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What's in my prenatal bag for Mom?

11/15/2020

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Urine dipsticks:  I do a urine dip at every prenatal.  I can learn a lot about pregnancy health with a urine dip.  Specific gravity can tell me if Mom needs to drink more water, leukocytes might appear if allergies are cropping up, or if mother is recovering from an illness.  If sugar is in the urine, I would wonder about diet and the possibility of gestational diabetes.  If protein is in the urine, I will be monitoring closely for signs of preeclampsia (a very serious condition in pregnancy).  If Mom isn't eating enough calories, or it has been a long time since she last ate, ketones may appear in the urine.

Hemoglobinometer:  Hemoglobin levels drop as a result of blood volume expansion during pregnancy. Low hemoglobin can be a cause of low energy levels or fatigue.  I want Mom to feel her best throughout pregnancy, and I want to be sure levels are in a safe range for a homebirth. While not as accurate as being checked at a lab, this tool can give me an idea of what changes are occurring with hemoglobin levels.

Blood pressure cuff and stethoscope:  Blood pressure is a measurement of how hard the heart is working to circulate blood throughout the body. High blood pressure can create issues with how well the placenta functions to supply nutrients and oxygen to baby.  High blood pressure can also be a sign of preeclampsia. I take blood pressure at every prenatal, I want to know what is normal for each mom and I want to know blood pressure is staying in a healthy range throughout pregnancy.

My most important tools: I believe my most important tool is listening well to Mom.  Mom is the one who best knows her body.  My other important tools are my intuition and knowing what is normal for each client and how that lines up with a healthy, low risk pregnancy.  




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What's in my prenatal bag for baby?

11/1/2020

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Picturephoto by PBJ
Measuring tape:  I use this to measure fundal (the top of the uterus) height.  This helps me assess how well baby is growing, and if the baby's growth is what I would expect for gestational age. Did you know that after 20 weeks gestation, fundal height usually corresponds to how far along the pregnancy is?  For example, at 36 weeks gestation, I would expect fundal height to be right around 36 cm.


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Fetoscope:  This is a stethoscope that is specifically used to hear a baby's heart beat. It looks a bit different from a stethoscope.  I use a Leff style fetoscope. I have tried other styles but this is the one that works best for me.  I prefer to use the fetoscope instead of doppler because I can hear baby's actual heart beat and not a digital replication.

Doppler:  I do carry a doppler as an option to hear baby's heart beat.  I usually can't hear with the fetoscope until around 18 to 20 weeks gestation, however I can hear around 12 to 14 weeks with the doppler.  I carry it so there is the option to hear the heart beat before 18 weeks, or if it is hard to hear with the fetoscope later in gestation which can happen depending on baby's position.  It is also handy if a client wants to record the heart beat.  Since there isn't a lot of research of the effects of doppler during pregnancy,  I prefer to keep doppler use at a minimal level.

My Hands:  While not technically in my bag, my hands come with me to every prenatal.  My hands let me feel how baby is positioned, how baby responds to the stimulation of being palpated and if baby is growing.  It is so sweet to get to know so much about baby before he or she is born and I love it when baby kicks or pokes at my hands during palpation.
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My most important tools:  I feel my most important tools are my hands, my intuition and my client's intuition. Having my hands on baby at each prenatal enables me to check in with baby.  Clients are the experts in how their baby is doing so I want to understand how they feel baby is doing and assess how that aligns with what my intuition is telling me.

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    Author

    Gail Webster, CPM

    Gail is a Certified Professional Midwife serving Manhattan, Junction City, Fort Riley and other areas in Kansas.  


    When Gail is not occupied with birth work, she enjoys reading, quilting, baking, riding her motorcycle and spending time with family.
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