What I can expect from my birth attendants:

 

The following is a description of what you can expect from your birth attendants during prenatals and during the course of labor, delivery, postpartum and newborn evaluation. 

 

Note: The client has the right to decline based on informed consent

 

During prenatals: 

• Birth plans will be made and discussed

• Screening and continual assessment of maternal and fetal health will be done. screening for abnormalities or complications by checking blood pressure, pulse, FHT(fetal heart tones) baseline and variability is determined, urine, weight, edema, position and lie of fetus, obstetrical, personal and family medical history taken and reviewed

• Labs and diagnostics discussed and ordered

• Physical examination(vaginal and breast exams if indicated)

Early labor: 

• Walking and normal activity are encouraged as long as no contraindications exist

• Upon arrival in early labor or active labor we will evaluate baseline FHT’s, listen before, during and after several contractions and check blood pressure, pulse, fetal well-being and maternal well-being

Active labor:

• Monitoring of FHT’s every hour (as described above) and as labor progresses every 15 minutes, intermittently before, during and after a contraction (listening for any decelerations)

• Evaluate progress of: descent of presenting part, maternal psychological well-being and fetal well-being

• Vaginal exams will be done upon consent and always discussed with the client first

• Blood pressure and pulse will be taken, regularly in the case of unusual situations (v-back, tachycardia, ect.)

• Urination is encouraged every hour

• Enemas are not given unless necessary (constipation)

• Drinking fluids often throughout labor.  Eating is encouraged if it sounds appealing to laboring woman.

Pushing considerations: 

• A slow controlled birth is encouraged

• Warm compresses can be applied to the perineum

• Continued evaluation on all of the above

• FHT’s (as described above) are taken more often throughout pushing

Delivery considerations:

• Immediate contact if no fetal distress is present

• Immediate care of the baby – APGAR score given, warmth and suction ( suctioning is not routine, only done if secretions are thick)

Placental considerations:

• Spontaneous expulsion is encouraged – within a safe amount time 

• Cord is allowed to stop pulsating- before father or other designated person cuts the cord

• Nursing is encouraged as this contracts the uterus and helps to minimize bleeding – we will help get you started

• Inspection of the placenta for normalcy and completeness 

• Care of the placenta after expulsion is reviewed

Immediate Postpartum considerations:

• Bonding- we will give the family time alone for this to take place

• Evaluation of mother- blood pressure, pulse, fundal height, amount of blood loss, firmness of the uterus, alertness, temperature – will be done for 2 hours postpartum or until vital signs are stable

• Evaluation of newborn 

• Postpartum and newborn instructions are given before the birth team depart

 

1-4 day visitation will be done to re-evaluate all the above plus extra newborn care. Maternal nutrition and supplements are reviewed as well as hygiene of both mother and baby.

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The PKU (newborn screening) is done after the baby has ingested breast milk or formula. 

 

Newborn hearing test is available.

 

Your two week and six week postpartum visits are done at the office.