Scope of Services Provided

The following is the scope or list of services included in your fee. This list is not all inclusive and not everything mentioned is required or will be offered to everyone. 

Antepartum these are services and procedures completed at each antepartum visit. Visits are usually once a month until 30 weeks, twice a month until 36 weeks and once a week until birth.

1. Weight
2. Fundal height
3. Determination of fetal position
4. Fetal heart tones using a Fetoscope
5. Medical and nutritional history since last visit
6. Check for edema of legs, face and/or hands

Intrapartum to be completed during labor.

1. Mother's physical condition (i.e. temperature, pulse, respiration, blood pressure, etc.).
2. Labor status (assessment of contractions, status of membranes, etc.).
3. Fetal position, station, size & presenting part.
4. Vaginal exams are kept to an absolute minimum, if any to avoid infection.

Postpartum procedures completed during immediate postpartum period. I will remain with the birthing family no less than two (2) hours postpartum; most of this time is spent filling out records, as not to impede on the birthing family’s private time with their new baby.

1. Ascertain that the placenta has been delivered completely and thoroughly exam it.
2. I do not repair anything more than a 2nd degree perineal laceration/tear.
3. Assess as needed: uterine firmness, vaginal bleeding, vaginal swelling and/or tearing, maternal blood pressure & pulse.
4. I will leave instructions for follow-up care including signs & symptoms of conditions requiring medical evaluation.
5. Postpartum follow-up will include family planning & dates for postpartum follow-ups at 24hrs, 4 days, 2, 4 & 6 or 8 weeks following birth.

Newborn Care procedures pertaining to the newborn completed postpartum.

1. Suction nose and mouth well, if needed. Most newborns do just fine at draining themselves.
2. Clamp & cut cord after birth of placenta unless it is a Lotus Birth.
3. Keep infant dry & warm with blankets and skin to skin contact.
4. Determine Apgar scores at one, five & ten minutes after delivery.
5. Observe and record specific information about newborn (height, weight, etc)

Postpartum Follow-up to be completed at each postpartum visit.

1. Weight
2. Medical and nutritional history since last visit
3. Assess as needed: uterine firmness, vaginal bleeding & vaginal swelling and/or tears.
4. Assess mother’s over all emotional and physical state.
5. Evaluate breastfeeding process and offer assistance if needed.
6. Evaluate infant’s overall appearance and well-being, as most parent already have a pediatrician or other health care provider for infant.

Procedures NOT Offered or Completed

1. Circumcision or other forms of genital mutilations
2. Hospital or birth center births
3. Prescribe or give drugs before, during or after the birth.
4. Suturing of perineal tissue or repairing of tears exceeding 2nd degree
5. Cesarean births
6. Clinical/Medical laboratory or Diagnostic Testing
7. Pap smears and other obstetrical procedures

The Birthing Parents will supply and be responsible for obtaining and paying for the following:

1. Educational Items: (books, videos, etc. not supplied/loaned by Natural Attachment) and outside childbirth preparation classes, if needed or desired.
2. Medical Laboratory or Diagnostic Tests: (Requested tests may include prenatal blood work, urinalysis, dietary analysis, nutritional supplements, viral blood screening (HCV, HBV, HIV, VDRL, Herpes, Strep B, Chlamydia, etc.), ABO-Rh blood typing and antibody screening, and any other medical tests that may be necessary in providing good prenatal care to the mother and baby and aid in the detection and management of possible birth complications. This may include amniocentesis for chromosomal analysis, or an ultrasound for fetal or placental concerns. All these listed must be attained from other Professional Medical Services such as those provided by a Medical Doctor, if the birthing couple wants or needs these services.
3. Rh Antibody Testing and Rhogam Treatment: In the case of an Rh negative mother and an Rh positive infant. This may include lab tests done on cord samples to determine the baby’s blood type.
4. Any hospital, clinical, physician, nursing, doula expenses related to the present pregnancy and any postpartum care not provided by Natural Attachment or that is not included in our Scope of Practice.
5. Prescriptions & Nonprescription (OTC) Medications required by the mother and/or infant related to the present pregnancy and postpartum care.
6. Emergency Care Expenses which may include taxi or ambulance transport, emergency room and physician expenses, surgery and medications.

Services Included

• Services of a Traditional Birth Assistant/Montrice/Doula On call 24 hours, every day  Homebirth with Waterbirth and Lotus Birth options Referrals to quality medical and alternative professionals Privacy of your own home for prenatal/postpartum care Referrals to childbirth educators, doulas or other complementary professionals Specialized out of hospital empowering birth education Personalized birth plan conference & birth kit Educational materials: Handouts, Lending library, Video library Heath/Wellness/Nutritional counseling Homeopathy, Herbal supplements, Vitamin/mineral supplements Birth attendance, Complete labor attendance; two to four hours postpartum (or as needed) Placenta disposal if desired 24-48 hour check up, 4th day check up, 2 week check up, 4 week check up, 6 or 8 week check up Newborn care, Newborn physical assessment at birth, pediatrician referral/consult if needed Herbal Oral Vitamin K administration if warranted/desired Newborn check ups with mum's visits to discuss any concerns