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 60 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 clinic for safety reasons. Please understand that we do not have the staff to supervise your children at this time. We appreciate your cooperation.
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. 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.
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.
Postpartum care at CMS continues through the full 4th trimester. We feel strongly that close postpartum support can contribute to a better experience for both mom and baby. A visit will be scheduled in your home for 24-48 hours after birth where we will be checking in on breastfeeding and performing the CCHD screening through a pulse oximetry evaluation. We will return to the home between 3-5 days postpartum. This visit we will be looking at breastfeeding, weight gain or loss for baby, metabolic screening and maternal physical and emotional well being . The remainder postpartum visits will be scheduled in the office at 2, 6, 9 and 12 weeks. The hearing screening will be performed in the office at your 2 or 6 week visit. Other visits may be necessary and will be scheduled accordingly. All normal postpartum care is included in your birth fee.
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