The hallmark of midwifery care is relationship. As midwives, one of the greatest tools we carry is to know our clients. During your prenatal visits, the birth team at Montana Birth & Midwifery Services will take the time to get to know you and your family.
Prenatal Visits
Each prenatal visit is approximately 1 hour in length and includes:
30 minutes for assessment
30 minutes for education and questions
Initial prenatal visits should allow for 2 hours and include:
Health History & Paperwork
Head-to-Toe Exam
Vital Signs
Urinalysis
Belly Check
Discussion of tests and labs
Education and Counsel
Prenatal Assessments Include:
Routine Assessment of Mom-
Blood Pressure
Pulse
Edema
Urinalysis
Weight
Overall Well-Being and Concerns
Routine Assessment of Baby-
Fundal Height
Fetal Heart Tones
Movement
Education and Counsel
Questions and Answers
Discussions of Tests and Labs
Preparing for Home Birth
Our prenatal schedule is as follows:
Our visits are every four weeks until 32 weeks then every 2 weeks until 38 weeks and we will see you every week from 39 weeks until birth.
First Trimester
10 weeks-
Interview & Establishment of Pregnancy (Hearing the Heartbeat)
If you desire an early ultrasound we will schedule it at this time if we have not already. This is not a recommended ultrasound unless dating is in question.
12 weeks-
Initial Visit and Lab Work
At this visit, we will review your nutritional and exercise diary and give recommendations as needed. Genetic screening is discussed at this visit and labs will be scheduled as desired.
Second Trimester
16 weeks-
Routine Visit
20 weeks-
An anatomy scan is scheduled. This ultrasound is strongly suggested as it allows us to know the position of the placenta in the uterus and know it is located safely away from the cervix. This also allows for the visualization of the vital fetal organs in order to know they are well without identifiable anomalies, and healthy for homebirth.
24 weeks-
Routine Prenatal. This week you will be asked to purchase a quality brand alfalfa supplement. We strongly encourage each first-time couple to take a childbirth education class. You can purchase an on-line class to watch from home, you can find a class in town that fits you, or we offer this class the first 3 Monday evenings of the month most months.
28 weeks-
Glucose Tolerance Test and CBC Lab Redraw. The glucose tolerance test (GTT) is a one-hour screening measuring glucose levels in your blood. We do not use glucola, but rather a postprandial screen, or you can order and bring with you a natural alternative such as The Fresh Test. We also as each mother to begin taking their alfalfa daily from 28 weeks until birth.
Third Trimester
32 weeks-
Routine Prenatal. This week you will need to rent your tub and order your birth kit.
34 weeks-
Routine Prenatal. This week you will be asked to purchase Dr. Christopher’s Birth/Labor Prep
36 weeks-
This appointment will be done in your home. We will talk about where you plan to labor and set up your tub if you are choosing to birth in water. You can give us a tour of your home and we will also look over your supplies and make sure everything is prepped and ready for your homebirth. You can safely give birth at home beginning 36 weeks and 4 days, here in Montana. The GBS screen will also be completed during this visit. This week you will be asked to begin taking your birth and labor prep.
38 weeks-
Routine Prenatal. This week, and each week until birth we will complete an AAT screen on your baby. This is an Auscultated Acceleration Test where we listen to the baby for 5 minutes to assess a fetal heart baseline.
39 weeks-
Routine Prenatal
40 weeks-
Routine Prenatal
41 weeks-
If you happen to still be pregnant at this point, which is very common for first-time moms, with 41 and 3 being the average, we will schedule a BPP. This is a biophysical profile which is an ultrasound measuring fetal movement, well-being, and amniotic fluid levels.
We are accessible for emergencies 24 hours a day throughout your pregnancy by phone, text or in person, and Monday – Friday from 9am-5pm MDT for non-emergencies.
Montana Birth & Midwifery Services is a team of birth professionals and our goal is two-fold: to serve the women and mothers of the Southwest of Montana and to train the next generation of midwives. Our office and care are frequently home to students under direct supervision.
“There is such a special sweetness in being
able to participate in creation.”
Pamela S. Nadav
Immediate Postpartum
The postpartum period begins the moment your baby is born and continues for the next two years. As your midwifery team, we will help facilitate the delivery of the placenta within 30 minutes to an hour following the birth of the baby. We encourage mom to be an active participant in this process. As providers, our desire is to hold and maintain the same sacred, calm space for the birth of the placenta as we did for the birth of the baby.
During this time your midwifery team will be assessing both mom and baby for well-being. Typically, your birth team will prepare a high protein meal, clean away birth necessities, start a load of laundry, chart, tuck you and your baby in and depart your home within 3 hours following the birth. We will examine the placenta and ensure mom has emptied her bladder prior to our departure.
Newborn
Your baby is here! What you have waited and longed for is now in your arms. As your birth team, we will do our best to honor this sweet time and assure as much assessment as possible is done all while skin-to-skin with your newborn and with the utmost care to not interrupt or disturb your sacred moments. Most assessments can be done without disrupting the bonding period with mom and baby, but we will want to assure the baby is pink, breathing well and has a strong heartbeat. After the first hour of uninterrupted mom and baby time, your birth team will fully assess your newborn. A newborn exam will be completed within close proximity to mom and dad. Your baby will be weighed, measured and examined thoroughly, then tucked near the breast and skin-to-skin with mom.
Breastfeeding
Postpartum
Following your birth, we will contact you at 24 hours by phone for a virtual check-in and will see you in your home at 48 hours. We do offer a 1-week complimentary breastfeeding wellness check in the home for first-time moms. At 2 weeks and 6 weeks, we will see you and your baby in our office for a well-visit and assessment. At 6 weeks we like to offer a complimentary mini photo session of your baby to say goodbye. We will assure you and your baby are recovering well and breastfeeding is a success. You may call or text at any time if it is an emergency. For all non-emergencies, we ask you to call or text during normal business hours.
Fees and Payment Plans
We will work towards billing your insurance so that you can afford the home birth you want and deserve. Most insurances are accepted, however if yours is not or you do not have insurance we never want price to be the reason you do or do not choose a home birth or a particular midwife. For this reason we offer several payment options and benefits. For example, if you pay in full by your second visit you will receive a 10% discount*. We will help you create a payment plan that suits your budget. A birth doula is included in our pricing, and we would love to tell you more about what we can offer you!
Call us today for your interview: 406-404-7388
*Refund policies can be found here.