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Prenatal Care Visit by the Nurse’s Point of View

You can hear the faint creak of the metal gait from the front of The Coit House as you make your way to enter the facility. Opening the front door, you notice a warming ring from the doorbell that will trickle throughout the three floors. Welcome to The Coit House led by Maura Winkler CNM and the Fika Midwifery team. We are so delighted that you are here!

 

At this point, you have established care as a birthing person and are currently expecting. So, some folx wonder, why prenatal care? Why is it necessary? By providing prenatal care, we are continuously ensuring your pregnancy remains healthy throughout the whole nine months. Routine prenatal care is important to make sure that the provider can detect problems early or prevent furthering issues in pregnancy. As far as statistics go, newborns of mothers that do not receive regular prenatal care are three times more likely to have a low birth weight and have possible birth complications. And according to the World Health Organization, mothers who do not receive any type of prenatal care are three to four times more likely to die from pregnancy-related complications. We focus on making sure the birthing person and baby stays healthy while maintaining requirements for low-risk community birth.

 

Who performs routine prenatal care? As you attend your prenatal care visits, you will be seen by the midwife Maura Winkler CNM along with the nurse at the birth center.

 

Where does all of this take place? Inside the Coit House where it is structured to feel like you are right at home. Literally. We even ask that you kindly remove your shoes and leave them by the door anytime you expect to spend time at the facility. The Coit House is the oldest house in Buffalo, New York and the beauty is evident throughout the house, bringing about a distinctive feeling when inside. Prenatal appointments take place on the third floor of the house. In these offices, which do not feel like regular offices, you will find yourself sitting on a cozy couch across from the provider. You’ll also notice furniture you would see inside your own home. The rooms are meant to be naturally inviting and warm. We try to make sure the atmosphere and environment is relaxed and comfortable, easy for trusting conversations. 

 

Here you are in the office, waiting to see the provider. What exactly is performed in routine prenatal care? Education. Conversation. Informed consent. Collaboration. Your first prenatal appointment will be the longest visit where we obtain your medical history and talk about any risk factors that are evident. This visit is to really learn about you and identify ways to ensure we are taking the best steps to care for you. We inquire about your lifestyle, diet, and habits. We will talk about your due date and will perform lab tests. The lab tests are to check things such as your blood type, measure hemoglobin (indicator of anemia), vitamin D levels, screening tests for fetal genetic abnormalities, and check immunity to certain infections. Urine samples are also collected to check for different types of infections. During this time period, you will have an ultrasound done for “dating” purposes around 7-8 weeks. Going forward, your visits will include an ultrasound at 20 weeks to examine your baby’s anatomy, screening for gestational diabetes, group beta strep screening, and a 36 week ultrasound for baby’s presentation. Your prenatal care is not limited to this and may require additional consultations.

All appointments will include gentle hands-on care which includes weight measurement, maternal blood pressure and heart rate, listening to the baby’s heart rate with a hand held doppler, and quick measuring of your fundal height. We cherish family involvement and encourage support systems at the office. 

 

We offer more than one prenatal care schedule. When do you need to see the provider? It all depends. We have a traditional care schedule that is followed by most care providers in the United States. However, we do offer a reduced care schedule that is more common in European countries which have better maternal and infant outcomes than in the U.S. There is also group care that can be added in conjunction to your prenatal schedule that includes evidenced based educational sessions and a chance to be a part of a-like minded individuals that are due to give birth around the same time. If you are having a baby for the first time, the traditional schedule is most likely the most comfortable for you. If you are someone who has had babies in the past or possibly resides quite far from the Birth Center, the reduced schedule might be more for you.

What do these schedules look like?

 

The traditional schedule is broken down into visits: 

  • Initial visit at 10-12 weeks
  • Monthly visits until 28 weeks
  • Visits every 2 weeks until 36 weeks
  • Weekly visits from 36-41 weeks
  • Biweekly visits 41-42 weeks

 

The reduced schedule is broken down into visits:

  • Initial visit at 10-12 weeks
  • Visit at 20 weeks
  • Visit at 28 weeks
  • Visit at 32 weeks
  • Visit at 36 weeks
  • Visits at 38 weeks, 40 weeks, and 41 weeks

 

We want you to feel right at home.

We need you to feel heard.

We promise during your prenatal care visits, we will actively listen.

 

We will collaborate together and use shared decision making. Bottom line, in our care you will be made aware and understand the best available evidence and we will incorporate your values and preferences into the decision!

 

Author Ashley Fino is a registered nurse and birth assistant at The Coit House and Fika Midwifery.