What do prenatal checkups look like with homebirth midwives?

I remembered viewing this video some time ago, posted by another momma who had an OB for her previous pregnancy and was seeing a midwife for this pregnancy. (Not sure of her birth location for either.) She put together this funny but 100% true video outlining the actual time spent and how it was spent, at her OB appointments vs. at her midwife appointments. The average amount of time a pregnant momma spends face-to-face with her OB at each appointment is 6 minutes. This momma actually spent 3 minutes face-to-face with her OB. That doesn't leave a lot of time for asking questions, discussing birth plans and preferences, and scoping out OB's birth philosophy and standard routines/practices, let alone relationship-building. My first pregnancy and birth was with an OB group that had 2 midwives in the practice, but the midwives practices were closely in line with the OBs', both with prenatal checkups and at births. The timeline in this video lines up with my experiences at the OB office.

I've had several people ask me what a typical midwife appointment looks like. It will vary from midwife to midwife, and it will also depend on where she practices (hospital, birth center, or homebirth). Her practices may depend on state laws or on the policies of the hospital or birth center where she works, if she's not independent.

Here's a photo essay of a typical prenatal appointment with my primary midwife of the last nearly-8 years, through 3 home waterbirths (thus far), 1 loss, and this upcoming birth. Angy (Angelita) Nixon, CNM has been my primary midwife through it all. Jennifer Stewart, CPM, was my assisting midwife at my other homebirths, and I love her to pieces, but she has a wonderful opportunity to move to California to attend homebirths. She'll be moving before I have my baby, so Dorothy Kaeck, CPM, will be the assisting midwife at my upcoming homebirth. Dorothy is wonderful too, and I'd have been happy to have had her at any of my prior births, but she has only been in WV for 2 years. Here is an overview of the personalized, one-on-one care I receive from my gentle, experienced midwives.

I arrived at my midwife's home/office for my prenatal appointment. What a view.

I got my kids settled in with the toys they brought and the toys that my midwife keeps in her living room for visiting children.

Unlike OB appointments that frequently require moms to wait with a full bladder in a waiting room for up to 30 minutes, I headed directly for the powder room, where I collected the sample, then tested it myself with the test strips my midwife leaves under her bathroom sink.
*Note* the Urine Collection Container in this photo is clean and empty. You're welcome.

This is my midwife's exam room. I didn't need it today.

My primary midwife, Angy, with her cup of coffee, just the way a prenatal should start.

My assisting midwife, Dorothy, making notes in my charts. I told her my weight from this morning when I weighed myself at home, then I told her that my urine sample was negative for both glucose and protein (which is good news on both accounts).  How freeing it is to have that kind of trust with one's care providers.

My kids think that my midwife's spiral staircase is the most fun part of the appointments. That, and smelling her candles to find their favorites.

Dorothy gets ready to prick my finger for the fasting blood sugar test.  She looks way too happy to be inflicting this... Just kidding. It wasn't bad. (At my previous appointment, she drew a vial of blood for the thorough 2 hour blood sugar test plus hemoglobin check and other blood screens. It all came back with healthy results.)

Explaining to my kids what Miss Dorothy is doing and why.

She checks my blood pressure.

My son tries to get her to smell his feet, while stealing her chair. Successfully. He's a charmer.

Having the fasting blood sugar test behind me, now it's time for breakfast. My midwife made me Starbucks coffee and put half & half and sugar in it and brought it to me. I had brought with me 3 pumpkin muffins I made, and I shared the 3rd one with my midwives.

Leopold's Maneuvers, which allow Dorothy to determine baby's position. He is head-down, Right Occiput Anterior.

My son is the blur on the left, always in motion, taking it all in.

Are your prenatals this fun/funny?

Dorothy gave me the option of listening to baby's heartbeat using fetoscope or Doppler. I prefer to use fetoscope when possible to limit unnecessary exposure to ultrasound waves. Dorothy was able to find his healthy heartbeat.

My son is fascinated. I wonder how this will shape his views of healthy and normal pregnancy and birth, for his own future wife and children?

My 5 year old knows more than most adults do about normal pregnancy and birth.

Dorothy let me try to hear baby's heartbeat with the fetoscope, but I couldn't hear it over my children's (quiet-ish) noise. I was content to take her word for it that she heard it and it sounded great. 

Dorothy measures from my pubic bone to my fundus. Baby is measuring 31.5 cm when I'm at 30 weeks, but that's within normal, and could just be a growth spurt or a due to his position.

I arrived at my midwife's home/office right at 9:30 for my checkup (9:30 checkup time). I had 0 waiting time. In between photos, we discussed how I'm feeling, whether I've experienced swelling (some but minimal), how frequently I've been noticing baby's movements and how/when to do kick counts, whether I've had Braxton Hicks contractions, whether I've had any troubling physical symptoms (I haven't), how to recognize symptoms of preterm labor, how and when to get rid of Braxton Hicks contractions, benefits of perineal massage and when to begin, benefits of Evening Primrose Oil and when to begin, what kind of birth control plans we have, what plans I'm making with my doula, scheduled my next appointment for 2 weeks from now, and chatted about what's new in the last 2 weeks since I saw them.

All inclusive, I was there 1 hour 15 minutes, with everything covered at a leisurely and relaxed pace. No wonder I so look forward to prenatals. It's just about the only time I have to devote to real focus on my pregnancy and baby, since life gets so busy with the everyday functions of running a house of 6.

I realize that there are a lot of variations in care among OBs and midwives. This is just *my* experience with *my* midwives. What have been your experiences? Have you changed care providers and experienced different practices?