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Prenatal
Care
Regular prenatal screening is required of all mothers preparing for an
out of hospital birth with CMS midwives. Appointments include monitoring
your baby's growth and heart rate, fetal position and size, maternal weight
gain, a urine dipstick test, blood pressure and uterine growth. You will
be given a lab slip to obtain your routine blood work. This must be done
by the 16th week of pregnancy. Finger sticks to check hemoglobin or blood
sugar may be done as needed in the office at additional charge. Glucose
tolerance tests will be offered but not required unless there are other
indications pointing to gestational diabetes.
Nutritional counseling is at the basis of all prenatal care at CMS. We
will discuss your nutrition at every visit and assist you in learning
what you can do to ensure a healthy pregnancy. Problems associated with
pregnancy can many times be traced back to a nutritional deficiency and
can be alleviated by a change in diet or nutritional supplements. Each
visit is scheduled at 30 minute intervals. If you feel that you need a
longer visit please inform the midwife prior to your appointment and we
will schedule an extended visit.
We encourage you to bring the people close to you along for your prenatal
visits. We want the opportunity to become familiar with those who might
be at your birth. We have great interest in answering questions or addressing
fears posed by your family and friends. Homebirth is something that seems
out of the ordinary for most people today so we understand, encourage
and welcome questions.
Children are also welcome at CMS but for your child's safety, we must
ask that you keep your children with you at all times. We have toys and
books in the exam rooms for them to play with but they cannot be allowed
unsupervised access to the house for safety reasons. Please understand
that we do not have the staff to supervise your children at this time.
We appreciate your cooperation. |
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Labor
and Birth
The attendants at your birth will include at least one Senior Midwife
and one assistant. Your midwife may decide that more assistance is needed
at your birth and call in more help. You may have the opportunity to choose
the assistant who will be helping at your birth, however this is at the
midwives discretion. She may have a very good reason for choosing a particular
assistant based on her personality or special skills. Midwives at CMS
follow the Code of Ethics, Standard of Practice and Protocols set forth
by the OMA Certification Handbook. Our Certified Nurse Midwife follows
the guidelines of practice set forth in the Nurse Practice Act and by
the ACNM. If you would like to see any of these guidelines, simply ask
and they will be made available. Our guidelines of practice serve to ensure
the safest birth possible but should not prevent us from honoring your
wishes whenever possible.
Care during labor will consist of monitoring the progress and condition
of the mother, the condition, position and station of the baby while assisting
the family in birthing their baby. After the baby is born, we will assist
in the birth of the placenta and evaluate the mother and baby. Antibiotic
ointment and Vitamin K is available for the baby after the birth, if you
choose. We will be happy to explain these procedures so you can make an
informed decision. Other topics regarding your newborn are PKU screening,
hearing screening, breastfeeding, circumcision and immunization. We will
be happy to explain these issues in order for you to make the decisions
that are right for you and your baby. The midwives CMS will not make decisions
for you regarding these procedures.
We will do our best to provide an unbiased review of the reasons for the
procedures, reasons some choose to decline and then allow you to decide
for yourself. One or more attendants will remain with the mother for 2-6
hours. We will remain with you until it is determined that the mother
and baby are stable. If you birth in our birthing cottage we ask that
you stay at least 4 hours.
We are trained to initiate emergency procedures, according to our ability
and available equipment. We are trained to detect common abnormalities
in the mother and baby. The midwife will alert the parents to any abnormal
situation and offer them the options available. If you are from out of
town and are traveling to CMS to birth your baby, you may wish to stay
over night or wait until you are well rested to return home. We will do
our best to accommodate your needs. The midwife will file a certificate
of live birth with the Oklahoma State Health Department Vital Records
Division.
A postpartum visit will be scheduled for 2-4 days after the birth, either
in your home or by phone when necessary. You will have a two and six week
check- up in the office. Other visits may be necessary and will be scheduled
accordingly. There will be no additional charge for additional visits
in the 6 week postpartum period.
If you transport to the hospital during labor, at least one attendant
will remain with you until your baby is born or the situation is resolved.
In the event that your baby is born in the hospital you will still have
the benefit of postpartum care by our midwives. |
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Responsibility
of the Client
It is vital that you take responsibility for your health and the health
of your baby. Delivery of your baby at CMS or at home is dependant on
your health and low risk status. Remaining low risk involves eating a
healthy diet, moderate exercise and avoiding any substances that could
harm your baby or endanger your health. Parents who choose an out of hospital
birth with CMS are saying that they are educated about birth and the possible
risks in and outside the hospital, have chosen to birth outside the hospital
and assume responsibility for the outcome.
When you choose a CMS midwife you have the freedom to make choices regarding
your prenatal care and your birth. When you choose to birth outside the
hospital you will not have to be subjected to the interventions that can
create added risk and are common in hospital birth. However you must be
aware that situations can arise quickly and time is lost in receiving
advanced medical attention. These situations are very rare but they do
happen. You need to spend time educating yourself about the risks and
work to try and prevent them. Again, the best way to stay low risk and
ensure the health of your baby is to gift yourself with exemplary nutrition
and good health practices. These issues will be discussed at your prenatal
appointments and in your classes.
If you have any pre-existing conditions, such as cardiac disease, diabetes,
hypertension, etc., you cannot be accepted as a client by CMS and you
will be strongly advised not to attempt a birth outside the hospital.
We can assist you in finding a physician who will allow us to be involved
with your prenatal care and your birth.
Communication is very important. We will be open and honest with you and
we expect the same in return. Please feel free to talk to us if you have
any physical problems or problems affecting your emotional health. Sometimes
pregnancy hormones can make even the simplest thing hard to cope with.
The good news is there are usually solutions that are easy to implement
and you will enjoy your pregnancy so much more if you trust us enough
to share your concerns. Your birth experience will be greatly enhanced
if there are no lingering problems or anxieties. |
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Insurance
Many insurance carriers are paying for the services of midwives. We will
assist in filing for insurance reimbursement with an itemized bill. You
will be required to pay your deductible and any co payments required by
your insurance policy. CMS will do everything possible to aid in insurance
reimbursement. |
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Classes
Offered
We are pleased to offer a variety of classes to our clients. Childbirth
education, breastfeeding, nutrition, early pregnancy, infant massage and
other classes may be presented at CMS. Please ask for information on any
classes you maybe interested in and we will do our best to provide a list
of instructors and fee schedules. |
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Special
Circumstances
We have already discussed the possibility of special circumstances that
can occur requiring a transfer of care during pregnancy, labor or postpartum.
CMS has an excellent plan of action in the event that you should need
care by a physician or your baby should need extra attention. Be aware
that the midwives at CMS participate in Peer review through the OMA and
any special circumstances are shared with the Certification Review Board.
A member of the OMA CRB may contact you after your birth to discuss your
experience. By signing this document you are giving permission for your
birth to be included in this peer review process. Only Intern and Senior
Midwives are allowed to attend Peer review and all of the information
shared is confidential. |
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