Services

The compassionate care provided by Midwife Alyssa is tailored to the individual needs and desires of the client. Services provided by Family Heritage Midwifery are offered to families within a 1.5 hour radius of Wilder, TN, which includes the following counties: Fentress, Overton, Cumberland, Putnam, White, Morgan, Scott, Pickett, Clay, and Jackson counties.

 

Family Heritage Midwifery follows the Tennessee Midwives Association practice guidelines and community standards of care. Midwife Alyssa works in partnership with Upper Cumberland Midwifery Services to provide the following:

 

Prenatal care:

• Team of midwives - Every client hires both Midwife Alyssa and Midwife Lauren Stum. One functions as the primary midwife and sees the client for the majority of her care.  The secondary midwife will see the client 1-2x during her prenatal care to give the opportunity for the client to connect with her also. Both midwives will attend the birth.
• Routine schedule of home visits - monthly until 28 weeks, bi-weekly visits until 36 weeks, and weekly visits until birth. Additional visits can be scheduled as needed.
• Physical exams – Each visit will include a physical that assesses the mother’s vitals, as well as the position, heart rate, and growth of the baby.
• Lab work – routine labs can be collected during routine home visits and are included in the fee.
• Referrals for ultrasound – Anatomy scans are routine at 20 weeks. Other ultrasounds can be ordered for a client as indicated or desired. 
• Nutrition, supplements, herbal and lifestyle counseling – Each visit includes evaluation of these areas and recommendations as needed to promote a healthy pregnancy and birth. 
• Risk assessment with referrals provided as indicated – discussions followed by informed decision making when an intervention or collaboration with another provider is recommended.
• Direct communication with the midwife – The midwife can be contacted directly during normal business hours for any question regarding the pregnancy, birth, postpartum, or newborn. She is also on call 24/7 for any emergency or concern that comes up.
• Birth plan and emergency back-up plan – Discussed throughout care and in more depth at the 36 week visit. 

• Family members, including children, are welcome to be involved in the care!

 

Labor and delivery:

• 24/7 on call availability for questions and support via the phone in early labor. This includes assessing with the client when it’s time for her to come.
• Home birth supplies – this includes all the supplies needed by the midwife. The only thing the client is responsible for are basic items like towels, blankets, etc.
• Intermittent fetal monitoring – listening to baby’s heart rate periodically assesses their well-being. A hand-held doppler is used, which allows the mother to freely move and choose positions best suited in the moment. 
• Birth assistant – Every birth team has at least two licensed midwives on it. One is the primary midwife who has performed the majority of the client's care, and the other is the primary midwife's assistant. The attendance of the assisting midwife with the primary midwife increases the safety of home birth.
• Assistance and preparation to reduce perineal lacerations – this begins prenatally and specific attention is given to it during the pushing phase. If a tearing does occur and is significant enough to require repair, the midwife is able to suture.
• Routine delayed cord clamping – The decision of when to cut and clamp the cord is left up to the parents, but it is routine to wait until the cord stops pulsing before clamping it. 
• Immediate skin-to-skin – Evidence supports this to help facilitate bonding as well as maintaining appropriate temperature, heart rate, breathing, and blood sugar in the newborn.
• Home birth setup and clean up – The goal is for the birth space to look like it did before labor commenced. The midwife sets up the equipment needed when she arrives. Following birth while the parents are bonding with their baby, the space is cleaned and laundry is started. 
• Comprehensive newborn exam – A head-to-toe exam is performed on the newborn after the first golden hour following birth. This includes measurements and baby’s weight and, if desired and chosen by the parents, administration of vitamin K and erythromycin.
• Initial breastfeeding support – That initial latch is crucial to establishing a good breastfeeding relationship between the mother and her baby. The midwife is there to help the mother achieve a good latch. If additional support is needed beyond the skills of the midwife, a referral will be given to lactation specialist.
• Filling birth certificates with the state – This is included in the care provided. Parents are responsible for ordering a physical copy of the birth certificate.

 

Postpartum:

• Routine postpartum home visits – 24-36 hour visit after birth; 72 hour postpartum visit, 1-week postpartum visit; 3 week postpartum visit, and 6-week postpartum visit. Additional visit can be scheduled as needed.
• Newborn assessment – physical exam, including weight gain, assessment of newborn wellbeing.
• Critical Congenital Heart Disease Screening (CCHD) – This is required by the state and is performed at the first postpartum visit The procedure is non-invasive while checking for adequate oxygen levels in the blood, which in turn screens for heart defects. 
• Newborn Metabolic Screening (formerly known as PKU test) – Performed at the first postpartum visit. It is also required by the state and assesses for specific conditions that if diagnosed/treated early can help a child lead a relatively normal life.
• Referral for Newborn Hearing Screening – A state required test that is non-invasive. Testing the newborn’s hearing after birth is helpful in detecting hearing loss so a treatment plan can be put in place before developmental milestones would be affected. A referral is provided as the midwife doesn’t have the necessary equipment to perform the testing.
• Breastfeeding and newborn feeding education and support
• Wellbeing assessment of client – this includes vital signs, physical exam, indicated lab work,
• Ongoing screening and education on postpartum depression and referral to other health care professionals, when needed.
• Continued direct communication with midwife – This part of the services continues until the client is discharged from care at 6 weeks postpartum.

Fees

Clients With Insurance: At FHM and UCMS, we use a third party biller, Birth Professional Billing, that specializes in out-of-hospital midwifery billing. A free verification of benefits may be obtained from the biller at any time.

 

Clients Without Insurance: For those without insurance, the fee is $5,500. Following the initial deposit of $500, the remaining fee may be paid in full at any point in the care. Or, a payment plan is set up to have the fee paid in full by 34 weeks gestation.

 

Clients With Health-Share Programs: Some clients don’t have insurance but do have memberships with a reimbursement Health-Share Program such as “Medishare”, Samaritans, and Christian Health-share. If the client is a member of a Health-Share, then she will be considered as a Client Without Insurance and follow the payment plan setup for that. A statement is provided to the client to submit to the health-share program, who will reimburse for the costs of services.

Interested in receiving midwifery care through Family Heritage Midwifery? Contact us to schedule a free consultation!