We're proud to offer out of hospital birth services to the Hill Country area, at our beautiful new birth center or in your home. 

Midwifery & Birth Center 

The Midwives Model of Care™ is a fundamentally different approach to pregnancy and childbirth than contemporary obstetrics. Midwifery care is uniquely nurturing, hands-on care before, during, and after birth. Midwives are health care professionals specializing in pregnancy and childbirth who develop a trusting relationship with their clients, which results in confident, supported labor and birth. While there are different types of midwives practicing in various settings, all midwives are trained to provide comprehensive prenatal care and education, guide labor and birth, address complications, and care for newborns. The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:
  • monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
  • providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • minimizing technological interventions and
  • identifying and referring women who require obstetrical attention.
The application of this model has been proven to reduce to incidence of birth injury, trauma, and cesarean section.  Across our planet, eighty percent of people alive today have been born with midwives. In many of the industrialized countries of the world, midwives attend approximately 70% of all births. The countries with the lowest mortality and morbidity rates for mothers and infants are those in which midwifery is a valued and integral pillar of the maternity care system. The midwifery model is a low-tech, high-caring model that produces excellent outcomes.

Prenatal Care

Labor & Birth

Postpartum

What Prenatal Care With Us Looks Like

Prenatal care is one of the largest components of midwifery care, which is why we spend a full hour with you at every appointment. It is so exciting to hear the baby’s heartbeat for the first time, to get to know the client and their family, to watch a woman grow into a mother. Prenatal care is a nurturing and intimate time to talk about all aspects of pregnant life. From how the baby moves, to the aches and pains, from the joys and the struggles, prenatal care is a time for you to focus on this unique journey of pregnancy. And of course, it is a time to prepare for your birth.
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Following a regular schedule of appointments, which are tailored to your needs, we will take time to talk, share and get to know one another. We will also spend time assessing the baby, how you are doing, and answering any questions that may arise. Lab work and physical assessments, along with conversation and inquiry, give us valuable information. Prenatal visits last for an hour and you can use as much of that time as you’d like. We will share time preparing for the birth, addressing any concerns that arise and hopefully, empower and prepare you for motherhood.

Your Labor & Birth 

Personalized labor and birth support are paramount to having a safe and fulfilling birth experience. As your midwife, I provide you with the exact support you desire while monitoring the well-being of you and your baby.
I will listen to your baby's heart rate intermittently and check your vitals. I will have a trusted assistant join us when birth is imminent to help monitor you and your baby during pushing and the immediate postpartum period. You can birth in whatever position you desire.

At home, I stay with you for a minimum of 2 hours after the birth of your baby, providing care and monitoring of both you and your baby. A complete head to toe examination of the newborn is conducted as well as monitoring maternal vitals and overall well being. Breastfeeding support is provided to ensure a positive start to you and your baby's breastfeeding experience. The team does not leave until specific criteria have been met by both mom and baby.
Once it is determined that you and your baby are stable and resting in bed, our team will clean up any "mess" and even get the birth laundry started.

​My midwife assistant and I regularly train for emergency situations and maintain our neonatal resuscitation and CPR training if the need arises. If transporting to the hospital becomes necessary, I will stay with you and continue providing you personalized, compassionate support.

For your birth center birth, once you have arrived at Hill Country Birth Center, an initial labor assessment will take place to ensure the safety and well being of both you and your baby. Intermittent monitoring of fetal heart tones, use of hydrotherapy, freedom of movement, physical and emotional support are all standard of care at the Birth Center. A licensed midwife will be with you throughout the entirety of your labor, birth and postpartum stay. The midwife will also have a trained assistant to help with the care of you and your baby. Once the baby is born and both you and your child are stable, a complete head to toe examination of the newborn is conducted as well as monitoring maternal vitals and overall well being. Breastfeeding support is provided to ensure a positive start to you and your baby's breastfeeding experience.
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The average stay after your baby is born is about 4-8hrs. Specific criteria must be met by both you and your baby before discharge to home. Upon discharge, your midwife will give you instructions for monitoring you and your baby at home. A visit will take place between 24-48hr from birth time. In the interim, you can call your midwife with any concerns.

Postpartum Care

The postpartum period, or the 4th trimester, is just as important as prenatal care. Adequate care, support and nurturing is vital to the healing mother. After your birth I will return at 24-48hr to check in on you and your family, offer breastfeeding support, perform routine newborn assessments/testing (with your consent) and address any concerns. The next visit will be at day 5 (or sooner, if needed). Subsequent visits will take place at 1-2wks, 4wks and 6wks.
As a licensed midwife I am able to care for you and your baby until 6 weeks postpartum. Routine tests and screenings offered for the newborn are: ​Newborn Metabolic Screening , CCHD Screening , Newborn Hearing Screening.

Postpartum Doula Support Services

As a professional Postpartum Doula, I come into your family's home after the birth of your baby to help facilitate the adjustment period. I offer to do various household tasks and offer support to the whole family with primary focus on the new mother. I am there to encourage and educate the family on taking care of a newborn, assistance with breastfeeding (if desired) and the overall help with transitioning into a new family unit.

​Here are ways that I offer support:
· help with breastfeeding
· help with infant care including bathing and changing the baby
· help with umbilical cord care
· laundry
· meal preparation
· light housework
· running errands
· attending Dr. appts/outings
· fielding visitors
· helping with older siblings
· of course, a listening, experienced, and compassionate ear

Monitrice Services

In short, a midwife is your primary care provider during your pregnancy. A doula is a labor support person. And a monitrice is an interesting blend of these two roles.

A monitrice’s primary role is that of labor support. Just like a doula, a monitrice offers continuous, hands-on support during labor. Unlike a doula, whose scope of practice generally prevents her from providing any clinical services (by their certifying organizations), a monitrice will perform limited clinical assessments such as monitoring the baby’s heart rate during labor, mom’s vital signs, and assessing cervical dilation. This means that the monitrice is usually employed to labor with you at home–before going to the hospital. It would be very unusual for someone to hire a monitrice if they are planning a homebirth–I would imagine this would blur roles a bit. That being said, some doulas will come and labor with you at home. But if your goal is to labor at home as long as possible, you may prefer the reassurance of the assessments a monitrice performs.

The best candidates for hiring a monitrice rather than a doula are first-time mothers and women planning VBACs (vaginal birth after cesarean), in my opinion. It can be very tempting to leave earlier for the hospital in both of these situations, and once you get to the hospital too early, you may very well find yourself confronted with interventions you were hoping to avoid. There are few avenues of study for monitrices, and no widely recognized certification that I know of. Most monitrices are either midwives who do some doula work (like me), or apprentice midwives who have learned some clinical skills. You will want to ask specific questions about where your (potential) monitrice gained her clinical skills and what her practice guidelines are. For instance, it is all well and good to say that she monitors fetal heart tones during labor, but does she know how to do it properly and what she’s listening for?
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Though everyone has their own pricing structure, my fees as a monitrice are higher than my doula fees. One reason for this is that it is more time consuming. As your monitrice, I am with you from the end stages of early labor through the first hour or so postpartum. When I’m your doula, I providing phone support, but meet you at a later time, normally once you’re well into active labor. Most importantly, though, you are paying for my clinical experience in order to safely assess you and baby during the time we are together

Prenatal & Family Chiropractic

Chiropractic care during pregnancy is our specialty! Regular care during this exciting time helps create proper balance and alignment of the spine and pelvis, increased flexibility, and a stress-free state for the quickly changing and growing body.  Restoring balance to our nervous system also opens the communication pathway to each and every system including the reproductive system supporting your growing baby! Dr. Summer is Webster certified, which is a specific chiropractic sacral analysis and gentle adjustment that reduces nerve interference and assists biomechanical balance of the joints and ligaments.
Beyond pregnancy, the postpartum journey also presents its challenges and physical demands. There are residual effects of Relaxin, a hormone that allows ligaments and joints to relax and expand to bring you precious baby into the world, makes the return to proper biomechanics and function difficult. Chiropractic care can aid in the recovery period by ensuring proper balance and alignment, facilitating a quicker and easier recovery. The 4th trimester (recovery period) is a part of your pregnancy experience, honoring yourself and your body for all of its wonderment is vital!
"Ashley was an awesome doula – just what we needed. Taking on a client who is a health care provider can always present in a challenge and Ashley took it on without flinching. She helped to calm my “know-to-much-itis” during our prenatal meetings. She presented us with literature so we could form our own opinions and choose the best options for our child. During labor, she was a huge comfort to my husband who felt very lost in the shuffle initially. When Ashley arrived, he knew she would guide him and help him to know if he was doing the right thing. My birth was a fairly quick one and I had my eyes closed much of the time, but I remember Ashley’s voice in my ear encouraging me to go on; directing me on how to push to be more productive. When Emory was crowning, she took James’s place behind me so that he could see his daughter come into the world. She stayed afterwards to help us with the first latch. That helped a lot because no one was around to assist with breastfeeding until the next day.
When she came to our house (way out in Charles City) she helped us out with breastfeeding again, just to make sure I had it right. We talked about the birth and she filled in the gaps. I have already recommended Ashley to friends because she is there for what you need and she knows that each woman and her family will be different. "-M.Keller