As midwives, we are committed to using our training and life experiences to promote health in the birthing family through comprehensive and individualized care during the prenatal period, labor, birth, and postpartum.

As part of your comprehensive care package, Sierra Homebirth offers:

Prenatal Care

Our care includes an in-depth initial visit and phone and email contact throughout care. Prenatal appointments are scheduled once a month until 28 weeks, every other week until 36 weeks, and once a week until the birth. At 36 weeks we make a home visit to familiarize ourselves with the birth environment and the route to your house.

Prenatal care is thorough and will include:

  • Risk assessment
  • Health history and physical exam intake
  • Regular physical assessment, including
    • assessment of blood pressure,
    • pulse,
    • weight,
    • fundal height,
    • fetal position,
    • fetal heart tones,
    • urinalysis,
    • physical conditions and complaints,
    • vaginal exams when desired or indicated.
  • Nutritional discussion and analysis
  • Some diagnostic testing, including
    • blood work,
    • gestational diabetes screening,
    • sexually transmitted infections screening
  • Birth education and preparation
  • Newborn care education
  • Resources and referrals

We will explain the procedures and answer any questions so you understand the childbearing process and the care you are receiving. We will monitor for signs of impending complications and offer suggestions when needed. Lab work including blood draws, pap smears, and STI screening with be gathered on site and sent out to a laboratory. All appointments are one hour long with the exception of the initial appointment and home visit, which may last longer.

Care During Labor and Birth

We will support you in creating the kind of experience you desire. We will attend the birth once active labor begins or earlier, if needed. Prior to active labor we will be in touch with you by phone. At the birth, we will monitor the health of the mother and baby by checking the mother's vitals, fetal heart tones, confirming fetal position, monitoring mother's eating and output and cervical dilation checks when necessary or desired. To the extent that it is deemed safe, you may give birth in the position and place of your choice, and may determine the level of our involvement in the birth.

Although most births can occur spontaneously and proceed best without interference, we will be there to offer assistance if needed, such as preventing perineal tears or managing a shoulder dystocia. Because complications can arise even in low-risk situations, we carry emergency equipment including oxygen, hemorrhage medications, and IV supplies. If needed, we can start an IV, suture a tear, and perform resuscitation. If a complication develops that would be most safely managed within a hospital setting, we will recommend transport and accompany you throughout the birth as planned.

After the baby is born we will be responsible for checking the newborn's condition, monitoring the mother and amount of blood loss, and checking the placenta. In the early postpartum, we will perform a newborn exam and procedures if desired, and continue monitoring the health of both mother and baby. We will stay at least 2 to 3 hours following the birth, until both mother and baby have eaten and are settled and stable, and the house is in order.

Postpartum Care

New moms and babies receive three home postpartum visits, with the first at 24 hours postpartum, the second between days 3 and 5, and the third between days 7 and 10 postpartum. Two in-office postpartum visits will also be scheduled at three and six weeks. Additional visits will be provided if there is any problem with the mother or baby.

Basic postpartum care consists of

  • Assessing the newborn:
    • vitals
    • body systems
    • umbilical healing
    • output
    • and nursing
  • Assessing the mother:
    • vitals
    • uterine size
    • bleeding
    • perineal condition and healing
    • pain
    • breastfeeding
    • bonding
    • emotional well-being

Special attention and support will be offered to help mother and baby establish successful breastfeeding. A newborn screen will be performed if desired. Pap smears and contraception counseling will be offered at the final postpartum visit for the price of lab work with no additional charge.

In addition, we offer the following services (not included in comprehensive midwifery care):

  • Low cost preconception counseling
  • Birth tub rentals
  • Herbal remedies
  • Well woman gynecological care

Our care does not include fees for lab work, physician consultation, hospital care, or ultrasounds. Every woman has the right to be accompanied by the person or persons of her choice to any visit. You have the right to a copy of any of your records and to additional medical opinions. Most importantly, you have the right to ask questions and to express your needs.