If you think you are in labor, I will do a complete assessment (similar to a prenatal) and determine whether or not you are in ACTIVE labor. This includes a vaginal exam to assess effacement and dilation. The only other vaginal exams I require during labor are when you want to push or if I suspect a variance from normal. Otherwise, let's keep everything coming down and out, not up and in. You may request a vaginal exam at any time.
Look at labor, meet it, greet it and don't run away from the idea of pain. I will never tell you it doesn't hurt, but I know it can be tolerated and will definitely be worth it.
You may have whomever you wish to labor coach or be your doula. My assistants are also trained to be birth doulas. I will determine when to gather the birth team. Sometimes a student or another midwife will already be with you. They can assess when to call me or you may call at anytime.
I encourage walks, baths, showers, food, drink, intimacy, music, naps and anything you feel relaxes you.
Monitoring you and the baby will be done with a fetoscope and/or doppler, blood pressure cuff, stethoscope, thermometer, and urinalysis sticks.
When it is time for the baby to come out, you may birth in the position you'd like and with the person you want to catch (barring any unforeseen differences). The baby will be placed on your abdomen and encouraged to nurse. I and my assistant will be monitoring the baby, your uterus, your bleeding, and delivery of the placenta.
At 36 weeks a prenatal visit is done in your home. We will review the emergency plan and be sure everyone is clear on the procedures. You will have a list of emergency numbers and be instructed on how and when to utilize them.
Transport could be by private vehicle, if time and conditions allow, or by ambulance. I am trained in neonatal resuscitation, adult CPR, and oxygen administration, as is anyone working with me.
If we go to the hospital, I will go with you. I will call ahead with pertinent information and an ETA. I will speak with the doctor and/or charge nurse to relay a synopsis of the situation and give them copies of your history, labs, and prenatal flow sheet. It is best to leave other children with a caretaker if we transport.