services

Holistic pre-conception care

Nutritional counseling

Complete prenatal, birth, postpartum, and newborn care

Direct access to an on-call midwife 24-hours a day

VBAC & Waterbirth

All routine prenatal labs and testing as desired

Collaboration/referral to obstetricians and pediatricians for any abnormal conditions

Well-woman gynecological care, annual exam, pap smears, etc.

Prenatal care

nicole-prenatal 

I believe that pregnant women are their own primary care providers.  When supported both physically and emotionally, their mothering instincts have the space and nourishment to flourish.  Those instincts are women’s perfect guide to navigating her profound transformation into motherhood.  One of my primary jobs as a midwife is to encourage and support women’s autonomy and instincts.

The bulk of a woman’s prenatal care occurs in her daily, everyday life as she nurtures herself and her growing baby.  Women carry the responsibility for making conscious and informed decisions;  They are the  best decision-makers for their body and their baby.  My clients’ prenatal care is tailored to meet their individual preferences;  Some women may choose genetic screening or Group B Strep testing while others may choose to avoid these tests.  I strive to offer my clients the most current and relevant information, along with time-honored midwifery knowledge to support their decision-making.

Prenatal visits are conducted in your home and typically last one hour or more, allowing ample time to get to know each other.  Routine visits generally include all the standard physical assessments plus ample time to discuss your questions and concerns related to anything pregnancy, birth, postpartum, and parenting a new baby.

Labor and birth

DSC_0074One of the best parts of birthing at home is that when labor begins (or stops and starts), there is no place else to be;  Women can stay safely nestled in their own familiar environment.  Once labor is underway I remain in the mother’s home providing continuous and complete intrapartum care and support.  This includes ongoing physical assessment of mother and baby (vital signs, monitoring fetal heart tones, etc.).

Labor and births generally flow best when women have the privacy, time, and autonomy to follow their own rhythms and instincts.  I generally take a hands-off approach when labors and births are proceeding normally (as they typically do)  however I am poised to be a stronger presence or partner for mothers who want more guidance and physical support.

I attend births with a skilled assistant or second midwife in order to provide the safest, most attentive care.  After the birth, and after mom and baby have had a good long stretch of getting to know each other, I perform a complete newborn exam and any other standard newborn procedures elected by the parents.  I remain close by mother and baby in the hours postpartum until they are safely and happily nestled in bed, and baby has nursed well — typically around 3-4 hours after the birth.

Postpartum care

baby weighingPostpartum care for mom and baby begins immediately after birth, and continues through 6-8 weeks postpartum.   I am immediately available 24 hours a day 7 days a week for any urgent concerns.

For a new mother, the first few weeks after birth can be a time of overwhelming joy, exhaustion, and uncertainty.  I honor the delicate nature of this time with close and attentive care by phone and frequent home visits.  In the first ten days after birth, visits may be daily or more infrequently depending on the family’s needs. Visits generally include all routine physical assessment of mother and baby and discussion of any questions or concerns parents have regarding mom or baby’s physical or emotional well-being.

After the first week postpartum, subsequent visits occur at 10-14 days after birth, and again at 3-4 weeks and 6-8 weeks postpartum. The final postpartum visit includes routine well-woman gynecological care, pap, and birth control counseling.