Living Waters Midwifery, LLC Emily Likens CPM, CD
719/429/0361 cell
MIDWIFERY SERVICES
Serving Plainwell, Kalamazoo and the surrounding areas
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 36 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 one hour long. Please feel welcome to have your husband/ partner, children, support persons and friends to your appointments. These appointments provide plenty of time to discuss any questions that may have come up as well as any concerns or fears surrounding the pregnancy and birth. At each prenatal I will check:
 •Weight
•Blood pressure
•Pulse
•Urine
•Fundal height
•Position of the baby
•Fetal heart tones
•Your emotional wellbeing
I will also check your temperature, go over your medical and obstetrical history, and discuss general prenatal nutrition during the first few prenatal visits. If possible basic lab work will be ordered in the first trimester. At 28-30 weeks, I will check your hemoglobin and random blood sugar. Between 34-37 weeks I will bring you the birth kit and email 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 home visit and for the birth.
Birth Care
When you start labor, I will come as soon as necessary or when you feel you need me. 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 guiding you during pushing and using warm compresses for perineal support. In the unlikely event of an emergency, I come prepared with the ability to perform neonatal resuscitation and CPR, administer oxygen, 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 7 and day 10
•Three week postpartum
•Six week postpartum (if desired)
These visits will include the following:
•Complete 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
The following may be needed and are not included in my fee for services:
•Dietary and herbal supplements
•Childbirth classes, which I recommend
•Lab work
•Diagnostic ultrasound
•Antepartum or postpartum RhoGam (if mom is Rh negative)
•Newborn screenings (NBS) or other screenings/tests required by Michigan
•Any referred services (i.e., diagnostic ultrasound, consultation with a physician)
•Transfer of care to a physician or hospital including ambulance or emergency personnel fee
•Pediatrician
•Circumcision (if you choose)
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 36 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 one hour long. Please feel welcome to have your husband/ partner, children, support persons and friends to your appointments. These appointments provide plenty of time to discuss any questions that may have come up as well as any concerns or fears surrounding the pregnancy and birth. At each prenatal I will check:
 •Weight
•Blood pressure
•Pulse
•Urine
•Fundal height
•Position of the baby
•Fetal heart tones
•Your emotional wellbeing
I will also check your temperature, go over your medical and obstetrical history, and discuss general prenatal nutrition during the first few prenatal visits. If possible basic lab work will be ordered in the first trimester. At 28-30 weeks, I will check your hemoglobin and random blood sugar. Between 34-37 weeks I will bring you the birth kit and email 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 home visit and for the birth.
Birth Care
When you start labor, I will come as soon as necessary or when you feel you need me. 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 guiding you during pushing and using warm compresses for perineal support. In the unlikely event of an emergency, I come prepared with the ability to perform neonatal resuscitation and CPR, administer oxygen, 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 7 and day 10
•Three week postpartum
•Six week postpartum (if desired)
These visits will include the following:
•Complete 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
The following may be needed and are not included in my fee for services:
•Dietary and herbal supplements
•Childbirth classes, which I recommend
•Lab work
•Diagnostic ultrasound
•Antepartum or postpartum RhoGam (if mom is Rh negative)
•Newborn screenings (NBS) or other screenings/tests required by Michigan
•Any referred services (i.e., diagnostic ultrasound, consultation with a physician)
•Transfer of care to a physician or hospital including ambulance or emergency personnel fee
•Pediatrician
•Circumcision (if you choose)
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