Living Waters Midwifery, LLC Emily Likens LM, CPM
MIDWIFERY SERVICES
Serving Kalamazoo and the surrounding areas
Prenatal Care
Prenatal care begins around 12 weeks gestation and appointments are scheduled aboutevery 4 weeks until 32 weeks gestation. Appointments are scheduled at 35 and 37 weeks and then weekly 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 40 min long. During these visits I will take your vitals, measure fundal height, assess the fetal position, and check fetal heart rate. These appointments also provide time to discuss any questions that may have come up, your emotional wellbeing as well as your feelings surrounding the pregnancy and birth. 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.
From time to time I have a student midwife working with me. I require students to be enrolled in a MEAC accredited midwifery school while learning the “art of midwifery” through hands-on clinical experiences with me. I believe that every experience a student midwife encounters ultimately makes her a better midwife and I enjoy sharing my knowledge with the next generation of midwives. Because of this, I will ask you before or at the first appointment if
my student may participate with your care alongside me. If you are uncomfortable with her performing any of the clinical tasks under my supervision, please let me know.
Birth Care
When you start labor, we will be in contact and I will come to you when it is appropriate. UsuallyI will have a midwifery student or assistant with me for the delivery. If I am not available when you begin labor (at another birth, for example), I will provide a qualified midwife as my backup or make arrangements with my transferring hospital. During labor, I will monitor your vital signs and general condition, cervical dilation (if appropriate), 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 ability to perform Neonatal Resuscitation, CPR, and to control hemorrhage with practical skills and 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. Care includes:
Mother:
• Assessment of vitals, blood loss, uterine tone
• Assessment of perineum and repair, if appropriate
• Shower, bath, or sponge bath
• Help to establish breastfeeding
• Ensure mother has eaten and is drinking fluids
• Ensure mother has urinated within 6 hours
• Give Postpartum Care instructions for mother/baby
Newborn:
• 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 Care
Postpartum visits are scheduled around the following times:
• Day 1 (within 48 hours of 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 made to the Department of Human Services
- Birth certificate is filed with the State of Michigan by midwife
- Newborn Hearing Screen referral, if desired
