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My logo photo
Highland Midwife
Birth Services
South Central Washington
& the Columbia River Gorge






For Clients
Information and documents to read and download.
Many of them will require your signature.
I will provide you with a complete set of documents,
so there is no need to print them out unless you need a new copy.





Extra Info:
      Radiation Exposure:   sources of Iodine to protect your thyroid.
      After Birth Control:   ways to Cleanse Your System prior to conceiving.
      Washington State Insurance Commissioner:   file a Complaint if you have problems with your insurance company (like denials of claims, or slow pay). This form gives the Commissioner the ability to investigate and act on your behalf, otherwise he cannot help you!





Packet 1:
Important documents to read before your first midwifery appointment.

Informed Choice for Midwifery Care & Home Birth
(signature required for you to become my client).
Client-Midwife Contract
(signature required for you to become my client).
Financial Agreement & Payment Schedule
(signature required, sets out the details of your payment arrangements).
Indications for Physician Consultation & Referral
(signature required, conditions & situations for which I consult or refer).
Medical Records Request / Release
(to have health care records sent to me from other providers).
Insurance Information Form - for established 2012 clients only
(needed if you intend to use my biller to help you with insurance).
Insurance Benefits Questionnaire - the ultimate tool for interviewing your insurance company to determine your benefits.
MANA Statistics - Midwives Alliance of North America
(disclosure & consent to collect limited research data).
Genetic AFP Screening - for specific birth defects
(informed choice for prenatal risk screening test at 15-20 weeks).
Ultrasound & Doppler Use - informed choice; risks and benefits of fetal imaging and/or use of doppler fetoscope during pregnancy.
Vaginal Birth After Cesarean - only for moms with previous C-sections
(informed choice for mothers considering VBAC).
          Additional Info for early pregnancy:

When to Call Your Midwife (with contact info) and
If Your Bag of Water Breaks. Print and post this at home.
Practice Guidelines
(describes my typical client care in more detail).
Charting My Pregnancy / Labwork in Pregnancy
(helps you track your care and explains routine prenatal labwork).
HIPAA Notice - as it affects my policies and procedures
(Health Insurance Portability and Accountability Act info).
Exercises for Pregnancy
to relieve discomfort in pelvis, hips, low back.
Weighing the Risks and Benefits; additional reading
to learn why I rarely recommend ultrasound.
Due Dates - OB Calculator, prints on one page
(a link to a fun resource for calculating your dates).
Due Dates - OB Calculator from ATM
(if you prefer a traditional calendar-style dates report).




Packet 2:
To read during your second trimester.

Informed Consent for Glucose Tolerance Testing
for gestational diabetes (done between 24 & 28 weeks).
Informed Consent for RhoGam, only moms with Rh-negative blood types (done at 28 weeks and again at birth).
Emergency Transport Information
(info we will take with you if you go to the hospital).
Hospital Transport Plan
(needs to be decided and filled out well in advance of labor).
Informed Consent for Vitamin K Prophylaxis
(includes alternatives, some of which start at 30-32 weeks).
          Additional Info for mid-pregnancy:

First & Second Stages of Labor
(defines and describes labor and delivery).
Parent's Guide brochure; information that I am required to offer, not necessarily something that is endorsed.
Article reprinted by permission; critical information about both circumcision and care of intact boys. Active links.




Packet 3:
To read as you enter your third trimester.

Informed Choice for Group B Streptococcus
(testing is done after 34 weeks gestation).
Prophylactic Antibiotic Eye Ointment
(informed choice for newborn treatment).
Map & Directions to Birth
(so we can easily find your home, even in the dark!).
Important:   You should order your birth kit no later than 34 weeks.

Custom Birth Kit for Highland Midwifery
(click here to order at Confident Beginnings).
          Additional Info for late pregnancy:

Third & Fourth Stages of Labor
(defines and describes what happens after baby is born).
Birth Supplies List, items in addition to your Birth Kit - above
(things to have ready at home before 37 weeks).
Labor Tub Use & Care
(how to clean, set up, and fill the tub that I will loan you).
Video - How to set up your home for a birth
(easier than you think).
Video - What your midwife will bring along in her bag
(all the equipment that we almost never use).
Same as "When to Call Your Midwife" above
to print and post in your home if you haven't already.
How to deliver without assistance (in the unlikely event that you ever have to, & assuming you took our birth class).
from Passion for Birth - Childbirth Educator Training, just for fun,
videos of dancing for labor induction - way too good to miss!
Newborn Screening; what it is, why it is done, prices in Washington and Oregon. Parental refusal is still optional at home.
Postpartum Instructions for Mom & Baby
(Important information about your care after the birth).
Instructions for Visitors, for parents who want (or need!)
to post helpful reminders after the birth.
Growth chart for newborn to 2 years;
boys and girls, height and weight, adjusted for breastfed babies.
Newspaper Birth Announcement
(Easy submission form if you want your birth in the newspaper).




After the birth:
Things you may need later.

If your insurance is through Apple Health (state of WA), you MUST add your baby within a week of birth! Instructions here.
How to order a Washington Birth Certificate; I send the info
to the state within 10 days, and you order the certificate directly.
How to order an Oregon Birth Certificate; I mail the info
to the state within 5 days, and you order the certificate directly.



Webdesign and content copyright 2009-2013 by Lorri Carr, LM CPM; site maintained by Highland Midwife TM.
Original logo designed by Justin Farnsworth; copyright 2012-2013, all rights reserved for Highland MidwifeTM and the artist.


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