While we do not accept Medicaid, we do offer a sliding scale for those who currently have Medicaid.
Most visits are scheduled for one hour. We take time to get to know you and your desires for your birth, discuss any physical issues you may be having, or any concerns about your birth. We also will discuss topics relating to pregnancy and birth to prepare you for your birth.
We perform standard labs throughout pregnancy and will order extra labs if necessary. We also refer you for ultrasounds for early date confirmation if necessary, request a fetal anatomical survey at 20-22 weeks gestation, and will order other diagnostic ultrasounds as needed. Genetic testing is also available.
Pursuant to FL Law, we are required to assess all clients’ risk status according to a specific scale. If you score 3 points or more on the risk assessment you will need to have a consult with an obstetrician to determine if you are expected to have a normal pregnancy, labor, and birth. Often times, you are sent back to us to resume your care. Should you develop a condition that risks you out of our care, you will be transferred to an obstetrician of your choice.
No. Licensed Midwives are autonomous care providers and are not required to practice under the supervision of a physician. You will not need to see a physician during your pregnancy if you do not have any complications.
Yes. Pursuant to FL Law, Licensed Midwives must carry malpractice insurance. When you sign on as a client we will provide you with our malpractice information.
All first time mothers are required to take Hypnobabies self study childbirth preperation series. For all other mother, while it is not a requirement, it is stressed as something that is very important, and is highly recommended. We do not refer clients to any one particular educator, but we are happy to provide referrals to several educators that we have found to provide solid comprehensive classes that have been beneficial to others.
As with child birth eduation, while it is not a requirment, it is stressed as something that is very important, and is highly recommended. Doulas are not a part of your clinical care team and provide continuous physical and emotional support thoughout your labor and birth, while your midwife and the birth assistant work to ensure the health and saftey of both mom and baby. We are happy to provide referrals to several doulas in the area.
You will need to gather some common household supplies, such as towels, a flashlight, paper towels, etc., as well as purchase supplies for your birth. We will provide a list of items for you to gather and have prepared by your 37 week home visit. We have taken the time to carefully put together a birth kit with the supplies you will need. We ask that you purchase your birth kit through Precious Arrows no later than 34 weeks to ensure that you have received it prior to your 37 week home visit. The link to purchase your kit can be found under our resources tab.
If you go beyond 40 weeks, it’s no big deal. Many women deliver after their due date. On average, first time moms will deliver 7-10 days after their due date. As you approach your 41 week mark we will send you for a test called a biophysical profile and non-stress test to ensure the health of your baby and the condition of the placenta. We will discuss natural measures to try and encourage labor to start. These measures may include using a breast pump, walking, herbs, acupuncture, etc. We will not, under any circumstances, induce labor using pharmaceuticals such as Pitocin, cytotec, or other drugs used in the hospital setting to induce labor. These methods of induction require significant monitoring and are not safe for out of hospital use. If by 42 weeks we are unable to get labor started, we are required to consult, refer, or transfer to a physician.
We do limit the number of clients we take on in any given month to avoid conflicts as best as possible. It is feasible, however for women who have due dates even three weeks apart to give birth on the same day. For this reason we have a backup midwife. The backup midwife will only be used if we are unable to attend your birth due to another birth happening at the same time, serious illness, or for cases of planned absence which you will be made aware of.
We will always have a birth assistant with us at the birth. All of our assistants have gone through extensive training and are certified in both CPR and NRP. You will meet the birth assistant at your 37 week visit.
Once we have spoken over the phone and determine you are in fact in active labor, we will make a plan for our arrival. It is often not the best thing for us to come to your home right away if you are in very early labor. This can make many mothers uncomfortable as we sit around waiting for something to happen. We will direct you as to when to check back in with us if you are not in active labor and keep in close contact with you.
It’s your birth. You may have as many or as few people as you like at your birth. Children are more than welcome to be in attendance; however we ask that you plan to have someone other than your partner available to care for them throughout your labor. We also know that sometimes when there are a lot of people present it can hinder the labor process and prevent you from getting into your labor zone. We advise that you plan carefully and take into consideration that we may ask people to leave temporarily if we feel it necessary.
Yes. We will discuss this during your 37 week home visit. Your partner will need to be present for this appointment if they wish to catch the baby.
During labor we assess the baby’s heart rate using a Doppler. Depending on how far you are in your labor progress will determine how often we check. The closer you get to delivery, the more frequently we will monitor baby’s heart rate and pattern. In general, we do assessments every hour during early labor, every half an hour during active labor, every 15 minutes during transition, and every few minutes during the pushing phase.
Licensed midwives are trained to handle many different labor complications and we carry the same medications and equipment found in the hospital for vaginal deliveries. In the event of an emergency that we cannot resolve, we are equipped to handle an emergency until transport to the hospital is complete.
During pregnancy we will educate you on perineal massage techniques for you to perform yourself prior to labor. It has been shown that perineal massage prior to labor reduces the incidence or degree of tears. During your delivery, we will support the perineum as best we can, however tears still happen a lot of the time. We will assess any tears after delivery and repair them if necessary by suturing. In the rare case that a tear is beyond our capabilities to repair, we would transfer to the hospital for the repair to be done.
Yes, we will go with you if a transfer becomes necessary during your labor. We will typically remain with you throughout the rest of your labor at the hospital. In the event we must leave we will do our best to provide a doula to take our place.
Yes. Sometimes babies need a little help getting started. We are equipped to handle resuscitation and both your midwife and her assistant are certified in CPR as well as NRP.
Yes. We will perform a complete newborn exam after birth before we leave your home. We will perform the newborn metabolic screening test at your 48 hour postpartum appointment. You will be encouraged to make arrangements for your baby to see your pediatrician at 48 hours after birth.
We will typically call to check in on you at approximately 24 hours, depending on the time you give birth, and then come to your home at approximately 48 hours, or day two, for your first postpartum visit. We will see you again at approximately one week, three weeks, and six weeks postpartum.
