Midwifery Care
Seattle Natural Family Medicine offers comprehensive maternity care throughout the childbearing year. Dr. Tracy McDaniel is both a naturopathic physician and licensed midwife; attending births at home and in free standing birth centers. A free standing birth center is one that is not affiliated with a hospital.
Having given birth to her son at home, Dr. Tracy sees labor as more of an athletic event than a medical one. She believes a solid relationship between a family and its birth team is fundamental to creating an environment in which a woman can come to her labor, and a couple can come into parenthood, feeling joyful and strong.
Training in both naturopathic medicine and midwifery enable Dr. Tracy to follow women through an essentially normal childbearing cycle. Naturopathic therapeutics such as nutrition, herbs, homeopathy and physical medicine are used to address health concerns which may arise during pregnancy, labor and the postpartum period. When complications of pregnancy or birth occur, appropriate maternity specialists will be consulted and referrals arranged as necessary.
Dr. Tracy and her team carry the equipment, medications, and necessary supplies to support a normal childbirth in a home or birth center setting. There are, however, certain specialized services and equipment which are not available outside of the hospital. For example, we do not carry equipment to intubate a baby or adult, perform vacuum extraction, forceps or surgical delivery, nor do we administer blood. Epidurals and narcotic pain medications are not available at home or in the birth center.
Naturopathic midwives acknowledge your fundamental right to choose how to birth your baby. It is our philosophy that the best outcomes for mothers and babies are achieved when preparation for birth is regarded as a mutual responsibility of both the client(s) and her naturopathic midwife. We will work with you to help you make decisions regarding your care. Routine maternity screening tests, procedures and treatments will be explained during office visits. You are encouraged to ask questions and to ask for additional written materials or resources when you want more information regarding any topic relating to your maternity care.
YOUR INITIAL VISIT: Your initial visit is a consultation session which will include a discussion of the following topics: Your reasons for choosing home or free standing birth center birth with naturopath/midwifery care; a description of the midwifery model of care; a review of how labor and birth in a hospital differs from home or birth center; a discussion of the risks of childbirth to the mother and infant and the management of complications in a home or birth center setting. We will also discuss arrangements for medical consultation and referral when it is needed. Ample opportunity is provided for prospective clients to ask questions.
PRENATAL CARE: Pregnancy care begins with an initial history and physical, dietary assessment and laboratory testing. Prenatal checkups at the clinic occur monthly until 28 weeks, twice monthly until 36 weeks, and weekly until your baby is born. Visits are generally 30 minutes long and are structured to give ample time to discuss any questions or concerns you may have about your pregnancy, discuss the coming birth and assess the health of you and your baby. Dr. Tracy or another covering midwife is available twenty four hours a day by calling our answering service.
WHAT TO EXPECT DURING LABOR: Toward the end of your pregnancy, you will receive a handout with guidelines about when to call in labor. Once active labor has started, the midwifery team will come to your home or meet you at the birth center. With your team assembled you will have access to as much, or as little, hands-on support as you want. The SNFM birth team generally consists of Dr. Tracy and two birth assistants. They will stay with you continuously throughout your labor and the immediate postpartum period, which lasts approximately 3 hours.
POSTPARTUM CARE: A postpartum home visit is generally done within 48 hours of your child's birth. You will also be contacted by phone regularly until breastfeeding is well established, generally 3-5 days postpartum. Follow up office visits are generally scheduled at 7-10 days, and 4 and 8 weeks after you've given birth. If the baby is coming to the clinic for pediatric care, their visits are scheduled at the same intervals.
SCREENING: Giving birth at home or in a birth center is a powerful and joyous choice for many women and their partners. The safety of birth in these locations, for low risk pregnancies, has been well documented in the literature. To ensure that your pregnancy is low risk, your naturopathic midwife will rely on your medical history, review of medical records, labs and physical exam. Therefore it is vital that the information you provide be complete and accurate to the best of your knowledge.
Complications may arise during prenatal or intrapartum care which your naturopath/midwife diagnoses as high-risk. In this care she will recommend birth in a hospital. In some cases, you may be able to transfer to the care of a hospital based nurse midwife. If a transfer of care is necessary, your naturopath/midwife may come to your birth to serve in a supportive role if you so desire. You are always encouraged to ask questions and your doctor will gladly explain the reasoning behind any medical decision.
BACK UP COVERAGE: In the event that Dr. Tracy is not available to attend your birth, she will arrange for another midwife or naturopath/midwife to attend you in her absence.
CONSULTATION AND REFERRAL FOR OBSTETRIC SPECIALTY CARE: Dr. Tracy consults with several area medical centers, obstetricians and pediatricians. If significant deviations from normal develop at any time during labor and delivery, a specialist will be consulted. During the prenatal and postpartum period, consultation or referral will be recommended when the condition is outside of Dr. McDaniel's scope of practice and knowledge as a naturopathic doctor and midwife.
WHAT IF YOU NEED TO GO TO A HOSPITAL?: If, during labor, a situation arrises which necessitates a transfer of your care to a hospital, Dr. Tracy will accompany you. She will help to establish care with a certified nurse midwife or obstetrician and to continue to support you in person or by phone through the rest of your labor.
STUDENT MIDWIVES: Dr. Tracy is usually assisted in the office and at births by student midwives. Student midwives are in attendance for the added safety of both mother and baby and to further the students’ training. You will meet the student(s) prior to your birth whenever possible and we will make every attempt to honor your wishes regarding choice of birth assistants. We are very supportive and respectful of the intimacy of birth and are committed to training students with the same philosophy.
Click the links below for more information about the area's free standing birth centers: