Birth video's with Forward films

Click on the link above to check out our birth video created by a wonderful family and a talented film producer Joey Julius at Forward films in Los Angeles, CA.

See a new way that birth can be....

Blessings to you,

Amy Tinney RN CPM LM

Insurance reimbursment for Doula Monitrice services

Art of Nursing Care, Inc.
www.artofnursing.net
Amy Tinney CPM, LM, RN
Sarah Shealy CNM IBCLC


Offering Doula Monitrice services that can be covered by insurance.

If your labor support is provided by a Registered Nurse or a Midwife, your insurance may reimburse a portion of your cost. We have many options for care by our midwifery team. Doula Monitrice service offers 2 (one hour) prenatal visits being on call for your birth and one Postpartum visit. With this service you have 24 hour access to the Midwives and Nurses who can give advice and guidance during your pregnancy, birth and postpartum time.

What can a Doula Monitrice do that a Doula can't?

Doula's can provide emotional and physical support during pregnancy, birth and postpartum. Medical advice and providing medical treatment of any kind is not in their scope of practice.

A Monitrice (Either a Midwife or a Nurse) can monitor you and your baby during labor at home. Home is one of the most optimal places to help you get into active labor before traveling to your birth destination. If you feel that you would like to spend some of your labor at home this is a good option to be sure that you and the baby are doing well during your labor.

As Midwives and labor and delivery Nurses we also have the option to examine you for cervical change. In our experience it is rarely necessary to examine a woman in labor unless she requests it or she starts feeling an urge to push. Having this option before going into the hospital or birth center can be very helpful. In the case of ruptured membranes we will not examine you, due to the risk of infection. The less exams done after the membranes rupture the better.

Once we go to the hospital or birth center we remain your advocate but we are no longer able to act as your Midwife or Nurse. We can help navigate the hospital environment helping you understand interventions offered, and standard procedures and how to ask for and get what you want from the staff. All decision making about you and your baby rests with you and we will not speak for you. In the Hospital setting we play the traditional role of a Doula as a support person.

We wish for you a beautiful and empowering birth experience.

Blessings,

Art of Nursing Team;

Amy Tinney CPM LM RN

Art of Nursing Midwifery Services

Art of Nursing Care, Inc.

Amy Tinney CPM, LM, RN

Sarah Shealy CNM,IBCLC

Family centered Midwifery Services:

Well woman care

Preconceptual counseling

family planning

Pregnancy & birth services

Lactation consultation

Medela product sales

postpartum counseling

pregnancy massage

Well woman gynecological care

We offer routine gynecological care, pap screening and physical exam to women who desire a nurturing environment that respects and honors a woman’s body. We also offer birth control counseling and family planning options.

Preconceptual Counseling & Family planning

We offer counseling services to may increase your chances of conceiving naturally and consciously and give you emotional support thru the journey to becoming a parent. With you and your family in mind we can help you envision how it will be holding your new family in a place of nurturing and love. Open your heart and soul to new addition you want for your family.

Pregnancy Care

Our fundamental belief is that ”women are powerful” and that “birth is usually normal”. We specialize in water birth and provide holistic, preventative prenatal, birth and postpartum care for your family. We integrate alternative and western modalities into your care, our midwives have an extensive understanding of herbs and nutrition as well as birth and family psychology. We offer informed consent or refusal for all standard tests and procedures. We advocate for you in all aspects of your care, which will empower you to decide for yourself what is most appropriate for you, your baby and your family.

We believe birth is much more than just a physical process. Birth is a normal event in the life of a family and is unique to that family. During birth a woman and her family experience a powerful transformative “rite of passage”. When the baby emerges during their birth a new life force and soul enters our world. This is an enormous transition for the entire family regardless of the birth setting chosen. We believe birth can be held in a place of honor. During this precious transformational moment we as midwives serve to hold the space and safety for your family all the while providing quality medical care, support, patience and understanding.

We currently offer home birth to families that desire an intimate setting and the kind of care that is allows your family to choose who attends your birth. We also offer concurrent prenatal care to women who prefer the hospital setting for birth or need to birth in the hospital for medical conditions which are not safe in the out of hospital setting. Either way having our support during pregnancy will give you and your family the extra support and guidance you need to maintain a healthy pregnancy.

Prenatal Appointments either with home birth or holistic prenatal care

Prenatal appointments are scheduled for at least one hour. The atmosphere is family-centered, and you are encouraged to bring your partner, children and anyone supporting you through your pregnancy. During prenatal appointments, our midwives, obstetricians, nurses and interns will be a guide and mentor for your pregnancy and birth. We empower you by informing you of your options, counseling you about the risks and benefits of these options and supporting you in your choices. During pregnancy and birth there is a huge opportunity to blossom into empowered parents. It is our goal to create an evironment where you feel safe to explore your feelings, and you can develop a relationship with us based on trust and mutual respect. Meeting with and becoming familiar with the whole staff in our practice is paramount to creating good care and supports and eases your anxiety during birth if you have met and trust your care providers.

• We follow the standard obstetrical calendar for prenatal appointments:
• every 4 weeks until 28 weeks gestation
• once every 2 weeks from 28-36 weeks gestation
• once a week from 36 weeks until delivery
• If you are planning a home birth, you will have at least 1 prenatal visit at your home near the end of your pregnancy (we do offer other prenatal visits in your home for a small additional fee)
• Nutritional counseling is absolutely essential to a healthy pregnancy and is based on your individual needs and practices
• Inquiries into your pregnancy-related health concerns and appropriate recommendations
• Follow up blood work and cultures

Initial Exam

At the initial exam, one of our providers will take your complete medical, social and emotional history, draw blood for lab work as necessary, and perform a comprehensive prenatal exam. included in the basic lab work is a complete blood count, rubella, hepatitis B and C, HIV, as well as other sexually transmitted diseases. Some tests requiring an additional fee will be recommended as needed. (If it is unclear if a test is included in our flat fee or not, please inquire at the time the test is administered.)

Your Birth

Our midwifery team consists of midwives, Obstetricians, nurses and interns who will provide your labor support and attend your birth. If you are planning a home birth, we bring all necessary medical equipment with us. Necessary disposable supplies are provided to you in a home birth kit four to six weeks prior to your due date. We also provide a portable birthing tub for your use in your home during labor, which we bring to your home. You will be required to get a lead free hose and a fitting for your sink along with a few other preparations, which will be discussed during your prenatal visits. A comprehensive newborn exam will be performed on your baby within a few hours after birth. We are equipped to do the standard testing for the newborn and provide the basic newborn medications that are given around the birth. You will be given complete information and choice surrounding any and all interventions that may be needed.

Postpartum

After your birth, if you have a home birth we will stay with you for 4 to 6 hours during the transition period and continue to provide care for the first six weeks. We are available 24 hours a day for the entire 6-week postpartum period.

· We will provide two postpartum visits after the birth one within 36 hours from birth and the other within the first ten days, at your home. During these visits we will assess you and your baby and offer Newborn screening for genetic diseases.

· A 3-week and a 6-week postpartum visit will be done in our home office. Your 6-week visit will serve as a family planning consultation. Various contraceptives are available and discussed at this visit. This visit completes our care for your pregnancy. A Pap is included in your care if you are due for it at this time otherwise you may return for another visit when you are due.

Lactation consulting

We offer our clients lactation support by a certified lactation consultant and midwife. We also carry Medela supplies and can deliver them to your home as you need. Please ask about what we provide or visit our web page for information.

Postpartum Counseling

Are you experiencing challenges during your postpartum recovery? We offer counseling and support for women who desire a way to process their birth experiences and feelings of being a mother and that new role in a nurturing and supportive way.

Prenatal massage

We can also offer prenatal massage to women if they desire as well.

"Preterm labor awareness"

What causes Preterm labor?

Well this is still a scientific mystery. There are many risk factors as previously discussed, but nobody truly knows the exact cause. Stress can significantly impact your body in a way that can increase your risks of preterm labor.

Preterm labor can not always be prevented so that is why it is so important that every pregnant mother be educated to get early treatment that can help prolong her pregnancy as long as possible.

Warning signs of preterm labor

You are the best person to determine if there is a change going on in your body that is out of the ordinary. From day one in your pregnancy you will have a pattern that will become routine or normal feeling. Some of the signs of preterm labor can be misinterpreted as what occurs in a normal pregnancy. Just try to notice something that does not feel right. You may just have a feeling that something is different.

• Uterine Contractions: The muscles of the uterus are tightened or flexed. To determine if you are having contractions you must place your hand and fingers on your abdomen. Look at your hand, and your abdomen, can you push in and feel that your abdomen feels soft? When you are having a contraction your abdomen will feel like a flexed muscle. To determine how this feels try placing your hand on your bicep muscle in your arm. If you flex your muscle you will feel the change that you may feel in your abdomen. Having a contraction once in a while is normal in pregnancy but regular contractions are not. There are things that we do that can increase contractions. If you have a full bladder, change positions or other activities this may cause your uterus to contract. Determining if you are having contractions is a skill that is particularly important because preterm labor can be fairly painless in the beginning. If you feel a series of tightening in your abdomen that seems to have a pattern, contact your healthcare provider. Preterm labor contractions may occur every 10-15 min or closer and may last 40-120 seconds in duration. During this time your abdomen will be tight over the entire surface and will feel like a tight muscle.
The following signs may occur normally in pregnancy as well but if they are present you should monitor yourself to determine if you are having preterm contractions.

• Menstrual –like cramps: May be felt in low abdomen, back or near pubic bone. This may be rhythmic or feel like fluttering. You also may feel a constant cramp.
• Low back ache: the pain may start in the back and radiate to the low abdomen and be either rhythmic or constant.
• Pelvic pressure: a feeling of fullness or pressure in your pelvis and feeling as if the baby is going to push its way out.
• Gastrointestinal disturbances: Diarrhea, feeling of gas or bloating.
• Increase or changes in vaginal discharge: Determine what is normal for you and notice if there are changes or increased amount of discharge. This may be either watery, contain mucus, blood, or be pink or brown.
• You may just feel that something is not right. Even if you can not pinpoint a cause listen to that feeling and go to see your provider.
If you notice any of these things monitor yourself for contractions

Things you can do if you think that you are contracting

1. Use the restroom and empty your bladder frequently (every 2-3 hrs)
2. Drink at least 8-12 (12oz) glasses of non caffeinated beverages per day
3. Lie down on your right or left side
4. Palpate your abdomen for contractions.
5. Call your healthcare provider.

Emergency situations:
If you experience any of the following:
CALL YOUR PROVIDER IMMEDIATELY OR GO TO THE HOSPITAL

• Vaginal Bleeding: if you have bright red bleeding that is a large gush or steady trickle or flow this is an emergency. Get help right away. Lie on your side and keep your feet higher than your heart and head. Please keep all pads to show your provider at the hospital when you are evaluated.
• Spontaneous rupture of the amniotic fluid membranes: “Water breaking” Note Time, Amount, Color, and Odor if there is a constant flow or gush keep the pads and bring to the hospital.
• Severe stomach pain: This pain does not change or go away with position changes. This may occur with or without contractions.

"Why Do Women fear Birth?"

Over the last decade, there has been a rise in both medicated and instrumental deliveries. In some communities, the induction (Pitocin and Cytotec) rate is near 85%; the epidural rate is near 90%; cesarean section rate is above 25% and instrumental (forceps and vacuum extraction) is near 50%. What makes women of this millennium different from those of women at the beginning of the natural childbirth movement in the 1960's ~ in terms of trusting their bodies or seeking out managed births? Will women rediscover their true instincts for birth and what role can childbirth educators and doulas play?
We, as a society, have encountered a devaluation of life itself. Slowly over many years, this devaluation has seeped into the area of reproduction and taints some views of pregnancy, labor, and birth. This devaluation has contributed to the intensity of the fears women feel toward birth. With the help of the book, Birth As An American Rite of Passage by Robbie Davis-Floyd, these fears can be summarized in three categories.
Fear of the Unknown
We've heard of a proven pelvis. What about a proven spirit? Each pregnancy is different and each labor is different. Expectant women are no longer around family (mothers, sisters, aunts) to see the normal birth process. They tend to view birth as a mechanical process rather than a deeply spiritual and life altering event. Robbie Davis-Floyd, noted anthropologist, says, "birth rituals should affirm and reaffirm the unity and integrity of the family and the individuals that comprise it, instead of sending patriarchal messages about the primacy of science, technology, and institutions. Each of these have their place, but that place is to be of service to - rather than exploit - nature, individuals, families, and most especially birthing women."
Fear of the Known
Only 4% of all women who will ever birth feel no pain. In this modern age, women are too busy to investigate childbirth classes or read. Davis-Floyd makes the point, "hospital procedures are not specifically designed to serve as vehicles of concern and reassurance to birthing women, and often they do not. Women who fully believe in the technocratic model, expecting that 'the doctor will take care of everything' often experience feelings of shock, upset, and abandonment if he doesn't. Since these women do not take childbirth preparation classes, they usually have no cognitive matrix in terms of which they can interpret their experiences, no breathing rituals, no 'labor support person,' to mediate for them between cognition and chaos." Their frames of reference do nothing to assist them in coping with this fear.


Fear of Change
Many people are afraid of change, especially change in their routine or comfort levels. Birth typically does not come on a schedule. It is unpredictable. There is no one prescribed way that labor can begin, progress or end. Hospitals have prescribed to a comfortable technocratic belief system and practices that are standard for most laboring women. Davis-Floyd states, "I argue that these procedures serve as rituals and are so widely used in hospital birth because they successfully fulfill several important needs: (1) the individual psychological needs of the hospital personnel officially responsible for birth for constant confirmation of the rightness of the technocratic model, and for reassuring ways to cope with birth's constant threat to upset the model; (2) the individual needs of birthing women for psychological reassurance in the face of these same unknowns, for official recognition by society of their personal transformation, and for official confirmation of the rightness and validity of their belief systems; and (3) the need of the wider culture to ensure the effective socialization of its citizens and thus its own perpetuation."
So why change if everyone is comfortable? Why encourage women to birth naturally, trust their instincts when labor can be actively managed? Perhaps the closing paragraph of Birth As An American Rite of Passage will cause you to think, as it does me whenever I read it: If it is true, as psychotherapist Gayle Peterson says, that 'as a woman lives, so shall she give birth,' then perhaps it is also true that as individuals within a society shape birth, so shall they shape social life. It is both my belief and my hope that in the end - or the beginning - the salvation of the society which seeks to deny women their power as birth-givers will arise from the women who, nevertheless, give that society birth."



Reference: Birth source.com

Midwifery services and Out of Hospital birth

"What are the benefits of using a midwife?

One of the main reasons that women elect to use a midwife in their homes, at birthing centers or in hospitals is to experience the childbirth process as naturally as possible.
A focus on options is another benefit associated with electing midwifery care. Midwives often have payment plans, sliding fees, and accept most insurance plans, including Medicaid.
According to the doctoral research conducted by Peter Schlenzka, an election to use a midwife and natural delivery may result in the following benefits:

* Lower maternity care costs
* Reduced mortality and morbidity related to cesarean and other interventions
* Lower intervention rates
* Fewer recovery complications2

Electing to use a nurse-midwife is appropriate for low risk pregnancies which make up 60 to 80% of all pregnancies. In Schlenzka’s review of over 800,000 births, he reports there are no advantages of an obstetric hospital approach as compared to a midwife setting inside or outside of the hospital.


"Why should you consider giving birth outside of the hospital?”



Our fundamental belief is that ”women are powerful” and that “birth is usually normal”. Birth is a normal event in the life of a family and each birth is unique to that family. During birth a woman and her family experience a powerful transformative “rite of passage”. During this precious transformation we as midwives serve to hold a circle of safety for labor and birth to unfold naturally. “ Only intervening when absolutely necessary” When this process is supported in a way that does not interfere with the woman’s natural instincts, it can be one of the most empowering and fulfilling experiences you can have and it will impact everyone present in the deepest of ways. Having your baby outside of the hospital environment, gives you the choice of who you want to attend your birth and who cares for you. You can choose what foods you feel like eating and what you want to drink. During your labor, you can walk, dance or sleep uninterrupted if you want to. Feeling safe and supported helps your labor progress normally. If you desire to, you can give birth in water and then after the birth move to a cozy bed. During your recovery you are given the space to bond with your baby without unnecessary interventions inhibiting the serenity and connectedness of the precious moments following the birth.



If there is extra care needed for you or your baby like warmth and stimulation, we can provide it to your newborn while they are in your arms instead of a warmer with strangers. During any interventions which you, or your baby may require we will give you a full explanation about what is being done and why. Giving birth outside of the hospital allows for more of what you want during the labor and birth process while we as midwives provide the circle of safety with the watchful intuitive eyes and ears that keep things safe for you & baby, which allows you to do what comes naturally to you.



When families are provided with education, good prenatal care and possess a healthy positive outlook, homebirth is a safe alternative to hospital birth. We encourage women and families to take responsibility for their health and well being and make informed choices about their care.