This page is organized chronologically, so as you scroll down, you'll find a timeline of what to expect in our work together and things you'll need to prepare.
At our initial visit, we'll chat about you, how you're feeling physically and emotionally, when you had your last period, whether you'd like to order an ultrasound or have any kind of genetic screening, and anything else that comes up. Please print the forms and bring them to our first prenatal appointment.
I offer prenatal blood work around 12 weeks, gestational diabetes screening around 28 weeks, GBS screening around 36 weeks, and additional lab work as needed. The only lab work that I require for you to be in my care is a screening for blood type and Rh factor, and screening for blood borne pathogens.
We'll discuss genetic screening at your first or second appointment. When considering genetic screening, I recommend reflecting on your family background, your race and ethnicity (some groups have higher risks of certain issues), and ultimately, what you will do with the information. Some people feel anxious unless they know that their baby is okay. Some people would terminate a pregnancy if their baby had a serious problem that would be incompatible with life. Some people would not terminate a pregnancy, no matter what. If you choose not to undergo genetic screening, you can opt for the 20 week "fetal survey" ultrasound, which will identify most problems if there are any.
If you're interested in genetic screening, I recommend Non-Invasive Prenatal Testing, a blood draw that draws fetal DNA from a pregnant parent's blood. Some people also choose this test because they want to find out the sex of the baby prior to the 20 week ultrasound. I can offer this test, or you can have it performed at a maternal-fetal medicine department of a local hospital, where you can also meet with a genetic counselor if desired.
If you're unsure of how far along you are, I would recommend going for an early ultrasound. These are most accurate in your first trimester and can help pinpoint your due date. It's not relevant information at this point in your pregnancy, but it becomes important towards the end of your pregnancy.
For example, if you're not as far along as you think, then when you're actually only 41 weeks we might think that you're 42 weeks. This can involve unnecessary stress for you and sometimes, medical intervention such as induction. On the flip side, you may be later than you realize. If someone goes into labor before 37 weeks gestation, but their provider thinks that they're beyond 37 weeks, there's a risk of them birthing a preterm baby outside of the hospital. While I'll be measuring the growth of your uterus (which roughly tracks with your weeks of pregnancy), it's helpful to have this information if you don't know when your last period was.
As a licensed midwife, I am an out of network provider for families with private insurance in New Hampshire. Occasionally, some Massachusetts based families have home birth midwifery coverage. I do not personally submit claims to your insurance company; I work with Cohosh Billing, a small female-owned billing company that specializes in home birth midwifery. I recommend that my clients go through them to verify their insurance benefits and determine their reimbursement (that form is here). Clients can also have Cohosh submit claims to their insurance company, in order to pursue the maximum amount available to them.
Right around this time you'll go for a fetal survey ultrasound, if you're opting to do one. Now is also a good time to sign up for a childbirth class as they tend to fill up fast.
People are going to start giving you lots of stuff, including lots of stuff you don't need or don't want. Additionally, there are often local resources for getting things you do need inexpensively. Having a baby registry is a great way to get some of the more expensive items.
Here's when we begin bi-weekly appointments. At your 28 week appointment I'll offer screening for gestational diabetes.
Please order your birth supplies kit by 35 weeks so that it's ready for the 36 week prenatal appointment. This is a custom kit through In His Hands, which you can find via the link or by searching my name under the "Midwife Birth Kits" menu option. Feel free to remove items that you already have, or to include items you might need (like oral vitamin K).
Optional items that can be added to the birth kit include:
Additionally, please have these ready for your birth:
If you're planning a water birth:
Preterm labor refers to contractions with softening and opening of the cervix prior to 37 weeks. These contractions are different from the painless tightening “Braxton-Hicks” contractions that you may already have noticed.
Signs to watch out for would be contractions coming in a pattern of at least every 10 minutes for at least an hour. They may feel like cramping or discomfort in the lower abdomen, and/or back pain.
Someone might notice a change in their vaginal discharge, and in some cases, their water might break and fluid might keep dripping out.
Some common situations can cause increased contractions.
If you think you might be having regular contractions prior to 37 weeks, try:
If contractions continue and you suspect you might be in preterm labor, call me. And, if you think your water has broken, call me.And as always, if you have any questions or concerns, we can discuss them.
At your 36 week appointment we'll be looking at how you've prepared your home for birth. At this appointment I also offer screening for Group B Strep. And, we'll be seeing each other weekly now... almost there!
Below are the choices that you have for your baby in the immediate postpartum. We'll talk about all of these in prenatal appointments, and I strongly encourage you to read through the links.
Below are the choices that you have for your baby in the first few days of life. We'll talk about all of these in prenatal appointments, and I strongly encourage you to read through the links.
Vitamin K - Supplemental Vitamin K is given to prevent a bleeding disorder called Vitamin K Deficiency Bleeding (VKDB)
Yes--lots of pregnancies go past 41 weeks! For the most part, these are normal pregnancies, and it's not unusual to hear that someone's mother or sisters also went to 42 weeks (or longer). Hang in there!
I'll be visiting you in your home frequently during the first week postpartum. I visit between 24-48 hours, around day 3, around day 5, and then I'll see you at two weeks and at six weeks. More visits can be arranged as needed.
I will bring worksheets to your home that we will fill out. You will then bring these worksheets to the city hall of the municipality where you had your baby. See the form below to find out what kind of information the state requires from you.
This is a heelprick blood draw offered between 24-48 hours postpartum, and screens for roughly 30 different metabolic disorders that, if caught early in life, are treatable. States have different policies regarding the storage of infant blood samples. In NH, blood samples are destroyed after six months.