Living Waters Midwifery, LLC
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Living Waters Midwifery, LLC                                                                                                             Emily Likens CPM                  
719/429/0361 cell  
 MIDWIFERY SERVICES
Serving Plainwell, Kalamazoo and the surrounding areas


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Prenatal Care
     Prenatal care begins around 12 weeks gestation and appointments are scheduled about every 4 weeks until 28 weeks gestation. At that time I will see you about every 3 weeks until 37 weeks. After that I will see you every week until you deliver your baby. I encourage you to invite everyone whom you plan to have at the birth to attend the home visit at 37 weeks so we can meet each other.
     Each prenatal appointment is approximately 30 min long. These appointments provide time to discuss any questions that may have come up, your emotional wellbeing,  as well as your feelings surrounding the pregnancy and birth. During these visits I will take your vitals, measure fundal height, assess the fetal position, and check fetal heart rate.
     I will go over your medical and obstetrical history, and discuss general prenatal nutrition during the first few prenatal visits. If possible customary pregnancy lab work will be obtained in the first trimester and again at 28-30 weeks.  I will also give you the supply list of items you need to have for your birth.  Please have them gathered together with the birth kit in one location for your 37 week visit and for the birth.

Birth Care
     When you start labor, we will be in contact and I will come to you when it is appropriate.  If I am not available when you begin labor (at another birth, for example), I will provide a qualified midwife as my backup. During labor, I will monitor your vital signs and general condition, cervical dilation, fetal position, and fetal heart tones with a doppler. I will also assess your mental and emotional well being during labor. Communication with me is essential so that I may better help you achieve the birth you desire. Because the birth occurs at home, I do not provide pain relief medication. However, I am trained to provide labor support and can suggest different comfort measures to help you. I will make every effort to avoid perineal lacerations by using different techniques and perineal support. In the unlikely event of an emergency, I come prepared with the ability to perform neonatal resuscitation and CPR, and control hemorrhage with practical skills and natural remedies.

Immediate Postpartum Care
     After the birth I will stay with you for a minimum of two hours or until you and the baby are stable and doing well. During this time the birth area will be cleaned up and soiled linens put in the wash.  Care for both mother and baby includes:
     Maternal care will include the following:
•Assessment of vitals, blood loss, uterine tone & fundal height 
•Assessment of perineum and repair, if appropriate
•Shower, bath, or sponge bath
•Help to establish breastfeeding
•Ensure mother has a nutritious meal and is drinking plenty of fluids 
•Ensure mother has urinated within 6 hours
•Provide postpartum care instructions for mother and baby

     Newborn care will include the following: 
•Newborn exam
•Neurological and gestational age exam 
•Cord care instructions
•Vitamin K, if desired
•Eye prophylactic, if desired
•Cord blood typing, if mother is Rh-

     Postpartum visits are scheduled around the following times:
•Day 1 (within 48 hours of the birth) 
•Between day 5-7
•Three week postpartum
•Six week postpartum (if desired)

     These visits will include the following:
•Newborn assessment (including weight/height checks and measurements) 
•Checking your vital signs
•Addressing questions and concerns
•Newborn screen (NBS), if desired- Payment is made to the State of Michigan 
•Birth certificate worksheet is provided- Parents must file the birth certificate
•Newborn hearing screen information

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