530.694.2182 lstinseth@me.com

Our Services

Midwifery Services:

Alpine Midwifery serves birthing families in the Lake Tahoe, Carson Valley, Reno, Sparks and surrounding areas.

Our Birth Services include an initial exam, state and ten week gestation prenatal screening, prenatal care including one PN home visit, phone counseling, loans of videos and books, nutrition counseling, home labor and birth, midwifery medications, IV’s, O2 and supplies, newborn examination, postpartum care for 6 weeks, newborn care for 6 weeks including the newborn screen test, breastfeeding counseling and an assistant for every birth.

We also provide and/or order all your diagnostic labs, stress tests if needed, labs for monitoring special conditions (i.e. liver dysfunction, diabetes, Rh factor-RhoGAM injections are $150 ea.), ultrasounds and newborn hearing test. Other labs or medical procedures that are deemed medically necessary due to unexpected occurrences during prenatal care, labor, and delivery, postpartum and newborn care may also be necessary.

We carry a large selection of pregnancy-related supplements in the Woodfords office.

Our 40-year plus passion for successful breastfeeding has prompted us to stock every kind of breastfeeding device to aid in over coming breastfeeding problems as soon as possible. Breast pumps are ordered through your insurance company.

You are responsible for collecting your birthing supplies (i.e. washcloths, bowls).  In addition, you can purchase a birthing supply kit from our office for $50.

Sometimes birth plans need to change to ensure the health and safety of mother and baby.

As your practitioner, I have the experience to detect any problems and deal with them.  Some of the hardest work I do is during a transport, not only to ensure everyone’s safety but also at the hospital as an advocate to help you to still achieve as safe and as pleasant a birth as possible.

Costs are always important to discuss when planning for the birth of your baby. Fee’s for birth services are provided through our office.

We take all forms of payment including insurance. If you pay through PayPal or by credit or debit card a 3% convenience fee will be charged.   

At this time Medical and Medicaid do not reimburse Licensed Midwives.

Additional Services:

  • Baby and Child Health Consults $25 
  • Well Women Care $75
  • Family Planning and Natural Birth control $50-$100
  • Phone Consult $25
  • Vit B Complex/B12 injections and infusions $25 – $75
  • Birth Kits $50
  • Birth Tub Rentals- includes liner, pump and reversible pump $125
  • Rubbermaid hard shell birth tub (need a pickup truck to haul) NO FEE
  • Sears Health Coach Nutritional and Lifestyle Sessions $25 each (4 sessions)

What I can expect from my birth attendant:

Following is a description of what I can expect from my birth attendant during prenatal’s and during the course of labor, delivery, postpartum and newborn evaluation.
It is understood that during my pregnancy I will be seen by my physician at least one time before delivery.
Note: The client has the right to decline based on informed consent

 During prenatal’s:

  • Birth plans will be made and discussed
  • Screening and continual assessment of maternal and fetal health will be done (screening for abnormalities or complication by checking blood Pressure, pulse, FHT, urine, weight, edema, position and lie of fetus, OB, personal and family medical history.
  • Labs
  • Physical examination,(vaginal and breast exams if indicated)

Early labor:

  • Walking and normal activity are encouraged as long as no contraindications exist
  • Upon arrival, I will determine baseline and check blood pressure, pulse, fetus well-being and maternal well-being

Active labor:

  • Monitoring of fetal heart tones every hour and has labor progress every 15 minutes, before and after a contraction (listen for decelerations)
  • Evaluate progress of: descent of presenting part, maternal psychological well-being and fetal well-being
  • Vaginal’s will be done:
  1.  When rupture of membranes occur (in active labor only)
  2.  Change in fetal heart tones when there is a strong urge to push
  • Blood pressure and pulse will be taken every hour, unless there is a need to do more often (v-back, tachycardia, etc.)
  • Urination is encourage every hour
  • Enema is not given unless necessary (constipation)

Pushing considerations:

  • A slow controlled birth is encouraged
  • Warm compressions will be applied to the perineum (if the mother finds it comforting)
  • Continued evaluation on all of the above

Delivery considerations:

  • Immediate contact if no fetal distress is present
  • Immediate care  of the baby – Apgar score given, warmth and suction are done when needed

Placental considerations:

  • Spontaneous expulsion allowed – within safe time, not more than 30-45 minutes
  • Cord is allowed to stop pulsating- before father cuts the cord
  • Nursing is requirement – we will help get you started
  • Inspection of the placenta for normalcy and completeness will be done

Immediate Postpartum considerations:

  • Bonding- we will give the family time alone for this to take place
  • Evaluation of mother- blood pressure, pulse, fundal height, amount of blood loss, firmness of the uterus, alertness, temperature – will be done for 2-4 hours postpartum or until vital signs are stable
  • Evaluation of Newborn – respirations; rate, lungs and bronchioles, temperature, weight, alertness and muscle tone, reflexes, heart tones, genitals and joints, heart and spine, nursing ability and anything else that is deemed necessary at the time
  • 1 to 2 day and 3 to 4 day visitation will be done to re-evaluate all the above plus the newborns jaundice level, bowel movements and wet diapers.  Umbilical cord care is reviewed. Also, maternal nutrition and supplements are reviewed as well as hygiene of both mother and baby.
  • Any parental concerns are discussed and a review of the birth.
  • The PKU (newborn screening) is done after the baby has ingested breast milk or formula. Other labs are done and/or referrals if necessary.


Babies are bits of stardust, blown from the hand of God. Lucky the woman who knows the pangs of birth, for she has held a star. Larry Barratto

Lenny Sue Tinseth


230 Carson View
Markleeville, CA 96120

  • Office: 530-694-2182
  • Cell: 775-781-5381
  • Fax: 530-694-1032

Contact Alpine Midwifery

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