Informed Choice Agreement

My role as a Traditional Midwife

My role as a Traditional Midwife is to partner with you in your pregnancy, birth, and postpartum journey. I offer you trauma-informed, non-medical, wise-woman care, and experienced education, mentoring, and support to encourage a healthy pregnancy, a physiological birth, and a gentler transition to motherhood, while also recognizing that birth can be unpredictable and can sometimes take its own path.

During my time with you, I will draw on my knowledge, education, and experience as a lifelong researcher and practitioner of ancestral nutrition, physiological wellbeing, scientific pregnancy nutrition, physiological pregnancy/birth/postpartum, folk and nutritional herbalism, and as a wellbeing mentor to help you navigate your experience with full autonomy.

A Traditional Midwife is recognized around the world as one having knowledge, skills, and experience in traditional midwifery outside of the technocratic medical model. A Traditional Midwife learns through experience, mentorship, and additional formal training but has not chosen the path or training of a Licensed Midwife within the medical model.

A Traditional Midwife is autonomous and not beholden to the regulation or requirements of a licensed midwife. As such, a Traditional Midwife focuses her practice and skills on protecting physiology, and all support emphasizes this focus to the best of her and your ability. A Traditional Midwife does not practice medicine, but she can help you navigate participation in medical tests or care if your pregnancy or birth calls for it, or it is something that you choose.

My services as a Traditional Midwife

All services are uniquely tailored to you and your individual situation. There is no one-size-fits-all. You will have the opportunity to discuss your needs and to ask for more or less of my time and input. I will try to accommodate your needs within reasonable human and professional boundaries.

Prenatal Visits:

Prenatal visits are our time to get to know each other and to discuss your pregnancy, previous experiences, your wishes for this coming baby, and life in general. We will meet at your home where we will discuss holistic nutrition, lifestyle wellness, holistic strategies for pregnancy complaints, complementary care for health concerns, working through previous birth trauma, and much more. We will talk about possible complications and how these might be handled either at home or in hospital. We will talk about routine medical testing that is offered to all pregnant women and how you can access those tests through a medical practitioner or licensed midwife, if you choose to do so. If you inquire, I will provide you with up-to-date information on the value and risks of various medical tests, and you alone are responsible for choosing and accessing the medical services you believe are best for you and your pregnancy.

I like to meet a few times during your pregnancy where these visits most often last for an hour or two (sometimes longer, if time allows). The frequency of visits is up to you. We do not follow the medical schedule of one visit per month, then every 2 weeks, then every week until birth. Most clients choose at least 5 prenatal visits (and more are available if you so choose!). I like to at least see you once per month, so we can develop a trusting relationship and get to know each other well. You will also have access to me via phone calls and text, for check-ins and questions.

Labor and Birth:

We will be in communication in those final days of pregnancy via text or phone calls to keep me updated and to share in your excitement and to answer questions. I can encourage you in the early hours remotely. At an agreed upon time, I will come to you to join you for your labor and birth. I will bring my birth supplies with me and will settle in to stay with you until the baby arrives. Please ensure there is food for all of us and a private place for me to rest and sleep as needed. I will take frequent breaks to both give you privacy and to ensure I’m not exhausted for your baby’s arrival. If you feel you will need more in-labor support, you may wish to include supportive loved ones or to hire a doula. If you are at the beginning of your labor journey and it is progressing at a leisurely pace, I may leave to return home to give you privacy and time to get into your own rhythm. I will return when needed.

Additionally, I like to offer birth photography to clients who may want that during their labor and birth at no extra charge. Of course, my midwifery support comes first, so there’s no guarantee that I will capture every single moment during birth. But you are welcome to request this option, if you would enjoy having professional photos of your autonomous birth experience. You are also welcome to hire a dedicated birth photographer, if that is your desire.

I like to have someone accompany me to the birth to act in a supportive role and to provide an additional pair of hands, if needed. This person will also be a traditional midwife or a trained student with skills. She will be approved by you and (barring unexpected circumstances) you will have the opportunity to meet her before your birth. An extra set of hands is greatly appreciated as each family needs and deserves tender loving care as their baby arrives. There is no additional cost to the presence of this assistant.

If I am unavailable to attend your birth either due to illness or a prearranged matter of importance, I will do everything I can to call upon my colleagues to attend your birth as my backup.

No traditional midwife can guarantee the outcome of labor and birth. From time-to-time, medical care may be desired or needed, and a transfer to a hospital may occur. I will help you in making this decision, discuss options for your transport, and prepare you for communicating with your medical team. It is your choice as to whether or not you would like me to accompany you to the hospital. If you do not want me to accompany you to the hospital, I will remain available via text and phone and I will visit you at home after you are released for postpartum follow-up.

Postpartum:

Once your baby arrives, I will stay with you until you and baby are tucked into bed and ready to rest. If you like, I can weigh and measure your baby, walk you through assessing your new little one, help with the baby's first latch, and help you get cleaned up and settled into bed with a nourishing post-birth snack or meal. We will discuss early newborn care and new-mother care.

The number and frequency of postpartum visits is up to you. Most clients enjoy at least 4 visits in the early days and weeks. I offer these visits throughout the first few months, and up to one year post-birth, as needed. If I am unavailable, I will offer one of my colleagues to come see you. During these visits, we can weigh the baby, offer breastfeeding support, answer questions about newborn care and new-mother care, discuss further routine medical screening and services that are available for your baby, and discuss registering your baby’s birth with the state (which I can do for you).

In addition, I offer a more ancestral-style postpartum care which can include nourishing meals, ceremonial placental burial, documentary photography of those early newborn days, gentle bodywork and Ayurvedic mama-and-baby support, and I can support customized rites of passage rituals designed by you. I also offer herbal support for postpartum, and you will receive a holistic kit of handmade products, if you are interested. These are all optional add-ons, should you desire them as included in your care. We can discuss your wishes and needs during our prenatal visits, and plan for your postpartum before your birth.

You are responsible for accessing any medical services for your baby for routine examination or for routine newborn blood screening as you deem necessary. I can offer metabolic screening services, and direct you to practitioners for further screening as needed and desired.

I am available for several months postpartum to answer your questions and to hear about your baby’s milestones via text messaging and phone calls. I also offer additional appointments to support breastfeeding, oral function discussions and resources, holistic hormonal health for you, motherhood strategizing sessions, elimination communication, co-sleeping, babywearing, cloth diapering, nutrition, physiological baby care, and more. If this interests you, we can chat during your prenatal or postpartum meetings.

Accessibility:

I will be available to you throughout your pregnancy, birth, and postpartum journey. If I have a scheduled time away, such as a family event or planned vacation, you will have access to my backup for any questions, concerns, or in-person visits as needed.

Please note that I am often on-call and so I sleep with my phone next to me. Please limit all non-urgent texting to the hours between 9am and 9pm. If it is urgent, such as being in active labor and wanting my presence, don’t hesitate to call me at any time. If I can’t be reached, please call my backup.

Limitations:

• I do not replace a licensed medical provider. You are expected to seek the services of a licensed practitioner for you and your baby according to your and/or your baby’s needs within your personal values, cultural, and historical context.

• I do not provide prenatal, postpartum, or newborn testing; administer, inject, or prescribe prescription medication; provide a medical assessment, diagnosis, or treatment. I will not perform any act that is restricted to a licensed practitioner. Any medical testing is completely at your discretion. You are responsible for choosing or not choosing testing and the information it provides to take action or not according to your own goals and values.

• I do not make decisions for you. I will help you gather the information necessary to make an informed decision. I will share my observations and information, but you are responsible for making decisions concerning your care, including accessing hospital-based services. It is not my role to tell you to go or not go to a hospital. I am there to help you make decisions that are in your best interest. Emergent situations may require emergency care; I will encourage this if such a situation arises.

• I am trained in neonatal resuscitation through the American Academy of Pediatrics Neonatal Resuscitation Program. This does not replace the services of a licensed medical provider nor does it offer the comprehensive services of a medical institution. As a non-medical attendant, I do not carry oxygen. I can provide emergency breathing support for a neonate until medical help arrives to the best of my ability and cannot be held liable for the outcome.

• I do not carry restricted pharmaceuticals (including but not limited to Pitocin, Rhogam, oxygen). If it is important to you that your midwife bring these medications to your birth, I can refer you to other local midwives who do.

• I do not work with clients who plan to perform genital cutting on their newborns (i.e. male circumcision or female genital mutilation). I also do not offer or administer Vitamin K injections, as it is restricted pharmaceutical. If this is important to you, I can refer you to additional midwives in the area who do support this choice and offer this medication.

• Under Utah law, I am able to file your birth certificate, perform the metabolic screening and CCHD screening (and hopefully will also be able to offer hearing screening in the future). I also have access to recommending you for a diagnostic ultrasound and to have blood labs done, if that is what you desire. You are also welcome to decline any and all of these services, and we will discuss them as needed.

• I support a client-led birth, including catching your own baby, clearing baby’s airway and giving breaths yourself, and birthing your own placenta. That said, if an emergency arises or the situation dictates, I am there to support a different plan of action, as needed. We will discuss this prenatally.

• I cannot be responsible for the outcome of your birth.

Secondary Midwife:

I will typically bring a Secondary Midwife with me to births, as she may be desired to ensure that there are enough attendants to support you in your birth experience. Further, there can be circumstances in which I would insist that a second midwife be included, such as the birth of twins or a planned breech birth. The cost of a second midwife at your birth is included in the fee.

Backup Traditional Midwife:

Should I be unable to attend your birth due to unforeseen circumstances, such as being with another family or due to illness, every reasonable effort will be made to ensure a Backup Midwife who has similar values and philosophies is available to attend your birth. The Backup Midwife will be paid from the fees paid under the Informed Choice Agreement at no additional cost to you.

Consultation Services:

Consultation services are available in lieu of a traditional midwife and are available on an hourly basis. Consultations are available for preconception, pregnancy, and postpartum education and support. Consultations can include individualized childbirth education, breastfeeding education and support, support with creating a birth plan, preparing for a family-centered home birth, navigating our maternity system, information for health concerns, freebirth preparation, and more. See my website for these separate services.

Fees:

• Inclusive fees for these services: $5000

• Consultations & Coaching: $75/hour

If you live beyond a 60-mile radius of Santaquin, Utah, there will be additional travel fees for my attendance at your birth. We will discuss this in our consultation and make a plan to ensure that the additional effort needed to support your pregnancy, birth, and postpartum will work for both of us, and plan for a fee to support my additional costs.

The standard payment schedule is to pay a Retainer upon signing the contract ($1000), with a regular payment schedule thereafter. I am also happy to create a custom payment schedule for you, as fits your personal financial needs. The Balance is to be paid in full by 37 weeks gestation.

Once we’ve agreed on a payment schedule and signed the contract, I’ll send over an invoice you can easily pay online (we can also set up an automatic payment schedule this way, if you’d like). You can also pay via cash (I can offer a discount for doing so). If financial hardship is a reality for you, reach out so we can discuss how to navigate this together.

Refunds:

• If there is an early pregnancy loss, prior to 20 weeks gestation, half the Retainer will be refunded. The remaining half will pay for any prenatal support and any ongoing post-loss support you may choose.

• If there is a pregnancy loss after 20 weeks, the Balance is not owed or refunded if already paid. The Retainer will pay for any prenatal support and ongoing post-loss support.

• If I fail to attend your birth due to my negligence you will be refunded half the Balance fee. The remaining fees will pay for prenatal visits, phone and virtual consultations, on-call time, and postpartum visits. If you fail to contact me, or choose not to, once in labor, or experience a precipitous birth where I or my Backup don’t have the time to reach you, the usual fee is still applicable. If you transfer to the hospital in labor or prior to labor to birth your baby under medical care, the usual fee is still applicable.

• If you terminate my services for any reason, there is no refund. Travel costs, if any, will still be incurred.

• If we mutually agree to part ways prior to 37 weeks, the Retainer is non-refundable and the Balance will not be owed.