Well Woman Care
As Certified Nurse Midwives, we offer a full scope of well- woman services to all ages. Including complete annual gynecological exams, pap smears and STI (sexually transmitted infection) screening.
Annual exams may include other preventive health services, such as tests for cholesterol and triglicerides, thyroid screening, or referrals for mammography or bone density screening.
Our contraceptive counseling includes all modalities currently available, including hormonal contraceptives, diaphragm and cervical cap fitting, IUD insertion and natural family planning.
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Pre-Conception Care
The period of time prior to getting pregnant is a time of planning. The pre-conception visit can help you and your partner to identify areas in your lifestyle, or in your medical and family history that can affect the pregnancy.
Pre-conception counseling can help identify potential genetic vulnerabilities. If needed, we can refer you and your partner to a genetic counselor for a detailed evaluation of individual risk factors. We can also help you to resolve any existing illness or lifestyle issues that may have an impact on the pregnancy.
A complete well woman exam is advised as well as a blood test to check immunity status to viruses like rubella (German measles). Together we can review your diet and exercise routines, any herbs or medications you routinely take, and evaluate your need for vitamin supplementation, We will also discuss fertility awareness in order to help achieve and sustain a healthy pregnancy.
Prospective parents often use the pre-conception period to interview caregivers in a "consultation only" meeting. Please refer to the section on consultation under prenatal care.
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Prenatal Care
Prenatal care at MCA begins with an initial prenatal consultation visit. This visit is free of charge and generally takes about one hour. We will discuss our history and philosophy, the pros and cons of both home and hospital birth, and answer any questions you may have.
This is your opportunity to discuss your personal needs. You may wish to explore such issues as your previous birth experience, hopes and fears for this pregnancy and birth and your personal beliefs.
The consultation visit will allow you to see if our style of midwifery care seems to meet your needs and desires. Consultations and most other visits take place in our office.
At your first prenatal visit we will discuss your medical, social and obstetrical and gynecological history. We will also provide a physical and pelvic exam and perform lab work. You will be oriented to the self-care concept of our practice and shown how to check your urine and weigh yourself. This visit lasts about one hour. Subsequent visits will last about a half hour.
The prenatal care schedule will consist of monthly visits until 26-28 weeks, then every two weeks until 36 weeks then weekly until delivery. Women having risk factors will individually schedule a visit with Capital Health's Department of Maternal-Fetal Medicine, and a plan of care developed in conjunction with the perinatologist. A home visit will be done for those planning a home birth at about 35 to 36 weeks. We encourage the involvement of your family and welcome them at your visits.
Your acceptance for midwifery care and homebirth will be based on your low risk status, which we reassess continually as your pregnancy progresses. We also request that you have a primary medical doctor who attends to you for non-pregnancy related issues. If some aspect of your medical condition or history necessitates a hospital birth, we can continue to provide your care and you can birth with us at our hospital. Some complications may be beyond the scope of our practice. In this event we will discuss options for transfer of care with you. We will however continue to provide information and support, and will attend your birth if possible.
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Home Birth
Couples planning a home birth will have their initial prenatal visit with us by their 28th week of pregnancy, if they have had prior care, or by 20 weeks if not previously enrolled in care. We feel that it takes some time to create the atmosphere of mutual trust that surrounds a the ideal home birth experience. Later registrants may still use our services in the hospital setting.
Home birth couples often benefit from taking a series of childbirth classes, whether a full course or a brief refresher. Just taking the time with a class to focus on your wishes and thoughts around the birth of your baby can help prepare you for the reality of labor and the early days of parenting.
We ask that each home birth couple arrange for their baby's care by a pediatrician, pediatric nurse practitioner, or family practice physician. The baby will be seen by their chosen care provider within a few days of the birth.
We will provide you with an order form for birth supplies, and a list of items to have on hand for the birth. By the time of your home visit at about 35 or 36 weeks, preparations should be about complete, including child care for your older children, if they are to be in the home during the birth.
Remember that even with the best of planning and risk screening, not all births can take place at home. When situations arise which preclude a home birth, it is helpful to have a plan for dealing with practical issues, such as arranging care for older children and pets, having a small overnight bag packed, installing the infant carseat in the car, and knowing the shortest route to the hospital.
With some forethought, a home birth can be a very life-affirming, comfortable, and simple choice, giving parents maximum autonomy and privacy.
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Hospital Birth
When seeking an alternative to home birth, by choice or due to clinical risk factors, couples will find that a hospital birth under our care is a unique experience. The same care is taken prenatally to identify and resolve risk factors, in conjunction with our associated medical resources. This means that you will have ample time in each prenatal encounter to address your questions and concerns. The big difference in our approach is in our labor care. We make a commitment to provide continuous support and attendance for your birth from the time we meet you in the hospital through the hours following the baby's arrival.
Prenatal classes are strongly encouraged for all couples. Labor is very demanding, and having a good set of coping skills lined up is helpful. Our statistics show a low rate of medical intervention, as we focus on natural techniques for mitigating labor pain or stimulating contractions. The physical and emotional support you receive during labor helps shape your perception of the experience, but more important, it also can help you realize our shared goals of a healthy mother and baby, a vaginal birth, and even a birth of your dreams.
Our hospital is set up to avoid any separation of mother and baby, unless it is necessary for the baby's condition. Fathers may be present round the clock, and siblings and grandparents may visit. For couples who desire an early discharge, we will help make arrangements to have a healthy baby seen by pediatric care providers, and we will provide home follow-up as needed.
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Postpartum and Newborn Care
The Midwives at MCA understand that the postpartum time can be the most challenging time of all. We ask all our new mothers to check in with us on a daily basis during the first few days. A home visit is done during the first three to five days on all homebirth clients, as well as hospital birth clients with early discharge.
This visit includes completion of the baby’s birth certificate and Inborn Errors of Metabolism (IEM) testing, as well as physical exams of mother and newborn, breastfeeding support and weight check as needed. We expect parents to have the NJ state-required Newborn Hearing Screening performed on their baby within the first thirty days of life. We check in again with the family at about 1 week, then as needed until the final office visit.
A four to six week postpartum visit is scheduled to assist you with family planning, and to make sure that all is back to normal. This schedule is flexible and is adjusted according to the family’s needs.
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