What is Midwifery Care?

“The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.”-Midwifery Task Force.

Midwifery care, especially with RCM, is quite different from a visit to the OB.  Your appointments last around an hour and there is plenty of time to ask questions, explore options and talk about life. We want to understand what is going on with you, your baby, your family and your pregnancy. Our care is grounded in informed choice. This means we offer the same standard of care when it comes to labs, ultrasounds, and procedures that you would get anywhere else, but at River City, we are committed to making sure you understand the purpose, risks, benefits and any alternatives associated with these decisions. Most importantly, we fully support and respect your decisions, knowing that you are the best and final expert on your body and your baby. 

We are constantly working to stay on top of current research while maintaining perspective, honoring tradition and remaining humble.  While we are guides in your journey, you are in charge. 

What Services are Offered:

Complete Prenatal, Birth and Postpartum care. You do not need to visit any other provider!

  • Prenatal Visits-Extensive health and social review with an emphasis on healthy lifestyle behaviors. There are lots of ways to stay healthy during pregnancy. River City aims to meet you where you are-offering support through nutrition counseling, body movement, how to destress, and building positive mental, social and physical support systems. During prenatal visits we will monitor your blood pressure, fetal heart rate and measure growth. Clients will be offered standard lab tests such as the Obstetric panel, STI testing, glucose screening and a Group B Strep (GBS) test. We have an in-office ultrasound and will refer you for the 20week anatomy scan. We follow the standard prenatal care schedule, seeing you every 4 weeks until 30 weeks, every 2 weeks from 30-36 weeks, and weekly until you give birth. 

  • Labor, Birth and Immediate Postpartum-We will come to your home once active labor is established or when you need support. This includes labor assessment, fetal monitoring, labor and birth assistance, newborn assessment, lactation assistance, and monitoring the condition of you and baby for an average of 2-4 hours after the birth, or until stable. 24 hour on-call availability. In the event of a transfer in labor, midwives will accompany you to the hospital to ensure a smooth transition.

  • Postpartum-We come to your home at 24-48 hours after the birth and around day 3 to help with lactation, monitor jaundice, baby weight changes and assess overall health of you and baby. In office visits occur at 1, 3 and 6 weeks. Postpartum services include: postpartum maternal and newborn exams, lactation support, weight checks for baby, jaundice monitoring, newborn metabolic screening, congenital heart defect screening and Birth Certificate and Social Security Filing.

Labs, tests and procedures offered:

  • Initial prenatal labs (Blood type/factor, CBC, Hepatitis B, Rubella, Gonorrhea/Chlamydia, urine culture), HIV testing, as well as other blood or lab work including genetic screening (NIPT).. 

  • Gestational diabetes monitoring and screening

  • GBS (Group Beta Strep) culture around 36/37 weeks 

  • Rhogam injection at 28 weeks and post-partum (for people with Rh negative blood type) 

  • Vitamin K for the newborn 

  • Newborn eye prophylaxis

  • Hearing screen for newborn 

  • Pap smear, well person and birth control consultations may be offered 

Who attends the birth?

River City is a single midwife practice that has lots of additional support. Adrianna Ross, CPM, LM is the owner of RCM and loves being a midwife! Adrianna will attend your birth with at least one support person-this might be a student or midwifery assistant. By the time you give birth, we have spent many, many hours together-so there are no surprises on the big day! Adrianna collaborates with other local midwives, as needed, for additional support, but intentionally keeps a lower volume practice to provide the best possible care.

What is a CPM/LM?

Certified Professional Midwives (CPM) are the only midwives trained exclusively in out of hospital birth. They are registered through the North American Registry of Midwives (NARM) and complete rigorous training in the home birth and birth center setting. The state of Virginia also licenses midwives (LM) through the board of medicine. CPM/LM’s must maintain current NRP (Neonatal Resuscitation) and CPR status. They are considered the provider most experienced in out of hospital birth.

What is a home birth like?

Home birth is a great option for low-risk birthing people. You can move freely, eat and drink, labor in the water, birth in the water, delayed cord clamping is standard and we value your individual family decisions. The big picture is that you can birth the way you want, with professional support.

People giving birth outside of the hospital are usually low-risk, and emergencies are very rare. At River City Midwifery, we value our relationships with area hospitals, CNMs and OBGYNs and work to ensure a safe and timely transfer to the hospital should a need arise, before it becomes an emergency.

Do you take insurance?

Most of our clients are self-pay and many submit a super bill to their insurance company after birth for reimbursement. We accept Virginia Medicaid for professional fees.

How will I cope with labor?

You will do great! One of the best things about having a midwife for your first unmedicated birth is that we have helped hundreds of people do this! We have watched all kinds of folks, even those who SWORE there was NO WAY they could do it, do just that, and triumph. We have faith in you, and skills to help. If there is one thing we know, it is that you can definitely cope with the discomfort of normal labor. We do encourage childbirth education classes for most first time parents so that you are more prepared and confident. But seriously, you can do it!

What do you do if there is any emergency in labor?

We are trained to handle emergencies and have strict safety measures in place.  While it is our goal to always anticipate a problem before it becomes an emergency, if emergency arises, we quickly transition your care to a hospital of your choice.

Can I switch to River City Midwifery if already seeing an OB?

Absolutely! Please contact us to discuss details.

When should I start prenatal care?

You can start anytime! You can always start care later in pregnancy, but we love to see people at least once in the first trimester if possible.  The foundation of this model of care is relationship building and trust, and that takes time.  The more time we have to get to know you, your family and your perspective, the safer and more satisfying your birth will be. 

Can I eat and drink in labor?

Yes! We encourage it. 

Who can come to my birth?

You can have whoever you want at your birth. Some people like to give birth in complete privacy, others want close family and still others want a labor party with mom, sisters, a doula, a photographer and all the kids.  Whatever you want is fine - we adapt to you!

Can we do delayed cord clamping?

Absolutely! We do not clamp or cut the cord until you are ready, except in very rare situations. It is very common that we are not releasing baby from their cord until the newborn exam, several hours after birth.

Can I have a support person?

Yes! We love doulas and anyone else you want to be part of the team. However, doulas are never required.

Are there any books you recommend?

Yep! We have an extensive lending library. We also recommend podcasts and specific social media platforms to follow.

Are there any local classes you recommend?

Yes indeed. Richmond has a thriving birth community. We will offer suggestions during prenatal care.