Monitrice Doula Care
About our CPM Monitrice Team:
Jessica Elliott and Jennifer Pryal are both practicing midwives in Portland, Oregon. They both completed formal education and apprenticeships to take and pass the CPM exam given by The North American Registry of Midwives (NARM). They actively attend births as midwives and assist other midwives as birth assistants in the Portland Metro area. Now, they are joining the Portland MamaBaby Center to take on a new role as staff monitrices.
What is the role of a monitrice?
A monitrice is a perfect solution to women and their partners who believe that the best way to avoid interventions at the hospital is to stay out of the hospital until it’s time to deliver your baby. The monitrice team works with clients who want a natural birth and acknowledge that the way they are most likely to achieve that is to labor at home for as long as possible. Monitrice care provides you with the confidence and security to labor at home longer knowing that a midwife is there to monitor and assess your labor, your vitals, and your baby’s heart tones. She is also there as a guide and to give you support in the same way that a doula would be. If I had to sum it up in a sentence: a monitrice is the perfect combination of a midwife and a doula for women who plan to have their baby in the hospital with an OB or a nurse-midwife.
A monitrice is not the primary caregiver of the Mama nor the Baby. She is a a part of the birth team, but is not the primary birth attendant. Clients we accept must have an obstetrician or nurse midwife who plans to attend their birth in order to sign onto our care. This is really important to us to communicate clearly – we cannot, nor will we, be the primary attendant. If that’s what you’re looking for, then please look into our midwifery care.
What does your monitrice care look like?
The clients we work with typically have OB care or work with a nurse midwife who supports their decision to stay at home as long as possible to avoid interventions and agree that they have a low-risk pregnancy. Monitrice clients must live within a short distance of a local hospital as birth plans typically require less than one hour from door to door.
As a monitrice, we typically arrive at your home (or wherever it is you plan to labor) in early labor to assess where you are in your labor pattern. Upon arriving we check and chart your vitals and listen to baby’s heart tones. If it’s still very, very early in labor she may stay nearby but give you some space until you are in a more active labor pattern. If you are in a prodromal labor pattern we’ll check you and baby daily. Prodromal labor can become really frustrating really quickly, and having someone to talk to, vent to, and hope with can be really helpful. Knowing you are getting the expertise of a trained midwife advising you can give you the confidence you need to stick to your plan of having your baby naturally without induction.
Once you are in an active labor pattern, she will listen to baby according to midwifery care protocol. Once it seems that birth is imminent, after having worked out in advance a detailed transport plan, you will go in two separate cars, she following you, to the hospital. Once you’re admitted to your room, she will switch to a doula role and give you support and comfort care, distraction and positioning, and help you focus on positive affirmations to welcome your baby. She’ll also be leading your partner(s) by example, so that s/he is the one who is actually the one you’ll remember when you look back fondly on your day.
We will want to discuss your wishes for newborn procedures and care. There are hospital procedures that you may not want for your baby, such as eye ointment, that will automatically be done to your baby unless you explicitly waive them. You should also consider your wishes for vaccinations and other routine newborn procedures in the hospital. I think this part of the birth plan is an important part to consider carefully. Remember that your baby will have his or her own medical record the moment that his or her cord is cut, so it may be worthwhile to write a newborn care plan and also a birth plan. We’re willing to work with you on this.
If you plan to have your baby’s placenta professionally encapsulated by our resident midwife at the Portland MamaBaby Center, you will need to likely sign a release to the hospital that will release the placenta to you. From that point, you can give the placenta to your monitrice-doula to take home to our freezer. This is something we would discuss in a prenatal appointment. Your pills and/or tincture would be returned to you at your postpartum visit with directions.
Before leaving you at the hospital, she’ll help you to gather your things and straighten your room while you and your new family bond. She will make sure that you have a meal coming from the hospital staff, but they are usually pretty good about getting you something to eat and drink pretty quickly after you’ve given birth. It’s like a marathon – you need energy!
During the immediate postpartum period at the hospital she will try to stay out of the way as much as possible, taking pictures if you want them, writing down vital statistics as the nurses call them out, and trying to help you document those moments that become foggy within days. We do love to hold a brand new baby that we’ve bonded with and we’ll never turn down the offer to hold your new baby and have our photo taken with him or her, but we will usually not ask to hold your baby because we recognize how special it is for you to hold your baby and for you to choose who has that privilege to gaze into his or her eyes.
When it looks like you are all snuggled into bed with your baby and feeling ready to be alone, we’ll be slipping away home to get some sleep. We’ll upload images and send them to your email within 24 hours.
What about postpartum care?
Typically we ask Mamas to call within the first two days home. It’s better for them to call us than for us to call them and wake the baby! We offer unlimited support and so we do field a lot of questions. Sometimes new parents just need to know if something is ‘normal’ or not. Having a midwife to ask is especially beneficial!! Frequently new parents just need some support and confidence and the encouragement to listen to their inner voices. That’s where we excel.
Typically we do our postpartum visit around day three or four and will usually have your the placenta pills (if Mamas have asked for that service) along with a gift for Mama and Baby and a meal for the family. We do another postpartum visit at the two week mark where we have an opportunity to process the birth with the family and say goodbye. It’s difficult to say goodbye after going through something so intense and emotionally bonding, but we do enjoy keeping up with baby pictures and videos on Facebook! If you find that you need extra postpartum support, we are happy to be available to and your family for $35/hour with a two hour minimum. If you find that you need more postpartum support than just a couple of visits, then we can work out a package deal for you.
If you’re still unclear about the role of a monitrice and how that looks different from midwifery and doula care, please read the blog post that defines each of these roles.
Our Monitrice Doula Care Package:
- A sixty (60) minute initial consultation in the Portland MamaBaby Center with the monitrice team.
- Three (3) one-hour prenatal visits with your primary monitrice privately in our office
- Unlimited phone, text, and email support as needed throughout your pregnancy and up to two weeks postpartum.
- On call care (available 24 hours/day within a 60-mile radius of Portland) for your birth beginning on the first day of your 38th week of pregnancy (2 weeks before your due date) and continuing through your birth until you have your baby.
- Early labor monitoring at home (includes an assessment of labor, vitals, checking fetal heart tones, and chart notes that can be transferred with you to the hospital care provider for their chart.)
- Continuous, uninterrupted doula support during your labor and birth in your home, birthing center, or hospital of your choosing in the Portland metropolitan area.
- Two (2) one-hour postpartum visit in our office or your home with a gift for Mama and Baby
[a travel fee may apply for home visits outside of Clackamas, Washington, or Multnomah counties]
Fee: $950