Midwifery Care

A new baby is important to every family member. Children are always* welcome at appointments and are encouraged to participate as much or as little as is right for them.

*Unless there is a pandemic :( Children will be warmly welcomed to return when it is deemed safe and responsible to so. Until then, I am asking parents to leave children home for their in-office visits.

Welcome to Salish Sea Midwifery, where growing families find individualized, compassionate care. While starting or expanding a family is a normal, natural life event, it is also a very big, complex one! Health, safety, nourishment, connection, and empowerment are all tenants of quality health care. At Salish Sea Midwifery, you can expect to take part in decision-making, planning, preparing and experiencing a nurturing transition from pregnancy to parenthood. Here at Salish Sea Midwifery, families of all identities are warmly welcomed; your racial, ethnic, gender, religious, social and personal identities are respected and care is given with consideration of both our differences and our common threads.

Scroll down for FAQs and to learn more about midwifery and Beth's offerings at Salish Sea Midwifery.

What does LM mean? LM stands for Licensed Midwife, a medical license granted by the Washington State Department of Health (DOH) after demonstrating competency through education, clinical apprenticeship, and passing both state and national exams. Licensed Midwives are also referred to as "Direct Entry" midwives, which is a comparative term meant to distinguish between midwives who first became nurses (as in CNMs - Certified Nurse Midwives) and those who specifically choose to practice as community midwives (outside of the hospital environment). LMs are independent practitioners granted many rights through the DOH including carrying many life-saving medications. CPMs are Certified Professional Midwives, a national certification given by the North American Registry of Midwives (NARM). Here in Washington, licensed midwives have an excellent track record for safety; my clients' (mothers/parents AND babies) safety are always the top priority in my practice.

Where can I learn more about midwifery? Our state's midwifery association is a great place to learn about licensed midwifery in Washington. Visit MAWS 's website. To learn more about the Midwives Model of Care, see the Citizens for Midwifery website.

What is Included in Midwifery Care? I offer comprehensive maternity care. That means all your prenatal care, labor, delivery (which I prefer to call "birth"), immediate postpartum and 6-8 weeks of follow-up postpartum care. I use the same schedule for prenatal care and offer the same testing as physicians, except that I include more time for informational discussions so that you have time to consider your options, do your research, and ask questions before deciding what's right for you. There is also space to spend addressing emotional and overall wellbeing, planning, and getting to know you as an individual. Appointments last 45 minutes to an hour, including a free consultation before care is initiated. The postpartum care schedule and access to support is greatly increased over hospital-based courses of care. I do my own blood draws to save you trips to the lab and provide continuity of care. Blood and urine lab tests, paps, and ultrasounds are available along with routine care (such as checking your blood pressure, fetal heart rate, growth, etc.) which are part of the ongoing screening process to ensure that the pregnancy continues to be low risk, a requirement for planned home or birth center birth.

What about costs? Do you take insurance? Most insurance plans are accepted and in-network. Please ask if you are unsure. Midwifery care is considerably more affordable than physician care with a hospital stay.

Why Midwifery? I came to midwifery myself out of a desire for an empowering experience with a compassionate care provider who saw me as an individual and would treat both myself and my baby with gentleness, yet with a fierce protection of our safety. This is the type of care I think every family deserves, and I am honored to carry the torch of midwifery on for the generations to come. Pregnancy and birth are natural, empowering, deeply transformative, often challenging (physically and emotionally), bonding, human experiences. It is a gift to make it a part of my daily life and I look forward to sharing this unpredictable journey with you!

Home Birth

Why Home Birth? Well, when you get down to the root of birth, it has always happened in the home. There is something very special about being in your own space, not having to travel in labor, but having your birth team come to you. I carry all the same medications, supplies and equipment to home births as are available at the birth center (with the exception of nitrous oxide, which is only available at the birth center). Oftentimes people have more room to roam at home, be it indoors, in their yard, or around the neighborhood. You have unlimited access to your own comfort items such as food, drink, photos, music, candles, etc. And your labor doesn't have to be interrupted with a trip to a birthing place such as the birth center or hospital.

Isn't it messy? I think this is the number one question people have (even if they don't go ahead and ask). Yes, birth can be messy, but you'd be surprised how little mess there usually is after a home birth. We use disposable underpads, special ways to make the bed to protect your mattress, and midwife magic to get the place in fine order before slipping out to leave your new family in peace. I won't leave you with a mess and all in all, you can feel good about how little environmental impact your birth has made compared to in an institutionalized setting.

Do you come alone? Yes, I come to your labor alone (well, me and all my bags!). But when you get close to birthing your baby, I call an assistant in to help (usually another LM, but could be an advanced student or professional birth assistant). This way, we have one attendant for each "patient" - mom and baby.

How long do you stay after the birth? I stay until mom and baby are settled and recovered, with normal vitals. Baby has nursed, had an exam, mom has eaten, been to the bathroom, and usually ready for a good long recovery sleep after the work of birthing her baby. This is usually 2-4 hours after a normal birth.

And then we're on our own? Yes, but just like during your pregnancy, I'm only a phone call away. You can reach me 24/7 on my pager and I leave you with thorough postpartum instructions with warning signs. Being "on" at this stage when all is normal is really a wonderful, empowering thing for new parents. You made this baby, you birthed her, and now you're her parents for the rest of her life! But don't worry, I'll be back the next day to check on you both. I usually do two home visits, and then 1, 3-4, and 6 week postpartum visits along with plenty of phone support as needed. Normally, after a hospital birth, you don't come back for a check-up until 6 weeks postpartum. I recommend taking your baby to see his primary care doctor or nurse practitioner around two weeks of age.

Who has a home birth anyway? (i.e. is it just for hippies?) Home-birthers are a diverse group. I care for people with varied cultural, religious and educational backgrounds. But by and large, today's families who choose home birth are often educated mainstream folks who have done their research and made an educated choice about which risks best suit their family. If you think home birth may be for you, but you have questions, please call. I'm happy to talk with you. And if you want a midwife but don't want anything to do with home birth (or just live too far from the hospital), that's okay, the birth center is a charming and comfortable option.

What do we need? I'll give you a list of supplies to have prepared for your home birth from around the house along with some things you'll need to buy (like waterproof pads). You need the basics - hot water, electricity, phone or cell reception. And you need to be close enough to the hospital to make expedient transfer possible when needed. Some people use their own bathtubs for labor and/or birth, but more often they will purchase an inflatable tub, rent a large birth tub or borrow a tub from a midwife. It's quite simple really, and collecting and organizing your birth supplies is a fun way to nest!

Birth Center Birth

How is it Different from the Hospital? Laboring and birthing at a freestanding birth center is quite different from the hospital. It can be confusing since the hospital now calls its labor and delivery floor a birth center. For more comprehensive information about the Bellingham Birth Center, please see their website. The birth center is not staffed around the clock. When you go into labor, you are in direct communication with your midwife, who meets you there. Your room is very home-like and includes a deep private tub which is often used for water birth. Pain medication is not available at the birth center with the exception of nitrous oxide; see their website for more information). There are many ways to cope with the pain of labor and several medications on hand that support the safety of your birth experience (such as those that stop bleeding, oxygen, etc.). There are no nurses coming and going. It will just be me, and we'll know each other pretty well after all those hours spent together in prenatal visits! (I plan to attend every one of my clients' births, but of course circumstances could arise such as illness or two births at once, in which case a trusted colleague would step in to care for you). Of course, I have an assistant come for the second stage (pushing) so that two health care providers are there to care for mom and babe at the birth. Baby goes right to parents, procedures are performed on or near them, cord left intact; gentle, compassionate newborn care is provided. The first hour is treated with a great respect for the family's intimacy, bonding, and initial feeding.

How long do I stay after the birth? Just like with a home birth, care is provided for 2-4 hours postpartum, or until everyone is settled with all vitals normal. Baby has nursed, postpartum care instructions given, newborn exam done, mom has eaten and gotten up to the bathroom, suturing done if needed. For most families, the postpartum stay is about 3 hours.

What if there's an emergency? Emergencies are rare, but when we need help fast, we call 911 and use the Fire Department / EMS for quick transport to the hospital, which is just a few minutes away. Most transfers to the hospital are non-emergent and come to pass after discussion about an issue that doesn't resolve, requiring observation or intervention at the hospital.

Can my family and friends come? The Bellingham Birth Center does not have regulations* regarding the number of people you can have at your birth. There is a waiting room for visitors and they can be in the room at the mother's and midwife's discrepancy. *During the COVID-19 pandemic, visitors are being limited to two people in addition the laboring person. And children are temporarily being asked to stay home. We strive to keep the birth center a safe, clean, sacred space to transition from pregnancy to holding your newborn, and therefore must limit the number of people on site during the pandemic.

What about costs? Most insurance companies cover the cost of your facility fee at the birth center. Just ask if you are unsure and I am happy to assist you in sorting out how much is covered.

Do I have to have a certain midwife (midwives) to have a birth center birth? Yes, you can choose from any of the midwives on the Meet the Midwives page of the birth center web site. Midwives like myself practice out of individual offices, but offer birth center birth care.