Characteristics of the Midwifery Model of Care, which includes physiological management of labor and birth include:
1. Continuity of care with full prenatal care with lab work & ultra- sounds as necessary 2. Patience with nature 3. Social and emotional support 4. Full-time presence of the midwife during active labor 5. Mother-controlled environment (place) for labor and birth 6. Provisions for appropriate psycho-logical privacy (maternal control of persons present) 7. Mother-directed activities (positions & postures) for labor & birth 8. Opportunity for an upright and mobile mother during active labor 9. Non-pharmaceutical pain management strategies such as walking, one-to-one care, touch relaxation, showers, deep water tubs, doulas, and other traditional midwifery methods 10. Judicious use of drugs and anesthesia when needed for hospitalized mothers after a transfer of care 11. Absence of arbitrary time limits as long as making progress, mom & babe ok, 12. Vertical postures, pelvic mobility and the right use of gravity for 2nd stage/pushing 13. Birth position by maternal choice unless medical factors require otherwise 14. Mother-directed pushing – without prolonged breath-holding 15. Physiological clamping/cutting of umbilical cord, after circulation between baby and placenta has stopped 16. Immediate possession and control of healthy newborn by mother and father 17. On-going & unified care and support of the mother-baby during the postpartum/postnatal period.
What Responsibilities are Required From Home birth Clients?
As parents you no longer have just yourselves to consider but also your baby who is growing inside of Mama. Below are listed some scientific facts and responsibilities that will help you to achieve an optimal birth experience, no matter where you decide to birth.
1. Maintain good physical spiritual, and emotional health as a priority for yourself and your unborn baby throughout the childbearing cycle.
2. Eat wholesome and nutritious foods throughout pregnancy
3. Use nutritional supplements as indicated to maintain good health during
4. Abstain from the use of substances that could have a harmful effect on your unborn child such as cigarette smoking, alcoholic beverages,and other social drugs.
5. Protect yourself from exposure to infectious diseases where possible and from exposure to known or possible teratagens (x-rays, herbs, chemicals, toxins) in your personal or job environment.
6. Attend regularly scheduled prenatal visits at the agreed upon times.
7. Attend childbirth class series or a refresher course
8. Discuss, decide and choose your birth party well. Educate them as to your needs and ours. Give them jobs, as this is not a spectator sport.
9. Attend the La Leche League series (first two meetings at least) for breastfeeding education during the prena- tal period, unless you have successfully breastfed before.
10. Nurse your baby for a minimum of 6 weeks postpartum to ensure the immediate postpartum benefits to mother and baby. The American Academy of Pediatrics recommends breastfeeding for at least the first year and The World Health Organization says that a baby is lucky who is breastfed until the age of two.
11. Prepare your birth space well, and secure all the supplies needed.
What does Low-Risk Status mean to a client?
Although I believe that every woman has the right to choose where and with whom she has her baby, my practice is limited to low risk pregnancies and births. Should your pregnancy fall out of the low risk category, other arrangements will have to be made for the birth. Medical supervision within a hospital setting would be required for the safety of mother and baby. Some examples of these conditions are:
1. Poor Dietary Choices – which can lead to: Symptoms of toxemia & development of high blood pressure, premature labor, low birth weight babies, anemia, placental abruption, maternal PP hemorrhage 2. Finding mental conditions which affect major body organs, biological systems or competent mental function 3. Unstable relationship between parents of baby such as: Spousal abuse, drug, or alcohol use 4. Other physical reasons such as: Active Herpes II lesions, Chronic illness requiring treatment (thyroid issues, insulin dependent diabetics, heart disease, etc) 5. Home Living conditions with inadequate sanitation, light, heat, etc
Other reasons I will help you to find another health care provider include:
Refusal of clients to sign release forms
Inability to complete the Emergency Care plan form
Refusal of clients to follow a healthy eating choices
Inability to keep scheduled appointments or let us know in a timely manner
Refusal to eat or drink in labor
Refusal to breastfeed
If in labor, I ask you to transport and you decline, I will call 911 to initiate transport.
My absolute non-negotiable safe care standard in labor is that mom must be eating, drinking, voiding, and that her and baby’s vitals must be within normal limits. If any of these change and I am unable to stabilize the situation, than I firmly believe that a transfer of care is necessary. I base the standards of my practice on current written evidence, as well as commonsense and intuition.