At Home 

My model is called caseload midwifery. In the caseload model, I take 2-4 clients due in the same month that I am fully responsible for. When you work with me, you’ll see me throughout your pregnancy, labor, birth, and postpartum. This means that there is no jumping around to different providers throughout pregnancy care, or not knowing the midwife who will attend your birth. I will be on call for your birth from 37 weeks until you go into labor or 42 weeks (whichever comes first). I am committed to performing all your in-office, in-home, or virtual postpartum and newborn care, and providing breastfeeding support - unless we have worked out for another provider to step in for a portion of your care (if I am not available due to an emergency situation that changes my availability or another client is in labor at the same time). You even have direct access to me thru the client portal throughout your pregnancy and postpartum for any questions or concerns that come up along the way and in-between visits.

From the first prenatal visit starting at 12 weeks through labor and birth, to the final postpartum visit, I value and support the needs and desires of the women in my care.  Studies show that when women are seen by the same midwife every visit, including their labor, birth, and postpartum course, they have higher breastfeeding rates, a lower risk of postpartum depression, and higher satisfaction with their care experience.

Prenatal and postpartum visits are never rushed and always centered on your needs and questions. For clients who live over 30 minutes away (or are eligible due to their community birth experience), Michele offers a hybrid model of in-person and virtual prenatal, postpartum, and newborn care. There are no long office wait times or unnecessary travel.

My commitment is to help you achieve a satisfying pregnancy and birth experience just the way you want it to be!

• Low cesarean birth (<3%)

• High breastfeeding rates

• High satisfaction with the birth experience

• Freedom of movement

• The BENEFITS of Waterbirth

• True Physiological Birth, Newborn, and Postpartum Support

• Autonomous choices on your environment and healthcare

• The comforts of home

• Decreased medical interventions

• More time to bond with baby

• Reduction in perineal tearing - active birth & body balancing support

• Ability for you or your partner to be involved in “catching” your baby

• Calm, Intimate, Warm and Inviting birth space supported by your birth team

• Birth photography and video memories of the whole process

• Having a personal midwife that is trustworthy, known and relational vs. transactional

• A midwife with over 30 years of experience (former NICU RN) - in all 3 birth settings (home, birth center, and hospital) - that practices supporting physiology and natural remedies but also is well trained to care for you and your baby if emergencies occur

• Use of herbs, tinctures, and natural support as well as allopathic medicine if necessary since Michele has prescription authority

• Ability to be reimbursed by your insurance for CNM care - use of Tricare if you in the military and/or Tricare eligible

• Incredible postpartum and lactation assistance

I have been a registered nurse for over 30 years and a midwife for 22. A majority of my nursing career - prior to and after becoming a midwife - centered around birth assisting in a birth center and working in the hospital as a NICU RN. Although I have extensive medical experience, I am also a yoga practitioner and teacher with a regular meditation practice.

I also bring years of experience as a US Navy veteran. I began my career after high school as a Yoeman and then obtained an NROTC scholarship to attend nursing school. I served a total of 12 years in the service (active and reserve) and obtained the rank of LCDR prior to being honorably discharged to pursue my dream of attending midwifery school and having more time to care for my family.

My passion as a midwife is in the home setting - where I also had a very healing and empowering experience birthing my 3rd child in a warm tub surrounded by loved ones & an incredible midwife. Supporting women and their families in their homes - empowering them to listen to their bodies and intuition - is a privilege. I LOVE BEING A MIDWIFE and do not take my role lightly. I have had my share of challenges, personally and professionally, over the years, but I have also learned many lessons. I am now in my wisdom years and still believe “Every Day is A School Day”. I work hard to stay current in evidence and experience to provide my clients with the high level of care they deserve.

All clients with Lavender Moon will have 24/7 access to their client portal. The portal will have a record of every visit, lab, or test as well as billing information and a messaging system connected to your email. Non-urgent messages can be sent 24/7 to me in the portal and will be answered within 24 hours during business hours. Urgent matters and labor questions can be texted or discussed via a phone conversation with me 24/7. Appointments can be self-scheduled and modified by you through the portal as well.

Home birth is simple and safe. Women choose home birth for a variety of reasons but the most common reason is to have a healthy, physiologic birth, newborn, and postpartum experience on their own terms. Whether it’s because they want the benefit of being in familiar surroundings, the support of whomever they choose, or the freedom to be unrestricted by common hospital interventions - such as routine electronic fetal monitoring or induction - they are determined to have their birth their way in the privacy and comfort of their own home.

Other reasons women choose home birth is due to a history of fast labor, a desire to have a personal midwife, a previous traumatic hospital birth, or a strong belief that their best chance for a normal, undisturbed physiologic birth is in their own home.

Birth centers offer some of the same advantages. Still, they are often either governed by policies that don’t allow actual choice, are an additional expense for the space vs your home, and/or they have a large staff that shares call and does not provide a personal midwife/caseload midwifery. Often the same price - or more - than home birth, birth centers are mistakenly seen as safer. They can provide the same equipment and model of care as the home, but you have to drive to their space, and YOUR midwife does not come to you and your familiar, loving environment.

Some women choose the birth center because their insurance will not reimburse midwifery care unless provided in a birth center. But when it is all said and done, the home with your midwife is a much more personal experience - with the added benefit of never having to leave. Knowing your choices will be honored by a midwife with whom you and your partner/family have built a relationship throughout your pregnancy is invaluable.

Planned home birth is just as safe as hospital birth when the midwife is licensed and integrated into the healthcare system, and the mother is healthy and low risk. Even with 1-2% of moms or babies needing an urgent or emergent transfer in labor, outcomes for those moms and babies are the same as hospital births, meaning the chance of death is extremely rare and comparable to hospital maternal and infant mortality outcomes.

Home birth is safest for clients who are healthy and at low risk for pregnancy or newborn complications. This is about 85% of the pregnant population when starting prenatal care.

Home birth has more risks for women who have a breech-positioned baby, twins, women who’ve had a previous cesarean birth, placenta previa, and women who have a medical history of autoimmune disease, hypertension, blood clotting disorders, or diabetes.

No matter the setting you choose, you are weighing risks and benefits—deciding what types of risks you are willing to assume for your value system. The birth center, home, and hospital all have their own risks. It is wise to do your homework and meet with midwives and doctors in all settings before you make your choice.

Most hospitals and their providers work very hard to provide individualized care to the clients they serve. Unfortunately, the volume of clients and model of care are not focused on providing a true physiologic birth and postpartum course. Most providers have not even witnessed a truly physiologic labor and birth without what they consider routine and necessary intervention.

Research has shown that across the U.S., 1 in 3 pregnant women receive a cesarean, and a majority of these are first-time mothers. There is a phenomenon in the hospital known as the cascade of medical interventions in labor. This cascade of interventions is highly linked to the many policies and protocols hospitals are built upon- related to liability protection for the hospital and its providers and the need for efficiency of the labor and delivery unit/hospital system.

These are things like induction of labor, Pitocin, epidural use, continuous fetal monitoring, episiotomies, vacuum-assisted delivery, early cord clamping, newborn separation from mother after birth, and premature newborn interventions when supporting transition. These interventions increase the risks of fetal distress, cesarean birth, infection, and newborns needing oxygen therapy post-birth. There is also an increased risk of having a traumatic birth and being separated for long periods from your baby in the hospital environment - due to many choices out of your control because of policies, protocols, and liability protections for the hospital and staff.

If you plan a home birth with me and my practice, I will work very hard to help you adapt to the need for hospital care - should you need to transfer. Medical teams want to provide the best care possible too - they are in a system that does not always support them to provide individualized care. Birth and postpartum plans will be provided to hospital staff in a friendly, professional way so we can work together as a team for your birth and/or newborn/postpartum time spent in the hospital.

I expect you to take responsibility for your health and your decisions AND I will do the same.

I expect you to understand that I am a knowledgeable guardian and will support you on your journey - but I am in no way the expert.

YOU are the expert. I want you to learn about yourself, your deepest desires and goals, your best coping mechanisms, and how you will be best supported in birth and the postpartum period.

Books and information can be helpful to learn a bit about where you are going. But there is no substitution for doing the work needed to prepare for YOUR birth. I will help you learn there is “No place like HOME” - your heart, your brain, your courage, your intuition, your belief system…that is what will provide you with the strength you need for this powerful rite of passage - no matter what the setting.

Some clients seek a Christian midwife who aligns with their values and beliefs. I was raised in an Irish-Italian Catholic family and became a confirmed catholic as a teen. I no longer consider myself a practicing Catholic, but I still love many of the teachings & rituals of the Catholic Church - which is one reason I enjoy Paulo Coelho’s writing so much. However, as I reach my Wisdom Years, I find myself drawn to the teachings of many different religious and spiritual leaders. I remain guided by spiritual principles - studying and following the teachings of Jesus, Buddha, Rumi, and others - but am not part of one religion. I believe there are many avenues to the same goal most spiritual and religious members seek - a meaningful life rooted in kindness, love, and grace for our fellow human beings. I pray, meditate, and read the teachings of spiritual leaders daily - including the Old and New Testaments of the Bible. No matter what denomination or religion you practice, I will remain committed to understanding, including, and supporting your values and choices throughout your care.

A low-risk pregnancy means that you are essentially healthy–- no medical conditions prior to pregnancy, or pregnancy complications. Women who have a known medical history including blood clotting disorders, high blood pressure, heart defects, diabetes, or obesity (BMI over 40), are unfortunately not eligible for care.

Medical conditions that are well-controlled prior to pregnancy and under the care of a healthcare provider, such as pre-existing thyroid disorders, asthma, PCOS, anxiety and depression, are all eligible for care. Schedule a free consult to discuss your eligibility and any questions you may have.

When you or your partner call to inform me that you are in labor, I will ask several important questions to assess the situation thoroughly over the phone. The primary aim is for me to arrive at the home when you need care and support. Upon arrival, I will conduct essential checks, including your blood pressure, pulse, and temperature, in addition to the baby’s heart rate. To monitor the baby’s heart rate effectively, I use a handheld Doppler, carefully following established guidelines for intermittent monitoring during labor.

I look for natural signs, such as vocalizations and movement, so I know when you have entered into the final phases of her labor.  If YOU would like to know the opening of your cervix at any time or if we need that information to make a decision, I will offer an exam. I do not routinely use cervical exams to assess where you are in your journey with your baby if it appears you are both doing well.

If you feel the pushing phase is near, I will offer to guide you to listen to your body and to push with your surges once you have the overwhelming urge to do so.  You may have planned to “catch” your own baby and provide “kisses” of initial breaths if needed during our prenatal visits. You are welcome to be as involved as you would like or to have my role be to complete those steps - it is your choice. Of course, my hands are always there in case the plan changes and I need to provide birth or immediate transition steps for your baby.  A natural birth under my care can unfold at its own pace, without unnecessary intervention, and with you and your partner’s wishes in mind. You are the agent of your own healthcare and I am an invited guest - ready to help you make decisions that are best for you, your partner, and your baby.

You are free to choose wherever you want in the house to have your baby! Some women plan ahead of time and envision their ideal place, while others just see where they feel the most comfortable when the baby is ready to come.

There is a range of positions to give birth in, from standing, to squatting, to hands and knees, or leaning on a table/counter or couch. The point is we work around you and your needs, not the other way around! No need for a lot of space. If you have enough room to move and/or for the tub, you’re good.

We clean up the mess and put a load of laundry in before we leave your home on the birth day.

Home is the perfect place to have your baby!

Birth assistants that work with my practice have extensive training in supporting women in labor as well as with emergencies, lactation, and neonatal care. I prefer to have a team of 2 to assist me at the birth but may only have 1 if you have a doula. I would also be happy to discuss using a qualified birth assistant of your choice for your birth.

Prenatal visit take place in my office in Coronado on a typical schedule - monthly until 28 weeks - twice a month until 34 weeks - home visit at 34-35 weeks - and then weekly in the office until your birth. If you have not had your baby by 41 weeks, I recommend we see each other twice a week until birth and that you consider testing for fetal well-being during that time.

Visits are 30-60 minutes….or longer when we get to talking ;-). Yes, I encourage you to bring any friends, family members, doulas, childbirth educators, birth photographers…anyone who will be with you on your big day and should be involved to understand your desires and my practice philosophy for the birth.

My philosophy is that you need to be in fighting condition to have your best chance at a successful physiologic birth and/or homebirth. But fighting condition or optimal health and vitality looks differently on different people. Optimal Nutrition, Movement, Sleep, and Mindful practices are the cornerstone of the recommended preparations we do in your prenatal care. I feel responsible not just for guiding you to healthy choices for your birth but your postpartum period. I want you to be at your BEST and will work hard to get you there without shame or blame - just guidance and support.

YES. YES. YES. I think it is ALL fantastic if you are in the hands of professionals who support you AND your physiologic homebirth — and they are all there because you chose them to be!

We hold childbirth education classes at our office and will soon have online courses available for those who live a birth further away.

Waterbirth!! MY FAVORITE! A majority of my clients give birth in the water, and almost 100% use the water for hydrotherapy and support in labor. I believe water is an excellent tool for pain control and privacy. I encourage you to listen to your body and will support your decision to use water or not to include it during your labor and postpartum (including the birth of the placenta). I rarely provide any parameters on when to use the tub unless there is no way to continue to support your health and that of your baby in the tub.

I provide all my clients an Earthside Tub (white) with a liner and pump as part of their Homebirth Package. I only ask clients to purchase their hoses to fill and empty the tub and ensure that the tub will fit in their space and that they have adequate hot water to supply it. And any twinkle lights they would like to add under the liner - which is very fun and pretty ;-).

Tools such as water, hypnobirthing, aromatherapy, breath work, hanging from a sling, chanting, prayer, dance, movement, and meditation are all used in labor at home but not pain medication. Water therapy has long been termed as the “midwife’s epidural” because of how it helps tremendously in managing labor discomfort. Nitrous Oxide (laughing gas) is used in some home birth practices and may be available with Lavender Moon in the summer of 2025. IV pain medicine is not given due to potential effects it could have on the baby (respiratory depression).

Never underestimate the value of being in your home with your loved ones. Being in familiar surroundings with your own things that you know comfort and calm you as well as having undisturbed loving support helps your perception and response to the intensity of the surges and labor overall.

The pushing phase should be physiologic like all the other phases of labor. There will not be directed pushing during your birth unless there is an emergency and we need to birth the baby together quickly. Otherwise, you will listen to your body, adopt any birth position that feels best for you, perhaps place your own hand on your baby’s head as it emerges from your vagina, and birth your baby slowly and gently. It has been my experience that if the baby comes gently and slowly, guided by its own mother and her instincts, in the position that she chooses, there is less or no labial and perineal trauma.

If you do have a breakdown of the area in a 1st or 2nd degree, we will assess if herbs, sutures, or glue would be best to heal the area well. Careful consideration will also include your lifestyle and whether you will be able to rest in bed or you will be up and about (against your midwife’s advice) days after your birth. Regardless if you opt for suturing or glue, herbs will be given to you for sitz baths postpartum (included in your care). Herbal tinctures, lidocaine, ice, and over-the-counter pain relievers will be available to help with the pain and healing.

The cord remains where it belongs - attached to the placenta - until you decide when to separate them. I recommend not cutting the cord until the placenta is birthed unless necessary. I will also support Lotus birth - where you don’t cut the cord but allow it to fall off on its own time over days.

The separation can be a sacred rite of passage for some and I will support any of those traditions - including burning the cord instead of cutting it. You or your partner may want to be the ones to separate the cord - that is supported as well.

Your baby remains skin-skin on your chest or body - even if neonatal or maternal resuscitation measures are needed (unless a situation occurs where we can’t support that - in which case your partner or another loved one will provide skin-skin).

The final step of your birth, the birth of your placenta, is not on a clock. Ideally, you will birth your placenta physiologically - like your baby - unless your body tells us that it needs to come sooner. In that case I will make a recommendation to speed up the process in the interest of your health and that of your baby’s.

After a baby is born at home, your team will stay for the immediate postpartum and will ensure that both you and your baby are stable, healthy, and well after birth.  In my care, you can be sutured (if needed) at home, your bleeding will be monitored, maternal vitals, as well as newborn vitals, will be taken regularly, and I will, my assistant will support you when it comes to establishing breastfeeding.  After you have nursed - been up to the bathroom - and eaten a meal, and if everything else is normal, we will tuck you and your baby into bed and leave so that you can get some much-deserved rest.

If you transfer to the hospital in labor or postpartum, I will accompany you and plan to be present for the birth and immediate postpartum period. I will remain in the hospital after the birth until you are stable and have nursed your baby. I will call you daily and visit you in the hospital should your stay become prolonged. We will set up an individualized postpartum visit schedule for you based on the care provided in the hospital for you and your baby.

I will stay on-call for your postpartum time in-between each of your postpartum appointments.  You will always be able to call, even in the middle of the night, if you are concerned about your health or that of your baby.

If you have had your baby at home, I come back to your home within 24-48 hours, 3-7 days, and 7-14 days for visits. The remaining two visits are done in my office individually, with your final visit between 8-12 weeks postpartum. At that visit, we do a full exam, labs, referrals for PT, or other f/u care for you and your baby. Should you decide, I will remain your primary care provider for your women’s health needs.

I have extensive experience supporting VBAC both in the hospital and in the community setting - as well being an HBAC myself for my third pregnancy after 2 cesareans. I also have completed training to support breech and twins in an emergency. I do not have what I would consider enough experience to independently manage Breech and Twins as a planned homebirth. I would plan to work in collaboration with providers that do have that experience, if I was to include that care in my practice.

*Stay tuned for updated practice protocols in 2025!

All of these services can be helpful for your overall health and especially during pregnancy. However, not all clients can include these within the limitations of their budget. I do have experience and will work with you on body balancing/Spinning Babies, and yoga during your pregnancy. I will also recommend and support you to obtain acupuncture, chiropractic care, massage therapy, and other professional assistance.

Tricare does not cover chiropractic and acupuncture care - but does cover physical therapy. I highly recommend PT as part of your prenatal and postpartum care plan and will work with you to get the appropriate referrals for care.

Yes - your Birth Kit is included as part of the Mobile Facility Fees included in your Midwifery Fee and some items will be brought to your home at the 34-35 week visit. Other items will be provided by me at the birth or postpartum. You will provide a few things that most have on hand in their home (such as large green garbage bags, paper towels/washcloths, sheets, and towels) for the birth - as well as the hoses/adaptors to accommodate filling of the tub from your faucets.

As a midwife, I am a supporter of physiologic birth on its own time. I don’t believe there is widespread value or evidence to support routine induction (especially at 39 weeks) and consider every situation on a case by case. I do not offer foley bulb catheter induction in the home setting. If clients would like me to do a “stretch and sweep” or ‘break their water”, we will have a long discussion about the risks and benefits before a decision is made.

I will not recommend that clients induce their labor on their own with castor oil, herbs, or “labor cocktails”. However, I will support them if they make that decision, understanding that sometimes it is made because they are up against a state mandated scope of practice protocol that would require them to transfer out of my care and their option for homebirth by 42 weeks. I hope to have protocols signed soon to support clients that have still not started labor by 42 weeks. Thankfully, most of my clients birth before 42 weeks without any intervention and rarely have to transfer care for postdates induction.

*If your baby is no longer thriving in utero or your body is no longer in a healthy place to support your baby - collaborative care with a physician would be recommended to develop a plan of care that would optimize the health of you and your baby.

Most home births go smoothly without the need for any medical interventions or hospital transfers. Since a low-risk pregnancy is required to qualify for a home birth, any emergencies that occur can usually be handled by the midwife at home. 

Sometimes, despite careful planning and preparation, a hospital transfer might be necessary. The decision to transfer during labor is never taken lightly and is one I will carefully consider with you, prioritizing the safety of both you and your baby. I average a very low transfer rate (including caring for a higher than average first-time laboring clients in her practice) with a 3% cesarean section rate. Even with these low numbers, it is always best to be prepared.

What are some reasons a transfer might need to happen?

TOP 3 Reasons for Hospital Transfer

#1 Reason: Exhaustion

Usually, slower labor isn’t something to be too concerned about, especially during the first part of labor or if you are a first-time mom. Physiologic birth has its own timeframe - and that is ok - labor care with Lavender Moon is individualized. If nothing seems to be progressing or contractions are slowing down, you may want to try to rest or try different ways to get things moving that don’t involve medical interventions:

• Try going for a walk, dancing, intimacy and hypnobirthing/relaxation

• Change your surroundings if you are uncomfortable, feel closed in, or need more privacy.

• Switch up positions frequently - being stationary for too long can slow things down - add body balancing techniques.

• Eat a nice meal, take a bath, rest, and renew with measures to increase oxytocin.

I work with you prenatally and during labor to prepare for long labors and to prevent exhaustion. But even with the best preparation and commitment to birth your baby at home physiologically, the labor may take a turn that makes it overwhelming. We cannot predict how your baby will navigate labor thru your pelvis, the position, and the time it may take for your body to birth. Sometimes you will feel it is time to choose a transfer to a hospital for an epidural and rest. I will respect your choice and continue to care for you in a supportive role after you transfer to your chosen backup hospital.

2. Maternal Conditions

I support physiology by always being focused on measures to keep you warm, well-supported, well-hydrated and fed, and in a calm environment - thereby increasing your oxytocin levels in labor and immediately following. However, sometimes conditions occur unexpectedly that are unsafe for both you and baby (very rare) such as postpartum hemorrhage, cord prolapse, placental conditions, hypertension, etc may occur. We are equipped to handle these emergencies but some will need immediate or follow-up care in the hospital.

In the event of hemorrhage, I will handle it the same as if I was in the hospital, and there is very rarely any cause for concern. Most hemorrhages are mild and are easily managed. If you become symptomatic and/or your bleeding cannot be controlled - a hospital transfer will be considered. Sometimes postpartum hemorrhages happen after the first 24 hours post-birth, which is one reason why I will conduct multiple postpartum visits to check on both you and baby.

In the rare event of a severe hemorrhage, an ambulance will be called while I initiate steps to attempt to decrease the bleeding and keep you stable until help and transport arrive. I will bring my equipment on the rig and accompany you to the hospital, check you in and provide full records and report, and remain until you are stable.

3. Fetal or Newborn Conditions

Prior to birth, your baby may show signs of distress (very rare) and transfer will be recommended. After the baby is born, his or her respiration is monitored and recorded until it has remained stable for two hours. If the baby is born compromised and in need of assistance, you/your partner and/or our team will initiate measures to support your baby’s transition & possibly resuscitation. I am a resuscitation instructor mentor with many years of experience caring for compromised newborns. However, a medical transfer will be recommended if the infant continues to show signs of respiratory distress, has cyanosis (blue skin due to lack of oxygen), or is otherwise compromised. I will make every effort to transfer you both together skin-skin and accompany you in the ambulance on transfer.

Remember, a decision to transfer to a hospital is not a home birth “failure!”

I am committed to ensuring the safety of you and your baby, and sometimes extra medical attention is needed. You will be well supported to birth your baby in the setting that you feel the strongest and that both you and your baby can remain the healthiest in. Should you or your baby need to go to the hospital for a higher level of care, I will remain in a supportive role in the hospital and work professionally with your care team. I will also care for you again as your midwife postpartum - after you are discharged home.

How will you help me plan for a transfer?

Although most births proceed without complications, you will want to have a plan in place just in case -

• I will help you with a written birth plan, and include a “plan B” if you need to go to a hospital. Your preferred locations for both urgent and non-urgent transfers will be listed along with a phone number. A section specifically addressing the possibility of a transfer, detailing preferences for transportation, choice of hospital, and preferences for medical interventions if needed will be included. Labor and Delivery units of your chosen hospitals will be called to let them know you are in labor and called again once your baby is born or should you need a transfer.

• Transportation options will be discussed in advance and arrangements so that you have a reliable mode of transport to the hospital if needed.

• Even if you are planning on home birth, you will still want to pack an emergency bag just in case you have an unexpected hospital stay. Include clothing, toiletries, personal documents, and any comfort items that can help make the transition smoother. Keep the bag nearby in case of a sudden transfer.

• Keep an emergency contact list close by of healthcare providers, family members, and anyone else who may need to be notified in case of a transfer.

Having practiced as both a RN & CNM and living in San Diego for 15+ years, I am very familiar with the different hospitals in the area and always comfortable transferring with my clients should we need to go. I will work closely and professionally with all the staff in the hospital and care for you in a supportive role until your discharge. I may not remain in the hospital during your entire stay but will stay if transferred in labor until the baby is born and you have nursed successfully. I will transfer any records needed to the staff and provide a full report of your course to the accepting provider, charge nurse, and staff nurse caring for you. I will work collaboratively to refer you to OB practices and hospitals in San Diego should you need to transfer to medical care during pregnancy.

Although I have been practicing over 20 years as a midwife, the only time I was involved with maternal or newborn loss was prior to becoming a midwife - when I worked as a nurse in the hospital setting. They were devastating circumstances and I learned a great deal from the decisions made and care provided.

I have been very fortunate to have had excellent outcomes for the clients I serve. That is not to say I have not made mistakes or reviewed the care I provided and regretted the recommendations I made or actions that I took. I have made my share of mistakes, learned the lessons, and modified my practice accordingly.

I also work with birth professionals in the community to debrief our difficult circumstances and we learn together from that as well. I never say never, birth is unpredictable and sometimes the plan is not in our hands. But I am committed to staying current in my practice, making the hard right choices with integrity, and providing the safest, most transparent care to each and every one of the families and professionals I serve.

Yes, we will work together on the paperwork and appointments necessary to obtain the birth certificate and social security number for your baby.

I can administer Vitamin K without preservatives in the shot form at your birth—it is included in your home birth package if you decide to give it to your baby. Oral Vitamin K and E-mycin are not offered as a standard of care in my practice. If you would like to have those available for your baby after birth, we will work together to obtain them and make them available, but they will be an additional cost.

If you have a homebirth, I will complete the Newborn Screen, CCHD testing, and newborn exam at the 24-48 hour visit. I will also work with you to start the birth certificate process.

I can order Rhogam for you ($200 additional cost) and administer the shot on your behalf.

The hearing screen can be set up with a local pediatric hearing practice or midwife who performs the screens. We will discuss the timeline for that test prenatally and decide on your plan.

I am a member of the Postpartum Health Alliance in San Diego and have extensive training on recognizing symptoms and providing treatment options/referrals for care. We have a great team of professionals in San Diego and if you require evaluation and treatment outside my expertise, we will work together to find you the best options for care.

Your final postpartum visit will allow us to ensure you are in the best health going forward. It will likely be between 8-12 weeks following your birth. It will include a complete exam, labs (Pap if needed), referrals, and an overview of lifestyle modifications to support your health and vitality for the remainder of the year. You will be able to see me for any health issues that you experience - such as anemia, depression/anxiety, insomnia, fatigue, sexual issues, fertility and pre-conception care, incontinence/UTIs, thyroid or hormone imbalances, vaginal health issues such as pain during intercourse or yeast infections, and more.