Prenatal Care
Prenatal care is holistic and family-centered. Intimate partners and siblings are welcome. The initial visit may take two hours to get acquainted, review your medical/family medical history and to perform a physical exam. Clients may borrow a binder full of information regarding prenatal self-care, birth suggestions, postpartum care, parenting and self-nurturing. This is returned at the 6-week postpartum visit. There is also a wonderful lending library available to clients.

Appointments usually last 45 minutes to an hour. This allows ample time to assess a client’s* emotional, psychological and physical well-being. We check your blood pressure and pulse, your urine (for clarity & color, or urine dipsticks may be used to check for sugar, protein, ketones or bacteria), your fundal height (size of the uterus as baby grows), your baby’s heart rate, reactivity and position. We’ll discuss your diet and fluid intake, and, when needed, provide nutritional counseling. We like to know that you are getting adequate rest, exercise and emotional/social support. Referrals may be made as appropriate.


*Our mamas-to-be are not considered “patients”, as pregnancy is not an illness, but a normal condition. Childbirth is a natural event for all other mammals. See www.mothersnaturally.com.

Birth Attendance
Birth Attendance
Birth Attendance
The birth team consists of two midwives and, if you are agreeable, an apprentice/assistant. We are skilled at being low profile and honoring your intimate space with your partner (if you have one). Most likely you did not have an audience when you conceived this baby. We realize you may prefer privacy together for much of your labor, unless you inform us otherwise. One of us will monitor your baby’s heart rate periodically during the early active phase, and more frequently during later labor. As appropriate, we may perform vaginal exams to determine progress during labor. This varies with each birth.

We are soft-spoken and attentive. We relate to family members with the same care and consideration that we show our clients. Following the delivery, once mama and baby are stable, we leave the room to give you some alone time to bond as a family. We clean up, do our charting and return to do a thorough newborn exam and provide instructions for aftercare for mama and baby. At least one of us remains for 3 hours following a birth.

Homebirth, Waterbirth
Waterbirth Services
For information about the safety of homebirth, check out the Citizens for Midwifery website: www.cfmidwifery.org. Also, it is worthwhile to read the CPM (certified professional midwives’) 2000 Study published in the British Medical Journal in June 2005. This is a prestigious journal which only publishes 19% of the articles submitted. This particular study was conducted by Ken Johnson and Betty Ann Davis in collaboration with MANA (the Midwives’ Alliance of North America).

For information about water birth, check out www.waterbirthinternational.org. We have birth tubs to rent. We also have a waterproof Doppler for listening to your baby if you choose to labor or birth in water.

VBAC support
There is little mainstream support for women desiring a vaginal birth following a prior cesarean. As noted in Silent Knife, a popular book in the 1980’s, the risk of uterine rupture to a VBAC mother (without labor induction) is less than .5%. (Also see Henci Goer’s books, “Obstetrical Myths and Research Realities” and “A Thinking Woman’s Guide to A Better Birth.” )

Currently, however, ignoring this information, some hospitals will not offer vaginal births after cesarean unless there is an anesthesiologist in-house 24 hours a day, 7 days a week (the cost of which would be prohibitive). Many women, who lacked appropriate emotional support during their first labor culminating in an unexpected cesarean, go on to birth an even bigger baby vaginally. Some women lack knowledge about their own pregnant bodies and the natural process of labor. They may not have had access to childbirth education or encouragement to have a natural childbirth. Their partners too may lack the resources to be helpful. The intensity of labor may trigger body memory of earlier overwhelming physical sensation, times of not being safe.

Fear during labor can arrest progress. Stress hormones trigger a primitive fight- or- flight response (shunting blood to the arms and legs so as to enable flight from the saber toothed tiger). The uterus is, then, poorly perfused and contractions become irregular and ineffective. This can lead to a cascade of interventions and, ultimately, a cesarean. The diagnosis/recorded reason for the cesarean may presume cephalo-pelvic disproportion (baby’s head being too large for mama’s pelvis). Many women, who were given this diagnosis with their first births, go on to deliver even larger babies vaginally subsequently.

Several of my clients, following their home VBAC births, experienced memory of early sexual abuse that they had not been consciously aware of. Their second births, as well as the inner work they did during their pregnancies, facilitated tremendous healing. They were able to mother their children and show up in partnership with greater confidance and clarity.

We are available to provide VBAC birth attendance in home or hospital. We do extensive counseling prenatally and may recommend a 36-week ultrasound to determine placental site. We listen to baby frequently during labor at home.

In the hospital we play more of a doula role and act as labor support, client advocate and liason with the medical staff. We are there to provide guidance regarding clients’ options and rights. We are there to support family bonding, to keep the family together as much as possible and to encourage early breastfeeding. Referrals may be given, as needed, for adjunctive therapies, such as cranial sacral, acupuncture, psychotherapy.

Postpartum Care
Postpartum Care
We routinely provide six postpartum visits, and more when there are special circumstances warranting them. We visit you at home within the first 24 hours to check on mama and baby. We come again on the third or fourth day, to assess nursing when the milk is in and to check baby for jaundice. We’re also assessing family adjustment and mama’s emotional state. We like to see you well supported. The next visit will occur somewhere between the 5th-8th day postpartum, possibly including the newborn screening if requested. Then, the two-week visit may be either in the office (if you’re up and about) or at your home. The four and 6-week visits are in the office. Information is offered regarding birth control and diaphragm or cervical cap fittings may be scheduled. Immunization information is provided prenatally and may be discussed postpartum as well.

If you are a first time mother, or, in Sonoma County, if you live in the Reading Readiness Area, you are entitled to three free homevisits through the Families First Program, which is funded by the tobacco tax money in California. I have taken two of the three necessary trainings to provide these visits to date. The first visit occurs within the first six weeks of your baby’s life; the second within 3-6 months; the third between 6-9 months. Much parenting and breastfeeding information is provided through client handouts, dvds, parent questionnaires and discussion with the homevisit. Developmental stages are addressed.

Hospital Doula Services
Hospital Doula Services
Hospital Doula Services
Women who have the continuous emotional support of another person in labor statistically experience shorter, smoother labors, with less intervention and fewer complications. We are there for you to interface with the hospital staff, to advocate for you and to assure that your wishes are respected.

Doula Services may be contracted to include several visits prenatally and one or two homevisits postpartum.

If a homebirth transport occurs, licensed midwives remain with clients in the role of a doula. We usually stay with a client until the infant has latched and is breastfeeding.

Well Woman Care
Well woman exams include a general physical exam, teaching breast self exam. Pelvic exams include gonorrhea/chlamydia cultures and pap smears. Vaginal imbalances may be cultured for as well. Diaphragm and cervical cap fittings are offered.

Placenta Processing
Placenta Processing Services
The placenta is a source of progesterone. Roasting/baking the placenta, pulverizing and encapsulating it may provide the new mother with a supplement she can take as needed postpartum. Other mammals consume their babies’ placenta immediately postpartum. This is an additional service we offer.

Prenatal Support Groups
Prenatal support groups enable mamas-to-be to deepen their relationship with their pregnancy, their baby and with other pregnant women. This series of meetings includes group process, guided visualizations, singing, dancing, prenatal/partner yoga, birth art. They are co-facilitated by Constance & Nancy Burns, MA, MFT.

Ceremonies
Blessingways/birthingways honor the mother-to-be, including friends and family. She is surrounded by loving community, celebrating her and this pregnancy with song, foot bathing, hair-dressing, and more. All are invited to contribute to this living ritual. The woman is empowered to bring the energy of this special time into her birth. Perhaps she chooses to wear a necklace of beads each person has brought to the ceremony or to bring cards and pictures she has received. We may sing blessingway songs together during her labor, invoking the nurturing energy of her circle.

Hypnosis for Childbirth
Hypnosis for Childbirth Services
Self-hypnosis may be taught prenatally. I have studied hypnotherapy with Richard Olney (Self-Acceptance Training), Lorna Cutler (Ericksonian), Marie Mongan (Hypnobirthing) and David Quigley (Alchemical). Hypnosis is a wonderful tool for relaxation during childbirth.

Se Habla Espanol
I am fluent in Spanish and use it frequently in my clinic work. A phrase which I can say quite glibly and reliably produces at least a smile, if not a chuckle, translates: “My Spanish is so-so. I miss the jokes, and very often my Spanish is the joke.”

Lactation Support
Lactation Support Services
I have been trained as a Lactation Specialist, have breastfed my own four babies and have been providing postpartum breastfeeding support for many years.

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