Expert Midwives - Home Birth
Before You Meet With Us

Congratulations!  You're pregnant!  We look forward to meeting you at our Initial Interview.

To Schedule an initial interview call: 763-286-5941

In order to make the most out of your Initial Interview with us, please plan on Father of the baby attending with you—we need to get to know both of you—and both of you should be comfortable with us. Please arrange childcare for your other children, so we can optimize our time together, allowing one hour for the Initial Interview..

During the Initial Interview, we ask for information that will allow us to help guide you during your ‘birth year’ in order that you will have a healthy pregnancy, delivery, and postpartum. We have helped hundreds of women avoid potential problems as they progress through pregnancy, labor, birth, & nursing. This allows them to focus on this special time in their lives and their precious new baby.

Please bring the following with you to the Initial Interview:

1.)  Completed Health History Form

2.) Completed 7-Day Diet Record

3.)  Previous birth and/or OB/GYN records.

4.)  The vitamins, herbal supplements, teas, tinctures, or green drinks as well as any Rx or OTC drugs you are currently taking to support your health should be brought with you in original packaging.

Health History
7-Day Diet

*The Consent Form and the Insurance Form will not be needed until we agree to work together for this birth.

We will ask you to answer the following questions:

1.) What is your experience with home birth? Do you know or were you referred by someone who had a homebirth? How did you hear about us?

2.) List mo/yr of any: live births/miscarriages/abortions/or stillbirths. How long were your labors?

3.) In previous pregnancies, please tell us of any complications such as hemorrhage, c-section, toxemia, high blood pressure, gestational diabetes, asthma, allergies, thyroid issues, & medications given to treat these.

4.) When do you believe your baby is due? Dates of: pregnancy test, ultrasound, or clinic visit.

5.) What was the mo/day/yr of your last period? Did you consider it to be normal in length & intensity?

6.) What is your current weight? What was your pre-pregnant weight? How tall are you? How old are you?

7.) Please list which, if any, & with what frequency you consume tobacco, alcohol, OTC or street drugs?

8.) Do you have medical/phycological conditions that require medication? What are they?

9.) What breastfeeding experience do you have? How long do you hope to breastfeed this baby?

10.)Will the Father of the baby be the only support system available to you at/after the birth?

11.) Have you ever experienced depression? What, if any, medications did you take? For how long?

12.) What concerns do you have about post-partum depression after this baby is born?

13.) How will your spiritual preference play a role in your home birth?

Riverside North Maternity Care
(Please leave name, phone number with area code, and due date)