Midwifery Services

Below you will find frequently asked
questions about my midwifery services. 
If your question isn't addressed, please contact me!

What are prenatal visits like and where do they take place?
I schedule prenatal visits on the same schedule that most physician's offices do. Every four weeks until the 28th or 30th week, then every two weeks until the last month when visits occur every week until the birth. A home visit is done around 36 weeks. A typical prenatal visit lasts about an hour and encompasses the following: discussions about nutrition, discomforts, family relationships, desires for the birth, parenting issues, emotional readiness, questions about pregnancy and/or birth, blood pressure check, prenatal testing options, measurement of baby's growth, abdominal palpation to determine baby's position, and listening to baby's heartbeat.

I typically do all prenatal appointments in my Salem office. A home visit (or two) is done towards the end of the pregnancy. All postpartum visits (at one day, three day, one week and two weeks) are done in your home, aside from the six-week postpartum visit.

In addition to prenatal appointments, I am available to my clients via phone or email to answer any questions or concerns. There are no such things as silly or stupid questions, and I encourage any concerns about you or your baby's well-being to be brought up with me between appointments.

How many births do you do a month and what if you have two people in labor at the same time?
I attempt to restrict my practice to three clients a month. I have an assistant midwife who attends births with me, and should the rare (very rare!) instance occur where two women are in labor at the same time, I will stay with the woman whose home I was at first, and send my assistant and another supervising midwife to the other client's home. Because all clients will have had a number of prenatal visits with my assistant midwife, they will have someone at their birth they are familiar with.

What about waterbirth?
The use of water for labor and birth has so many benefits and advantages. I encourage women to consider having a tub available to labor (or birth) in. Water is soothing, relaxing, and helps with the pain of contractions. Water helps facilitate various positions that would be cumbersome "on land". I have a few leads on birth tub rentals, as well as information on how to create your own birth pool at a fraction of the cost. I have many books and videos specifically on waterbirth. The majority of my clients choose to labor and/or birth in water.

What if there is a problem during the labor and/or birth?
While there is a wide range of situations one can encounter during labor or birth, I strive to be as non-interventive as possible, thereby reducing any risk of complications. Should an issue arise, there is usually ample time to transport to the hospital. Hospital choices are discussed prenatally with the parents, taking into consideration insurance coverage, physician relationships, and general support / respect for homebirth families. Of course, priority is given to the closest hospital for more emergent transports. Once I transport with a client to the hospital, I stay by her side helping her and her partner with decisions, support and encouragement until her baby is safely delivered and both mother and baby are stable. Postpartum appointments then continue as normal, as well as breastfeeding and parenting support.

What about the mess?
This is such a common question, one that many people worry about. While there are fluids such as amniotic fluid and blood involved in birth, the mess is often less than people would think. Instructions are given prenatally on how to make up a bed so that the mattress stays "safe" (as well as precautions for floors and carpets), and underpads are included in the birth kit to help absorb fluids during the birth process. We also clean up during and after the birth, washing the sheets and towels and doing the dishes. Many times, within minutes of a birth, you cannot tell a baby had just been born there!

Can we have family / friends / siblings at the birth?
Whom a couple chooses to have witness their birth is a personal choice. Prenatally, we can discuss your concerns and hopes regarding the birth, the atmosphere, and what is important to the family. The top priority is to have people at the birth that are not only supportive of homebirth, but are comfortable witnessing a birth. I encourage siblings to be present for the birth, and I like for them to be supported by another adult. I prefer to have whomever will be at the birth be present for the official "home visit", usually done at 36 weeks, so that we are all familiar with each other and expectations and concerns can be voiced.

What happens after the birth?
My assistant and I usually stay for about 2-3 hours after the birth of the baby. We provide immediate breastfeeding support, make sure mother and baby are stable, perform a newborn exam (right next to the mother and only after nursing has been well established), check for perineal tears and repair if necessary, and make sure the new family is fed. We do postpartum visits in the home at one day, three days, one week, two weeks, then do a last visit at 6 weeks (with a Pap smear and/or birth control information, if desired). Both my assistant and I are completely available 24/7 for questions or concerns any time during the postpartum period (and beyond!), including breastfeeding support. I encourage couples to stay in touch, as it is often a hard "break-up" after the baby comes!

Do you offer a free initial consultation?
I do provide a free initial consultation. Please call me for details in setting up an appointment.