​Midwives provide all the healthcare required for a low-risk pregnancy. Generally, if you do not have any serious pre-existing health conditions, and don’t take any medications that affect the developing fetus, you are appropriate for midwifery care. If you are unsure if you qualify for midwifery care, please fill in an intake form with your details or give us a call to discuss your situation.

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During the pandemic, we will be following our Pandemic Protocol. This means that all prenatal discussions and care planning will happen virtually, over the phone with in-person appointments reserved for the physical exams. Please be sure to have your list of questions ready for your phone appointment. To get all the necessary cleaning done between client visits and keep the traffic in the clinic low, midwives will be running on a tight schedule so please arrive for your in-person appointment on time. Each appointment will be split into 2 components, a phone call earlier in the week and an in-person physical exam later in the week. We will resume all care in-person like we used to do pre-pandemic as soon as it is safe to do so.

​What happens at appointments:

​​At every appointment your midwife will provide health teaching on topics that relate to your stage of pregnancy. They will also review your options around testing, screening, and care planning, order the tests you choose, make arrangements for any consultations you need, and spend time getting to know you and answering your questions. Each appointment consists of this discussion time as well as a physical exam. Physical exams include checking your blood pressure, your weight (if you choose to measure it), the growth of your uterus, the baby’s heart beat after 12 weeks and your baby’s position in the third trimester. We do a full physical exam when you begin care with us including a pap smear if needed. We draw blood and collect other specimens in our office for many of the routine tests so we may be able to save you a trip to the lab.

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​What happens at the first appointment:

We call the first appointment the Initial Interview and it is usually scheduled between 9 and 11 weeks (or as soon as you are accepted into care if you join us later than this). At this first meeting, we share lots of information about midwifery care and how the clinic works. We begin to get to know each other and discuss your plans and your concerns. We will discuss and arrange any time-sensitive tests. This appointment will include 30-60 minutes on the phone and 20 minutes in the office for a physical exam at around 12 weeks.

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​The history and physical appointment:

Your history taking and physical exam will happen at your first or second meeting with us. This appointment will last 30-60 minutes on the phone and 20-30 minutes in-person for the physical exam at 12 or 20 weeks.

We will take a thorough health history and discuss your options for routine testing and genetic screening.

The history taking will cover your past medical history including any previous pregnancies and births as well as your family history and the family history of your baby’s other genetic parent. It can be useful to talk with your baby’s grandparents and ask them about their family medical histories before your first meeting with the midwife. We also like to know about your family and lifestyle as well as your preferences for medical care so we can look after you in a way that feels comfortable and meets your needs. We encourage you to tell us anything about yourself, your life or your family that you want us to know. We have experience caring for people from all walks of life and all types of families including those on surrogacy journeys.

The physical exam will include listening to your heart and lungs, checking your blood pressure, feeling your thyroid gland, assessing your spine and lower back and palpating your abdomen. It will include a pap smear if you are due and a breast exam if indicated. Blood, urine tests or swabs may also be collected during the physical exam. We also measure your growing uterus and listen to the baby’s heartbeat.

​Schedule of visits:

9-11 weeks

• Initial Interview
• The midwife will likely begin your health history
• Discussion of your options for routine testing in early pregnancy and genetic screening
• Health teaching
• This visit will have a virtual component for the discussions and an in-person component for the physical exam

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15-17 weeks

• Health history taking if not completed at the Initial Interview
• Review your lab work and ultrasound results
• Plan for second trimester ultrasound if you choose to have it
• Health teaching
• This appointment is done virtually, by phone

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19-21 weeks

• Health teaching discussion and answering your questions
• Full physical exam including pap smear if not already done
• BP check, measure the uterus and listen to the baby’s heart beat
• Urine samples and/or vaginal swabs if not done in the 1st trimester
• This visit will have a virtual component for the discussions and an in-person component for the physical exam

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Late second and third trimester schedule of visits:

• 25-27weeks
• 29-31 weeks
• 33-35 weeks
• Then every 1-2 weeks until the baby is born

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​In the third trimester, visits include these components:

On the phone:

• Midwife will discuss certain topics and do health teaching
• Discuss and plan for any necessary testing
• Review results from any testing done since your last appointment
• Answer your questions
• You will review your plan of care together

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In person:

• BP check and you may opt to weigh yourself
• Measure the uterus to monitor baby’s growth
  
• Determine the baby’s position and listen to the heart beat
  
• May include a blood draw or other sample collection
  
• 38 weeks and later may include a vaginal exam