Standards of practice
- Continuity of care for the pregnant person and newborn throughout the perinatal period.
- Safe, satisfying, family-centered care that respects informed consent and self-determination within the boundaries of safe practice.
- Professional competence, continuing education, peer evaluation, and collaboration with consultation and referral resources.
Prenatal care
- Comprehensive history, due-date assessment, nutrition review, routine observations, appropriate laboratory coordination, documentation, and ongoing risk assessment.
- A standard schedule of visits every 3-4 weeks, then every 2 weeks, then weekly, individualized as needed.
- A home visit around 36-37 weeks to review the space, supplies, communication, family roles, newborn provider, and emergency transport readiness.
Birth care
- Ongoing observation of maternal and fetal well-being, labor support, attendance at birth, newborn assessment, management of the third stage, inspection for injury, and stabilization for at least two hours after birth or longer when needed.
- Julia makes every effort to attend with a trained assistant or second midwife and maintains 24-hour on-call coverage through backup arrangements.
Consultation, referral, and transport
- The practice maintains defined health conditions and clinical findings that require consultation, referral, a change in birth setting, or emergency transport.
- Reasons include maternal or fetal instability, significant bleeding, fever, signs of preeclampsia, concerning fetal heart rate, prolonged labor with declining well-being, retained placenta, severe hemorrhage, or maternal request.
- When transport occurs, Julia makes every effort to communicate with the receiving team, provide records with permission, and remain for support.
Postpartum and newborn care
- Follow-up around 24 hours, 3-5 days, 2 weeks, and 6 weeks, with attention to bleeding, uterine recovery, infection, feeding, rest, emotional health, newborn breathing, color, alertness, cord healing, elimination, and weight.
- Families are encouraged to establish care with a pediatrician, family physician, or other qualified newborn provider and complete newborn screening.
- Consultation or urgent evaluation is arranged for maternal or newborn findings outside normal recovery.
