. We ask clients to discuss with us in advance who will be invited to the birth. We like for anyone you plan on having at the birth to plan to attend the home visit at 37 weeks. At this point, a birth supply kit should be assembled and the home should be prepared for it's new arrival!

We have experience with all sorts of delivery positions, including on a birth stool and under water. We are open to suggestions. It is important that the mother feel comfortable and unrestricted during labor and delivery to facilitate the birth process and feel empowered to labor as she desires.

During the crowning of the baby's head we prefer to use hot compresses, perineal support or olive oil massage. We highly recommend prenatal perineal massage and will train you  and your husband during your pregnancy. Episiotomy is only done in an emergency. The cord is usually cut after it stops pulsating. The father, mother or a sibling is encouraged to cut the cord.

Post Delivery and Newborn Care

After the birth we will remain with mother and baby for at least two to three hours. The infant is placed on mother's warm skin and covered with heated blankets. Suctioning of the baby is only performed if deemed necessary to clear mucus. If there is evidence of thick meconium, suctioning with a de-lee suction catheter is done after the birth of the head but before the birth of the baby. Apgar scores are taken at one minute and five minutes after birth. Immediate breast feeding is encouraged to prevent heavy bleeding by the mother and to hasten the birth of the placenta. The family is allowed to privately bond with their new baby and revel in the miracle of birth!


When ready, a complete physical examination of the infant is gently done, including gestational age assessment, length and weight measurements, reflexes and other assessments. Eye ointment (erythromycin) is  introduced to the baby's eyes, a cord blood sample is taken to be tested for RPR, blood group and type, and footprints are taken.

Equipment at Births

Each client is provided with a source for ordering their birth kit around 34-36 weeks. This includes all your disposable items for the birth. In addition, each client is given a supply list of normal household items to have on hand. These will need to be in place by the 37 week home visit.

We bring the following supplies to the birth:

Doppler Urine Strips
Suture Materials Ring Forceps
Stethoscope Suture Scissors
Cord Scissors Infant Scale
Blood Pressure Cuff Hemostats (clamps)
Non-Sterile Gloves Fetoscope

We also have the following supplies for use in an  emergency:

  Oxygen tank with adult mask and infant ambu bag.
  Pitocin and methergine (as ordered by backup physician).
  Syringes and needles.
  Suture kit w/ sterile gloves.
  Herbs and homeopathy remedies.

Water Birth

Any client who is  interested in having a water birth is welcome to discuss their wishes with me and we can make arrangements for a birth pool if necessary. I have experience with water births and gave birth to my youngest in water. Water has proven for many to be a very effective way to reduce pain in labor and keep the laboring  mother peaceful, comfortable and able to better handle the intensity of contractions. Water births also provide a more peaceful and less traumatic transition for the infant from the womb to the large, limitless outside  environment. Most women who have water births have wonderful experiences and would choose to labor and deliver in water for any subsequent  births.

Post Partum Care

We provide a post partum home visit at 36-48 hours and when the milk comes in, usually around day four or five. All vital signs are checked, degree of bleeding carefully monitored, the perineum is inspected for proper healing, and the breasts are checked. We also help with breast feeding concerns, proper latch and positioning. The infant's vital signs are checked and the first newborn screening blood test is done on the first visit. Texas has recently updated the the newborn screening testing from 5 tests to 27 tests.

At two weeks post partum, there is an office visit to check the condition of mother and baby. A  second newborn screen test (as required by State law) is done at this time.

The 6-8 week final exam consists of a repeat mother and baby exam with the addition of birth control counseling and a pap smear.

Backup

Excellent medical backup is provided by a Houston physician who is very  supportive of home birth. If a transport to a hospital is necessary, he will do everything he can to respect the birthing mother's wishes and provide the most  natural birth possible.
In the rare instance that two clients go into  labor at the same time, an entrusted backup midwife will be available to attend  and oversee one of the births. Most often this will be Natalie Wommack, LM, CPM, RN who was one of my apprentices and a wonderful midwife. She also attends births with me as does Connie Blokkum, CNM, IBCLC. Connie is a doula and a lactation consultant as well as a new midwife and has worked with me for six years.