We are happy to schedule a free initial consultation with one of our midwives. The visit will take between 30 – 45 minutes. It is a great opportunity to see if our practice is a good fit for you and that your health status is a good fit for home or birth center birth. Please bring your partner or a support person & both read through our website before your visit. Feel free to bring a list of questions.

Click here for contact information.

While many pregnancies are unplanned, some folks are fantastic planners and like to prepare for their pregnancy. We would be delighted to meet with you for a preconception visit. We can run appropriate labs and discuss your concerns or questions.

The midwives at In Tandem Midwifery love waterbirth! Submersion in water can provide great pain relief in active labor. For the baby, waterbirth can be a more gentle entry into the world. Waterbirth is a very low waste birth option, which, when used also achieves the same reduction in disposable waste and the water can sometimes then be recycled onto your garden, both watering and fertilizing!

http://www.waterbirth.org/mc/page.do?sitePageId=38565&orgId=wi

We offer routine prenatal care every month until your 28th week of pregnancy. At that time, your appointment schedule will change to every 2 weeks until 36 weeks when we both come to your home for your prenatal visit. We will then see you weekly until your baby is born. Prenatal visits will last up to an hour, providing time for routine care, for you and your midwives to establish a relationship, and for you and your family to voice any concerns for discussion. Care will include obtaining and discussing medical, family, psycho-social and obstetrical-gynecological histories along with physical examination, fetal monitoring, and laboratory testing as appropriate. A midwife is available 24 hours a day, 7 days a week for urgent concerns and visits.

We also offer in-office Non-Stress Tests to assess fetal wellbeing as indicated.

A midwife is on call 24 hours a day to manage and answer your questions regarding early labor and to help determine when it is appropriate for the midwife to come to your home. Your midwifery team will aim to arrive at your home when you are in active labor. Natural comfort measures will be offered including; aquatherapy, homeopathy, massage, acutonics, and emotional support. Medical consultation and transfer of care to the obstetrician at the hospital will be available as needed. If a transfer of care occurs, the midwife will accompany you to the hospital and help facilitate a smooth transition of care to the hospital staff. Clients will be offered the option of having the midwife continue support while at the hospital as discussed prenatally.

More than 25 studies have shown that birth at home with a trained attendant is a safe option for low-risk, healthy women and their babies. You can find links to the most recent here.

We will perform a full newborn exam after your birth, before we leave your home. We will weigh and measure your baby, and provide the same physical you would receive in the hospital.

We provide in-home postpartum visits at days 1 and 3; assessing maternal and newborn health with full physical exams, jaundice check, weight check, metabolic screening, and lactation support. Your baby should be in pediatric care within the first 3 weeks after your birth.

We then see you in the office at week 1, 2, 4 and for your final visit at 6-8 weeks. Pap smears and other laboratory testing will be offered as appropriate at the final postpartum visit. A midwife is available 24 hours a day, 7 days a week for urgent concerns and visits. Postpartum doula care is available on an as needed basis. Postpartum doulas offer extenuated breastfeeding support, family support, light household support & help with planning.

We offer insurance billing for those with private insurance and we are in the process of
credentialing with several insurance providers, including DSHS medical coupons. Please contact us for instructions on how to verify your insurance coverage.

We acknowledge current financial challenges in this economy, but are also committed to providing access to quality, safe, affordable maternity care. Because of this deep-rooted belief, we will offer a sliding scale option for those in financial need who are paying out of pocket. Our regular global maternity fee is $4000 and includes prenatal, labor, and postpartum care (lab fees are not included).

The fee for Monitrice services is $1500.

Monitrice services are a great option for those planning natural, in hospital birth. As a monitrice, we offer labor support and advocacy. As midwives, we have the ability to perform certain medical tasks that are outside the scope of a doula including monitoring fetal heart tones, maternal blood pressure, and cervical dilation all of which allows you to labor at home for as long as possible. Monitrice services include doula support for the duration of your labor and extend to postpartum support 2 hours after the birth of your baby. The service also includes a home visit within your first week postpartum. We will offer breast-feeding support while you are in the hospital and once you and your baby return home. We provide emotional support throughout your pregnancy, labor and birth. We will see you for routine prenatal visits in your 3rd trimester of pregnancy along with your regular OB appointments. We will follow up with a postpartum visit within the first week after your birth. We will be available by phone to help with your transition to parenthood and offer referrals or resources as needed.

Please click here for research that shows the benefit of having a doula at your birth.

The evidence shows that out of hospital birth for low risk women is as safe or safer than hospital birth with fewer medical interventions. Women who chose homebirth have shown greater satisfaction in their care. Please see the articles listed below for review of the research.

Summaries of some of the most recent studies can be found below.

http://www.changesurfer.com/Hlth/homebirth.html

Some conditions that would be defined as high risk and are not appropriate for home birth with our practice are (multiple gestations/ twins, high blood pressure, breech presentation etc…)

No. Unlike what most people imagine, homebirth is rarely messy. The midwife and assistant will do everything possible to protect your home (and bed). Your birth kit will contain supplies that help us do this. When the midwife leaves your home you will be left with a bag of laundry (which we will happily get started for you) and a bag of garbage, but your home will look very much as it did when we arrived.

Sometimes circumstances of labor call for the need to facilitate transport to the hospital for additional support. Transport sometimes occurs in labor or in the immediate hours after the baby is born. In most cases there are events to precede the need to transport that lets the midwife know before a problem develops, allowing for transport non-emergently in your own car. Reasons for this kind of transfer may include, maternal exhaustion &/or desire for pain medication, insufficient contractions and need for pitocin, meconium in the amniotic fluid. Rarely, there is the need to call 9-1-1 and transport urgently by ambulance to the hospital.

Very rarely, and without warning, an event may occur that requires immediate and emergent transport to the hospital for equipment or services not available at home. In a situation like this, although there is no guarantee that being in the hospital would save a mom or baby it may make a difference. Parents choosing home birth must be aware of these risks and must be willing to accept those risks.

We love including older siblings into prenatal visits and the birth itself. With well-prepared kids, being at a sibling's birth can be exciting, special, and even fun. We really enjoy having siblings at births involved at a level at which both parents and kids are comfortable. Depending on age, it is important that older siblings have someone present at the birth that is there just for them: grandmother, babysitter, or family friend.

No, midwives do not offer pharmaceutical pain medication with the exception of local anesthetic for stitching small tears, which may occur during the birth. Midwives are trained to use many non-pharmaceutical techniques to help laboring mothers relax and manage the possible discomfort of labor. Immersion into a labor tub can be a very effective pain reliever for some women. Some of the techniques we can offer include: acupressure, massage, hydrotherapy, acutonics, sterile water injections, position-changes, counter-pressure.

YES! We love working with doulas & value the support that doulas offer throughout your labor, birth and postpartum period. Please see our list of recommended doulas. If you have chosen a doula that we haven't worked with before we would love for you to bring her to an appointment with you so that your team can meet before your birth.

We are happy to take recommendations from clients and add to our list.