When labor starts, the mother contacts the midwife on call for the practice. Upon admission, the family settles into their choice of available birth rooms.
One of the midwife’s most important roles is to support the mother and family with education about the process of birth. She carefully evaluates the mother’s vitals signs and the baby’s heart rate using a handheld doppler throughout labor. A vaginal exam is only done with the mother’s permission when checking for progress is deemed appropriate.
Our mothers are active participants in the unfolding of labor and birth. They are encouraged to eat, drink, and change positions often. They may relax in the warm birthing tub or shower, or they may use the birthing stool or birthing ball. Some moms spend periods of time in the bed, quietly relaxing through contractions and resting their muscles and/or receiving a massage from their partner.
Well-prepared family members offer additional support to the laboring woman or gather in our Family room, watching movies, cooking, or just staying close in order to greet the new baby.
Our midwives assist moms to birth in many different positions with the goal of facilitating the birth. The midwife is aided in the birth by a highly-trained assistant who is available the entire time in labor and during the second stage (pushing phase) of labor.
Upon birth, the new baby is placed on the mother’s chest for warmth and for bonding. There is no rush to cut the cord or to hurry the baby out of the room for procedures. All the emergency equipment for the baby is in the birth room next to the mother. A complete newborn exam is performed along with basic newborn care.
Some moms chose to labor or even birth in water. Laboring in water has many known benefits, the greatest of which may be its promotion of relaxation and effective pain management, minimizing the need for medical intervention. Advocates contribute the weightlessness of the water to decreasing the energy expenditure of the mother, and the increased relaxation to less anxiety and adrenaline levels which therefore, encourages endogenous oxytocin and oxygen to the uterus. Because there is no external compression of the inferior vena cava, as would occur when laying flat on the back in a hospital bed, blood supply to the uterus is improved, allowing for more oxygenation of muscle tissue to produce more effective contractions. Blood supply to the placenta is also increased, allowing for improved fetal oxygenation. The ease at which the mother can move in labor and while pushing is believed to optimize fetal descent.