Prenatal/postpartum visit(s)?

[Matrescence]

How many prenatal and postpartum visits do you do with each client?

Do you tailor it to their needs or have a set schedule?

What kind of things do you cover?

[raspberrymoondoula]

i do three prenatal one postpartum but i've varied it depending on a moms needs. i go over birth plan, nutrition, fetal positioning, emotional issues, and comfort measures for the birth. post parutm i bring a meal, help with breastfeeding and look for signs of PPD.

[Tiffany]

I like to do at least 2 prenatal visits and 2-3 postpartum visits. I have to say having gone through a birth experience with a midwife, I ABSOLUTELY want to make myself available to moms who have OBs for 3 postpartum visits. I needed that support so bad and my midwife came the day after birth, at 3 days postpartum, then 5 days, then i saw her at a week and 2 weeks, 4 and 6 weeks. I had a lot of breastfeeding trouble which is why she came at 1 week and I went to see her at 4 weeks.

Anyway, for my OB clients I want to offer them 3 postpartum visits. I do a call while still in hospital and due to hospital visitation restrictions I do not visit again in the hospital (c-section may be different.. i'll have to see). So I will see at 3 days postpartum, and I'd like to see them at 1 week and 2 weeks.

I love prenatal visits and I LOVE doing childbirth ed and labor preparation. I do a belly massage on or after due date and I make sure mom has no fears of labor and is as comfortable as possible.

Sorry this post is so scattered.. it's not normally like me, I just have a couple bulldozers in my back yard and I need to get downstairs LOL!

[Kim Trower]

I offer 3 prenatal...I have an outline I follow that covers Birth Choices, exploring options, birth team and roles, personal ways of coping with pain and/or fatigue, relaxation/comfort measures, emotional preparation using the book Creating a Joyful BIrth Experience, and then postpartum preparation emotionally as a couple, breastfeeding, physical recovery. Things usually stray from this but I don't like to show up with nothing prepared but the discussion is lead by the parents and I just follow along. Some clients take the 3 others only ask for 1...depends. As for postpartum I do lots of follow up calls but only visit before 2 weeks if there are signs of bf problems, support, emotional needs otherwise I follow up in 2 weeks...I do the Edinburgh Postnatal Depression Scale at this time and chat about the birth etc. I bring slings for moms to purchase, and a 12 week pass to Gymboree(I get these free)

[Matrescence]

I've always done 2 prenatals and 1 same day or next day visit and 1 postpartum visit (within 2 weeks) but I'm thinking about adding another prenatal. Running into so many moms now that aren't taking CBE for whatever reason (usually time) and even some that have taken it but still have so many questions unanswered.

Never thought about adding another postpartum before, but that's a really good idea! We only have 1 or 2 postpartum doulas in the region so it's definitely needed.

[Matrescence]

Quote:

Originally Posted by Kim Trower I bring slings for moms to purchase, and a 12 week pass to Gymboree(I get these free)

Awesome!

[dorothyh]

I generally do 4 prenatal classes - there is a set schedule of what I cover in each class, but I am flexible as to the needs of that particular client. The first class is a "getting to know you" class - background, my services, finding out what they are looking for, their fears, etc. Class 2 is the Emotional Preparedness/Comfort Measures, where we cover comfort measures, birth plans, optimal fetal positioning, early labor, relaxation and visualization, etc. Class 3 is the Physical and Technical Side of Birth- hospital procedures and interventions, pros and cons, signs and stages of labor, how do I know I'm in labor, when to call, etc. Class 4 is Breastfeeding and Parenting. If the couple is not interested in 4 classes, I can tailor it to 1-3 classes as well, but the four classes work so much better in getting to know the couple and having them get to know me!

I call the day after the birth, do one postpartum visit (generally 1-2 weeks postpartum), and am available for phone support after the birth as well. The postpartum visit we go over the birth, breastfeeding, how parenting is going. I have no set agenda for the postpartum visit - it really depends on the mom.

Dorothy Haines, CD(DONA)
www.MotherToMotherDoulas.com

[Kim Trower]

DorothyH...I generally do 4 prenatal classes

Do you do group "classes" or meet individual with each client. I was doing 3-4 meetings set up like "classes" and I was just getting overwhelmed driving all over town and getting these meetings in. I miss it but I have paired down to less meetings and a more free flowing agenda to let the parents direct the conversation. I'd love to know how you make this work?

[tlcdoula]

I usually do 2-3 prenatals depending on the families needs. I have a set script on what I go over, but then also add to it as necessary. I then see the mama and her baby one day postpartum and then schedule a meeting in her home at her convenience - usually 2 weeks postpartum.

[Tashina Marker]

Ok so how long do each of you ladies have your sessions for?

[Tashina Marker]

Also I am humm well a little bit nervous going over breastfeeding.After a while I remember asking myself why & I just think I am not qualified.I have read books,but I have no children of my own & have watched mom's breastfeed before.Watching doesn't bug me one bit,so I think that it's just the confidence part. Do any of you have suggestions,because I think that is such a crucial part of your visits.

Thanks!

[Stacie]

Tashina,

I have noticed at most doula trainings the breastfeeding information is really focused on getting the baby latched well. Perhaps you could purchase a video to watch with clients together? My favorite that I recommend to all doulas is Rebecca Glover's Follow Me Mum. It is filled with simple techniques that help a mom and baby latch up. Also, it is a great video to take back over if mom is having latching difficulties or soreness.

You can certainly share about breastfeeding benefits, some of that type of information. I know it could feel strange teaching something you have not done, but if you feel unsure about one aspect (maybe positioning) then focus on another aspect. I do have an outline I could share with you in you are interested, do you have Power Point? I have based my presentation on Linda Smith's suggestion of sticking to three main points:
1) How milk is made
2) Comfrotable breastfeeding
3) Where to get help

I think expectant parents are focused on the birth, so anything I have to share with them about breastfeeding is put in a 'second' place (many clients say, "Of course I am going to breastfeed, BUT the baby has to come out FIRST!"). My pesonal belief is to not overload them with all the worst-case scenarios of things that COULD happen. So I base my breastfeeding presentation on those three factors.

Linda has a great site where she shares these ideas, although I got more info her book "The Lactation Consultant in Private Practice." bflrc.com is the main site, click 'Linda's Pages' to find her info (and take a peek at Dr. Newman's, too -- he is a wealth og info as well). http://www.bflrc.com/ljs/teaching/bf_class.htm

[DL]

Tashina, (and anyone else who may be interested)

Back in September, I asked similar questions and got some really great answers (I'm NOT saying that the answers above aren't really great! ). Some of the ladies actually posted their outlines that they go by in their visits. That was soooo helpful to me! I just thought you might like to take a look at them. You'll have to scroll down some before you start seeing actual outlines, but all the chatter before and in-between the outlines might be helpful, as well.

Prenatal visits: lesson plans/topics? (click to view)

Just to let you know, since the Sept. thread, I have more of an idea of what I'm doing! : I usually do 2 prenatals, and 3 if I have quite a few months to work with a couple. Note: My prenatals do not count the Free Interview/Consultation.

1st visit:
I usually show the video "Special Women", discuss their past birth experiences, go over Stages & emotions of labor, Interventions & Informed Consent, and Normal Birth/Postpartum during the first visit.

2nd visit:
We go over Comfort Measures, practice relaxation & pain-coping techniques, and discuss their Birth Planning. I show the DVD "The 3 Rs".

**Intermingled in both of these visits are emotional issues and discussions that tend to follow the questions/concerns of the parents. I have an outline, but it sometimes varies with the needs of the parents. Prenatal visits 1 & 2 tend to be about 2-3 hours long....depending on how much discussion the parents initiate.

3rd visit:
IF we have time to fit in a third visit (a lot of my clients tend to hire me within 2 weeks of EDD so we don't have time for 3), we will practice relaxation and comfort measures, and generally review the first two visits. Answer questions/concerns, etc. Mom usually gets a hand/foot massage, if she obliges. This visit is usually about 1 - 1 1/2 hrs long.

Postpartum:
I, many times, will see them the day after the birth at the hospital, IF they aren't being discharged after 24 hrs (not uncommon to do so around here). If I cannot visit the day after, they at least get a phone call. They are told to call me ANY TIME they need me to come and/or just want to talk. I also call one week after baby's birth, and they get a visit at their home approx. 2 weeks after baby's birth for official "Postpartum Visit" (that's when they receive their birth stories & we talk about how the birth went). This Postpartum visit is usually an hour. I don't have a set outline/agenda, but go with what the parents seem to need (postpartum care, discussing emotional issues, baby care, breastfeeding, or just a friendly visit to talk about how the birth went & to admire baby).

HTHs!

[tlcdoula]

Quote:

Originally Posted by Tashina Marker Ok so how long do each of you ladies have your sessions for?

My sessions last for as long as there is information to go over and for however the parents want to keep talking. I have had families who have hired me and not participated in a thing I was saying and I thought "why am I doing this again?" Then I have had sessions go 3 1/2 hours in length because they wanted to know more and more and wanted to practice. I love those sessions because I know that those are the families that are going to seriously participate actively in the care they receive.