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Family Tree Midwifery of Central NY, PLLC

I believe birth is a natural physiological process, perfectly designed by God and not a medical event to be “managed”. I never cease to be in awe of this process. It is my firm belief that it should be interfered with as little as possible.

My role as a midwife is to adhere to the Midwifery Model of Care which is as follows:
The Midwives Model of Care is based on the fact that pregnancy and birth are normal life events. It involves:

  • Monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
  • Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • Minimizing technological interventions and;
    Identifying and referring women who require obstetrical attention

The application of this model has been proven to reduce to incidence of birth injury, trauma and cesarean section.
The midwifery model has advantages for many women because it avoids unnecessary interventions during labor, thus helping the process remain normal, and because it addresses needs that are often not adequately met by the medical management model.

As your midwife, I view myself as promoting a holistic viewpoint of pregnancy and birth. I provide the midwifery care which formally looks at your strengths and needs through the course of pregnancy, childbirth, and as a new family. I invite your active participation and shared responsibility in all aspects of your care.

My style of midwifery is evidence-based as well as non-interventive. I encourage and support women and their families to make choices surrounding their birth. I always strive to support the desires and preferences of my clients, providing they are safe.

Name(s) of Practitioner(s):

Merideth Geers, CNM, MSN, LM

Contact Info.

Name of Practice: Family Tree Midwifery of Central NY, PLLC
Address: 1675 Fire Tower Road Georgetown, NY 13072
Phone: 315 662-3011
E-mail: mgeers@hotmail.com
Website: http://www.cnymidwife.com/

Prenatal Care

How much time do you allot for prenatal visits?
One hour

What is your availability for questions between prenatal visits?
On call 24/7

What routine prenatal testing do you recommend to women?
I provide a comprehensive description of prenatal testing and screening and encourage women and their partners to familiarize themselves with the testing that is available, what information the tests give us and what the implications are of the various results. Routine labs include: Blood Type and RH Antibody Screen CBC

What kind of nutritional counseling do you provide?
I do a 24 hour spot check of typical dietary intake at the first prenatal visit. Then I have women do a three day diet journaling. I like babyfit.com (a free online nutrition site for pregnancy) Women can easily journal their fluid and dietary intake and get all kinds of nutritional advice and support. I work with women who are anemic to improve their iron levels and create a safety net of iron reserves in case of unexpected higher than usual blood loss. I prefer that women avoid white sugar, white flour and white rice in their diets as well as processed foods. I encourage plenty of fruits/veggies, whole grains, probiotics and good quality organic meats. I work with vegetarians to assure they are not anemic by their due dates.

Do you have any unique protocols for women over 35?
No

Do you recommend routine ultrasounds?
No

During prenatal care, how you do approach screening for Down's Syndrome?


During prenatal care, how do you approach screening for Gestational Diabetes?
Family and previous history screening done. I offer options such as Hemoglobin A1C for those who choose not to do standard screening. I prefer to do the more accurate 2 hour 75 GM GDM screen which includes a fasting blood sugar, 1 hour and 2 hour fingerstick blood glucose. Women do not have to drink glucola, but can use a 75 Gm sugar source of their choice. (Guidelines are given) Can be done in my office. I provide glucometers for self monitoring at home as well as Perinatal Center consult if positive screen for GDM and co-management

During prenatal care, how do you approach screening for Group Beta Strep?
Recto-vaginal screening between 35 and 37 weeks Following Informed Decision Aid materials and discussion, I offer CDC protocol or alternatives based on parents preferences i.e. Clindamycin Vaginal Tx if GBS is sensitive to Clinda, Hibiclens protocol etc

Do you discuss infant feeding with women prenatally? How do you approach this topic?
Yes. I encourage breastfeeding. I have not had client come to me who was not planning to breastfeed.

Labor and Delivery

What is your approach to post-dates delivery? At what point do you recommend induction?
A term pregnancy is 37 to 42 completed weeks. I have had a few women go to 43 weeks. I provide a Decision Aid for postdates considerations which is given to women at 41 weeks so we can prepare to make decisions together if they go to 42 weeks. I offer additional fetal well-being screening such as auscultation non-stress tests done in my office, biophysical profile and encourage moms to do fetal movement counts. I will often have additional prenatal visits once the pregnancy has gone past 41 weeks. I have a professional relationship with the Regional Perinatal Center in Syracuse and can offer medical induction through them or through a family practice MD with Delivery privileges at Crouse Hospital if clients choose induction. (none to date)

What methods do you prefer for labor induction?
Nipple Stimulation (partner or breast pump) Gentle sweep of membranes Sexual relations with partner - (prostaglandin in semen)

Does your practice attend women planning a vaginal birth after cesarean (VBAC)?
No

Continuous EFM offered?
Yes

Intermittent EFM offered?
Yes

Doppler offered?
Yes

Fetoscope offered?
Yes

What comfort measures do you provide for women during labor?
One on one support Hydrotherapy HypnoBirthing

Can women in your practice labor in water (shower or tub)?
Yes

Does your practice support birthing in water?
Yes

How long past rupturing of the membranes can women labor without augmentation?
As long as they or the fetus are not demonstrating signs of infection or compromise.

What methods of labor augmentation do you typically recommend when labor is slow or has stalled?
Nipple stimulation Herbal uterotonics Intercourse

Do you encourage women to eat and drink during labor?
Yes

Do you recommend the routine use of intravenous fluids?
No

Does your practice support women working with labor support doulas?
Yes

Do you support mobility and position changes during labor?
Yes

Are you familiar with the CIMS Mother-Friendly Childbirth Initiative?
Yes

If so, in what ways does your practice strive to be Mother Friendly?
Family Tree Midwifery (FTM) offers all birthing mothers: Unrestricted access to the birth companions of her choice, including fathers, partners, children, family members, and friends; Unrestricted access to continuous emotional and physical support from a skilled woman—for example, a doula,* or labor-support professional; I offer professional midwifery care. FTM provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes. FTM provides culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion. FTM provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back with legs elevated) position. FTM has clearly defined policies and procedures for: a. collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary; b. linking the mother and baby to appropriate community resources, including prenatal and post-discharge follow-up and breastfeeding support. FTM does not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following: shaving; enemas; IVs (intravenous drip); withholding nourishment or water; early rupture of membranes*; electronic fetal monitoring; Other interventions are limited as follows: Induction rate of less than 5% Episiotomy rate - 0% Have a total cesarean rate of 5% or less I educate regarding non-drug methods of pain relief, and do not not promote the use of analgesic or anesthetic drugs not specifically required to correct a problem. I encourage all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions. (Had one mother transfer out of my care at 21 weeks and babe was born at Level III Hospital at 24 weeks - now thriving) Discourages non-religious circumcision of the newborn. Inform all pregnant women about the benefits and management of breastfeeding; Help mothers initiate breastfeeding within a half-hour of birth; Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants; Give newborn infants no food or drink other than breast milk unless medically indicated; Practice rooming in: allow mothers and infants to remain together 24 hours a day; Encourage breastfeeding on demand; Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants; Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics

Immediate Postpartum

Do you wait to cut the umbilical cord until after it has stopped pulsating?
Yes

Do you routinely administer pitocin during third stage/immediately postpartum?
No

What are the standard procedures in your practice for babies staying with or being apart from their mothers after birth?
Immediate skin to skin. Only time they are not skin to skin with mother is when they are skin to skin with father. Newborn assessment is done when parents are ready to know their baby's weight. Babe is never out of parent's sight unless mom is in the shower.

Postpartum Care

What is your schedule for postpartum care?
Stay after delivery as long as needed to assure stable mom and babe. 24 hour home visit. 3-5 day home visit. 2 week (optional) office visit or phone call. 6 week PP visit. On call/available for lactation support and/or supplemental visits as needed for 6 weeks.

Do you provide breastfeeding support? Do you have a lactation consultant on staff?
I have been dubbed the "breast whisperer". I am my only staff member (solo practice) but I do refer to lactation support groups and lactation specialists/consultatnts if needed.

Statistics


% C-section: 5%
% Instrumental Delivery: 0%
% Inductions: 0%
% Pitocin: 5%
% Epidural/Intrathecal: 3%
% Other Pain Meds: 3%
% No Pain Meds: 95%
% Episiotomies: 0%
% AROM: 1%
% Initiate Breastfeeding: 100%
% BF Six Weeks: 100%
% Transfers: 5%

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