Prenatal care with a midwife

Your schedule with a midwife will probably be very similar to the schedule you'd follow if your primary caregiver were an obstetrician.

Starting in the first trimester you will see your midwife monthly until about 28 weeks (the beginning of the third trimester) at which time you will begin to see her every two weeks. At 36 weeks visits will increase to weekly. If there is some concern, your midwife will see you more frequently or refer you to an OB for medical care or testing.

If you are going to be giving birth at a Birthing Center, your visits may take place there as well.

Home birth midwives usually come to you for prenatal visits.

At each visit you will have your blood pressure taken, be weighed, and discuss with your midwife how you are feeling. She will ask questions, such as whether you have experienced any swelling, to get an idea of whether your pregnancy is progressing normally.

She will probably draw your blood at your first visit for a blood panel, which includes typing your blood (to determine RH factor), testing for HIV, and checking your iron levels to ensure you are not anemic. You will likely have a second blood draw at 28 weeks.

You may also do a simple urine test at each visit, to check for factors such as excess protein. You will do this yourself, simply comparing your test strip to a chart. There is no lab work involved.

Unlike visits to an OB's office, you will have your midwife's undivided attention for an hour at each visit (unless another client goes into labor, of course). She will answer any questions and concerns you and your partner may have. She will probably bring her assistant (often a midwife in training) to some visits, if not all.

Testing and Screening

In addition to the blood panel mentioned above, you will have the option of the regular tests that are routine if you see an OB. You may need to go into an OB or hospital for these tests, in which case your midwife will refer you to an obstetrician she works with or the hospital she takes transfers to (often this is the same person/place).

You may opt out of just about anything. Many women never have a sonogram or any genetic testing such as CVS. Most do not do amniocentesis. Everything is optional, though some tests are more strongly advised than others.

You also have the option to do some or all of the tests. Midwifery is about choices. Your midwife will help you to make informed choices.


More on Prenatal Testing:
Optional Genetic Tests
What a Doctor Knows by Looking at Your Baby's Nose
Earlier Down Syndrome Detection