What to expect during your pregnancy
- During your pregnancy, you will have visits with all three midwives in rotation, as we share call and want you to feel comfortable with all of us by the time you are ready to give birth.
- You will have a new OB visit, at which we will review instructions for pregnancy, warning signs, answer questions, and give you a requisition to get lab work done. The next visit will be the initial OB visit, which is an hour long. This gives us plenty of time to review your medical history, do a thorough physical exam, and go over instructions as well as answer your questions. You will then be seen once a month until 28 weeks, then once every 2 weeks until 36 weeks, and finally once a week until delivery.
- We offer family centered care, and you are welcome to bring your partner, friend, children, or other people that you would like to be involved in your pregnancy. Ultrasound is offered at 12 and 20 weeks, and may be indicated at other times for medical reasons. We will spend time getting to know you and providing individualized care.
- Midwives are experts in pregnancy and childbirth, and if any complications or situations of concern arise during the pregnancy, we will consult with and may have you see a perinatologist. Although most pregnant women are “low risk”, some women do have pre-existing medical problems or develop complications during the pregnancy. We do continue to care for women with well controlled gestation diabetes, pregnancy induced hypertension, and other problems. Having had a prior miscarriage or being Rh negative does not put someone in a “high risk” category; therefore they would still be a candidate for care by a midwife.
- At this time we are unable to attend the births of women planning vaginal delivery after cesarean due to policies at Alta Vista Regional Hospital. At this time we are unable to attend the births of women planning vaginal delivery after cesarean due to policies at Alta Vista Regional Hospital; however, we will provide your prenatal care and schedule an appointment for you to meet a provider we trust in Albuquerque who can offer you this important option. You would then deliver at either UNMH or Women’s Hospital
What to expect during labor and delivery
- A typical midwifery delivery will have less medical intervention than a tradition delivery. Many of our patients deliver without the use of medication. However, if the mother desires or it becomes medically necessary, the midwife has access to pain relief options.
- Other birthing options include water labor, birthing ball, rocking chair, birthing stool or squatting bar. Your midwife may also order IV pain medication or an epidural if you request or if medically necessary. An IV is not required; however if you desire pain medication or an epidural, you will need to have one. If you are Group B strep positive, will be receiving antibiotics through an IV periodically until your baby is born.
- During labor you and your baby are monitored for maternal and fetal well-being. In most cases this does not require being on the monitor in bed, and we encourage ambulation and use of tub. We also encourage drinking fluids and eating while in labor. Some women only want jello, soup or other light foods, while others prefer a larger meal. Your food intake may be restricted if you have an epidural or complications develop during the labor.
- When you are pushing your baby out, we may have you on the squatting bar, standing, on the toilet, on hands and knees or sitting up in bed. If it is your first baby, pushing can take a while and all these positions help the baby come down. We do not cut episiotomies; as the baby’s head crowns, we use warm compresses and gentle pressure to encourage a slow delivery of the head and decrease tearing. Should you need sutures, this will be done after the placenta delivers.
- The baby will be put skin to skin with the mom immediately following birth. If you plan to breastfeed (which we strongly encourage) the baby will be put to breast in the first hour following delivery, for optimal success in breastfeeding.
- Should complications arise at any point during the labor process an obstetrician is on call and available for consultation. If circumstance requires the obstetrician to be called, the midwife stays involved in the care and provides support throughout the delivery. Should you require cesarean delivery, your midwife will first assist with the surgery. Our c-section rate is very low, as is our rate of other operative deliveries, such as vacuum.
- After the birth of your baby, your midwife will come to see you in the hospital twice a day until you are discharged home. She will make sure you are comfortable and doing well, and teach you about breastfeeding, infant care, exercise and nutrition—as well as what to expect on return home with your new baby. A pediatrician or nurse practitioner who specializes in newborn care will come in to see your baby and talk to you about follow up care in the office.
- Two follow-up postpartum visits are scheduled with the midwife, at 2 weeks and at 6 weeks.