By Meredith Klein CPM, LDM, RN, BSN
People often comment on how “cozy” my office is. And while office decor is not one of the skills they teach in midwifery school, it is not unimportant.
Clients are welcome here by themselves or with their families, and we intend for them to be comfortable. We spend a lot more time together over the course of care than they would with a hospital-based provider. We serve them tea. We have toys for their other kids to play with and a library of interesting pregnancy, birth, and health-related books for them to peruse. We schedule enough time in our visits so we can attend to their human connection needs, as well as provide meticulous clinical care and risk assessment.
1- Expect to Feel Seen, Heard, and Supported
Your first visit with a midwife will likely be scheduled for 60-90 minutes. There is a lot to cover and we don’t want anyone to feel rushed.
You can expect that we will ask you how you are feeling, both physically and emotionally, before we jump in and start taking your vital signs and going through paperwork.
Acknowledging that there are many paths to becoming pregnant, and just as many ways of experiencing it, we want to get to know you and your story. This isn’t just ‘ice breaker’ kind of conversation, it is a deliberate foundation building and cumulative unfolding over time that helps us serve you better and more intimately on the day you give birth (and throughout the whole process, really). We are able to provide a much more individualized care model because of the time we take with folks.
By the time you are giving birth, we have:
- Been to your house
- Know your kids
- Made opportunities for your partner to get their questions answered and feel comfortable
- Know your most intimate desires for this experience (besides a healthy mom/birthing person/healthy baby, which is always the priority no matter where you give birth).
We are able to serve our families in the context of their community/family, honoring and tending to the whole experience of being pregnant and giving birth, without compromising safety.
2- Expect to Go Over Your Medical History
On your first visit, you can expect us to take a thorough medical history, as well as the benefits and risks of community birth, as well as hospital birth, so that you can make true informed consent about the path you are choosing.
Transparency and open communication are some of the hallmarks of midwifery care, and you will get a sense of that from the very first visit. We don’t shy away from questions about risks/benefits, our professional background, and how we’ve handled emergencies in the past. We want you to feel comfortable and well-informed.
That thorough medical history is so important, as we need to ensure that there are no risk factors that would be an obstacle to giving birth safely at home or at a birth center. It is also an opportunity to get to know more about you, as well as a “jumping-off” place from where we might talk about new research we’ve read on various topics or offer insight on natural remedies/nutritional support for various conditions. This will be a thread weaving through all of your prenatal care: we love talking about food and nutrition, and even end up swapping recipes sometimes.
Our focus is on supporting health and preventing complications, and basic things like food and movement (and targeted supplementation) go a long way in supporting healthy pregnancies. We give you suggestions that are reasonable and attainable with your particular preferences and resources. And while sometimes pharmaceutical medications become necessary, many of our clients are willing to try (and are successful with) lifestyle changes and natural remedies first.
3- Expect to Enjoy Yourself and Your Visit
You can expect to have a good time (or at the very least feel comfortable) when you come see your midwife for the first visit, and hopefully all of them! There’s nothing you need to prepare, and will never feel judged or criticized. We love what we do, and we are sincerely excited to support people in the journey to becoming parents and to be there when you get to hear your baby’s heartbeat for the first time. We’re also not going to overwhelm you with enthusiasm if you’re not excited about this pregnancy yet, or if you’re having prenatal depression or anxiety. We want you to feel seen for exactly where you are in the process.
This is a collaborative process, and you get to set the tone. You will likely be meeting the midwives on your first visit that will be the ones on-call when you go into labor, so the relationship building starts right away. It’s so reassuring for folks to know the people that will be there during one of the most intimate and transformational experiences of their life. The honest communication and trust we build over time actually lend themselves to increased safety in the out-of-hospital environment.
You Are the Expert on Your Body
It might take some getting used to, but we’re not going to tell you what to do. We are going to treat you as informed consumers of healthcare. While we are certainly experts with lots of experience and information to share, you are the expert on your body and your choices. Of course, we have protocols to ensure that you continue to be “low risk” and an appropriate candidate for giving birth outside the hospital, but within that, there is lots of room for you to make the decisions about your care.
It is more work for you, honestly, because we are going to ask you to do research about various choices and to think critically, but it can be so satisfying and empowering, to be more in the “driver's seat” of this experience. It turns the typical power dynamic between the healthcare provider and patient upside down. And by the way, we’re never going to call you a patient, since you’re not sick, you’re pregnant!