The childbearing years are a continuum of a woman’s lived experience in her body, her social context as a woman, and her emergence as source — a life giver, nurturer, mother.

Birth is not one isolated event in time. Birth is a continuum of all the prenatal readying, reveling, and inquiry. Birth is the the making of the mother, the emergence of the baby, and their awakening to the purest love that can be experienced. Birth is the ancient and wild process that tethers humans to one another, and to the spirit door.

How we show up for women through this continuum is a reflection of how we view women, birth, babies, life itself.

Women’s bodies innately know how to grow a baby and to give birth. Birth usually works best when women are given the freedom and privacy to birth spontaneously and uninterrupted.

For most women, the process of surrender — of allowing the mystery of birth to unfold, allowing her mammalian body to simply take over and birth the baby– is made easier by the presence of an experienced, skilled, calm, intuitive and discerning female guide. One who knows when to sit on her hands, and when to take action for the safety and ease of birth.

How women are guided through the birth portal matters, because how mothers are born matters. How babies are born, matters.

Midwifery is about holding women. Honoring women giving birth to themselves. Holding sacred space. Life, death, rebirth.

I provide nearly a full year of high-touch, compassionate, woman-centered midwifery care. My midwife role is to hold loving space for women to be their authentic selves, to help women experience a confident, grounded, and relaxed pregnancy, and to safeguard normal, physiologic birth, breastfeeding and newborn development.

Clinically, this includes standard maternity care assessments and ongoing evaluation of a woman’s risk status. Homebirth is best suited to healthy women and babies with a low risk of complications.

My practice balances the ancient art of midwifery with the best of our contemporary understanding of biological blueprints for healthy birth and maternal-child attachment.

My maternity care service includes:

Please read the remainder of this page for more detailed information about my prenatal, birth and postpartum services.

You can schedule a free consult visit to get to know me and my practice here.

My Prenatal Care

The truth is, women provide most of their own best prenatal care for themselves with what they eat and how they move. Ninety percent of prenatal care is about how women slow down, nourish their bodies, and tend to themselves emotionally and spiritually. It’s about eating nutrient dense foods and working on stress response. In fact, the vast majority of birth complications in our modern world are preventable with optimal nutrition, exercise, and a healthy nervous system.

Living in the same physical body together, mother and baby are an energetically entwined twosome. What is nourishing to the mother is nourishing to the baby. Blood. Water. Laughter. Dance. Listening to song birds. Feeling the morning sunlight on your face. Sweet sleep. Oxytocin. Joy.

While the mother’s body does the work of growing the baby, the mother herself is undergoing a metamorphosis. She is between worlds, between identities. She is preparing for her initiation. She knows she must ultimately birth the baby on her own, and it takes courage. She needs mirroring, witnessing, and tender love from all around her.

The mother’s physical safety mirrors her emotional safety. Both are paramount.

Midwives fill in any gaps with traditional and modern tools to help to keep pregnancy normal and safe. I am judicious in my use of medical tools and drugs that have the potential to distract or harm, and we use them only when chosen by the the client following a discussion of risk, benefit, and alternatives.

My appointments last about an hour and a half. We get to know each other well! I do all of the standard clinical assessments– mom’s vitals, baby’s position, growth, and heart rate, lab work if indicated, screenings if desired, consultations if needed. Herbal medicine is woven throughout. You will also receive nurturing abdominal and pelvic bodywork along the way, with movement practices for pelvic mobility, somatic exercises, and more.

By the time women become mothers, or want to become mothers, most of them have grown up believing that experts know more about their bodies than they do. Birth is often the pinnacle of this dynamic. I love helping women discover that they are their own authority and that they already possess inside of them everything required to give birth instinctively and in connection with their babies.

My goals for how you will feel in my prenatal care:

• For you to feel nourished in your pursuit of connection — to your deepest sense of yourself, to your womb, and to your baby.
• For you to feel deeply supported in your  joys, sorrows, your exploring, shedding, growing, surrendering, discerning, unearthing, leaping and transforming.
• For your confidence in your body, your heart, your soul knowing to expand as your womb steadfastly creates new life inside.
• For you to know in your bones that you will be completely held in the birth portal, wherever, however, with love.

Surrendering into Birth

Birthing at home gives you the space to slow down and relax in your own familiar environment and retain personal autonomy and boundaries. When you feel safe, your body opens. Most of labor is a parasympathetic process. It does not work well when women are in unfamilar places with unfamiliar people, smells, sounds, and sights. The privacy of being at home allows your body to surrender even more deeply into your birthing sensations. You can ease into the rhythm of your contraction waves knowing there is no where to go, no where else to be, and all is well.

Your hormones work in concert, like an orchestra, to bring your baby down. Your animal body takes over. Your natural oxytocin and endorphins bring intensity, progress, joy, and even ecstasy.

You are in the deepest, primal state of mammalian birthing.

Midwives hold the space for women’s bodies to do what they instinctively know how to do.

I provide continuous care and monitoring of mother and baby including vitals, fetal heart rate monitoring, and as much hands-on support and direction as the mother desires. Most healthy women’s labors proceed normally and safely in their own time when not interfered with. Sometimes assistance or intervention is truly helpful. Skilled midwifery care involves critical consideration of when such assistance is appropriate and not detrimental.

“Birthing is the most profound initiation to spirituality a woman can have.”

Robin Lim

Approximately 75% of the births I attend happen in water. Being in the water feels amazing. As soon as women sink into the tub they breathe a huge sigh of relief, and usually push their babies soon after.

Most of my clients catch their own babies, or the partner helps with my guidance. Then, the real magic happens. The falling in love begins. First snuggles, first smells outside the womb. Hearing mother’s voice. Hearing father’s voice. The first locking of eyes. Time stands still. All the biological imprints fast at work, bonding for life.

When all is well with mother and baby, I stand back, honoring the sacred time unfolding. There is nothing I can add to their experience, it is complete unto itself. Fleeting. Precious.

When needed, I help baby transition with gentle support and standard neonatal resuscitation care. I will help facilitate baby latching to the breast if appropriate. I continue to facilitate a safe, and biologically normal space for mother and baby to thrive. Standard newborn care/exam, perineal repair, and continued postpartum monitoring are routine. I remain at the home until mother and baby have bonded, breastfed successfully, and are tucked in for their first long sleep together, typically 4-6 hours after birth.

The Sacred Postpartum Window

Time becomes distorted and takes on new meaning. This is biological — it’s driven by the unique hormonal milieu after birth. Women need considerable spaciousness and rest to slowly begin to integrate the birth process, and to begin making milk. Nature has designed it this way for mothers and babies to thrive together.

These unique weeks are known as “The Sacred Window” in Ayurveda and are deeply guarded in many eastern cultures. It is sacred because in this fleeting state, the capacity for mothers and babies to fall in love and become bonded to one another is unparalleled. In the west, the months after birth are sometimes called “the fourth trimester.”

Women are simultaneously as vulnerable and as potent as they have ever been.

Adequate care taking is a must because women are susceptible to blood and tissue depletion, nervous system exhaustion and disease states. This is why ancestrally oriented cultures prioritize the tender care of mothers after birth.

 How a woman experiences this time sets the stage for how she will feel as a mother in the years and decades to come, and how she will eventually transition through menopause.

Co-regulation. Your body and your instincts are naturally attuned to your baby. This is our blueprint. You experience supreme satisfaction and safety when your baby is skin to skin. You know every movement, every sound, in a visceral way of knowing. Sensing your baby’s body snuggled up to yours allows your entire system to unwind and feel at ease.

Mother and baby are designed to easily and delightfully co-regulate one another.

Your baby feels deep safety and love lying upon you, next to you,  feeling your warmth, sensing your skin, smelling her pheromones and odors, hearing your voice and attuning to you heartbeat at your breast. This is the baby’s blueprint for safety.

When the mother cannot sense or trust her instincts, we tune in and correct any kinks in the blueprint. We fill in hormonal gaps to reconnect mother and baby with everything they need to feel capable and attuned.

My home visits are long, spacious, and hold the container for birth integration, grounding bodywork, biological breastfeeding and all the joys and sorrows of the first weeks.

My goal is to keep women grounded in their bodies. Most of my postpartum care happens in your home. I come back after birth for the 24 hours visit and at least four additional times in the first two weeks after birth (more if there are breastfeeding challenges).

In addition to the standard clinical assessments and breastfeeding support, I provide bodywork including womb work, sitz baths, moxa, vaginal steaming, and pelvic adjustments. I consider these vital to restorative postpartum care as they are deeply nourishing to the mother’s nervous system and help her to integrate the birth experience.

Postpartum care includes:

• 6 – 8 postpartum visits
• Sitz baths, pelvic steams and perineal healing
• Breastfeeding help
• Screening for newborn heart conditions
• Newborn metabolic screening
• Womb work and pelvic therapies
• Baby weight checks and growth assessment
• Well baby and mother care through 6 weeks
• Referrals to pediatrician as needed
• Mental-Emotional health evals
• Plant medicine
  

Frequently Asked Questions

I am seeing a doctor for prenatal care and was planning a hospital birth. Is it too late to consider having a midwife-attended homebirth?”

It is never too late to switch care providers. It is never too late to change your plans, or to make choices that are aligned with your values and desires. It is actually quite common for pregnant women to transfer to a new care provider as their needs and preferences change. You are the consumer of the maternity care you choose. Each woman possesses the autonomy and wisdom to know which birthing environment feels best for her — even if it’s late in the game. It is your body, your baby, your birth.

I was told I am high-risk because I am over 35. Does that mean I can’t have a homebirth?

No. Almost half of the women I attend are over 35. A long time ago, the age of 35 was designated as the start of the “high-risk” cutoff because of the nature of the amniocentesis test, which at one time had been the primary genetic screening test for Down’s Syndrome. At age 35, the chance of having a baby with a genetic problem like Down’s Syndrome was higher at that point than the same as the chance of having a miscarriage from the amniocentesis test. (Losing the baby is a possible consequence of doing amniocentesis). Mothers aged 35 and older were assumed to want genetic testing and amniocentesis was the best available tool many decades ago. While some genetic abnormalities do increase with age, being 35+ does not automatically make a particular woman “high-risk.” Indeed, the “older moms” in my practice are often the healthiest moms! We will talk at length about the risks to you and your baby as well as all of your testing options during your initial visit.

I had a complication in a previous pregnancy or birth. Does this mean I am too high-risk to have a homebirth this time?

This depends on the specific condition and the circumstances of the previous pregnancy. Many “complications” experienced in previous pregnancies or births result from interventions initiated by the care provider. Other complications are seemingly more random. In general, complications in pregnancy and birth do not repeat themselves, and are often prevented in future pregnancies and birth by maternal lifestyle choices, chance, or more woman-centered care on the part of the provider. During the consult or initial visit we discuss your reproductive and birth history in detail. We discuss at length the risk of the previous condition, the likelihood it would happen again, and any measures we can take to prevent it this time around, if possible. If we determine that the circumstances of your pregnancy are beyond my comfort level or experience, or are truly high-risk, I will help you find another woman-centered midwife or physician.

Do you offer ultrasounds and other tests?

I offer all of the standard routine prenatal and postpartum tests for you and your baby including ultrasound scans and genetic testing. The choice to have an ultrasound or do any special tests is always up to you. You are the primary decision-maker for your pregnancy and your baby. Referrals to Boise specialists are made for certain types of ultrasound and genetic tests. I make every attempt to refer you to a homebirth-friendly provider who supports women’s informed decision-making.

Do I need to see a doctor before starting midwifery care with you?

No. Midwives are primary maternity care providers. We offer complete prenatal, birth and postpartum care to women having healthy pregnancies. Midwives use the same lab tests physicians use. Midwives are trained to identify potential complications and deviations from normal. In these cases, midwives consult with or refer care to more specialized providers (obstetricians, perinatologists, pediatricians, etc.).  A woman man stay in co-care with a midwife and physician, or in some truly “high-risk” instances she may be required to transfer to medical management.

Below are some of the more common conditions for which that the state of Idaho requires transfer of care to a physician or hospital.

Are there any differences in prenatal and postpartum care between a Licensed Midwife and an OB/GYN?

There are many significant differences. The first major difference is the model of care. In the medical model of maternity care, pregnancy and birth are viewed as processes that require medical management to go well. The system is designed to be efficient and standardized so that multiple providers and staff can provide care to women, and everyone knows what to expect. Tests and medications are routine because they are perceived to make maternity care safer, and sometimes they do. Women are generally expected to go along with the routine protocols, tests and procedures. Opting out of medical management is possible but it is discouraged.

The rate of interventions in medical care is high. Most women experience multiple interventions including induction of labor, augmentation of labor, routine vaginal checks, medications in labor, continuous fetal monitoring, epidurals, forced pushing, premature pushing, and premature cord clamping. Women in medical care have a 1 in 3 chance of having a cesarean birth (sometimes 1 in 2, depending on her chosen provider and hospital’s cesarean rate).

In the midwifery model of maternity care, pregnancy and birth are viewed as normal biological processes. Birth is designed by nature to be successful the vast majority of the time, and interfering with it often creates more problems than it solves. Midwives recognize that each woman has a unique experience of pregnancy
and birth, and that attempts to standardize this process prevent her
from having a fully embodied and self-directed experience. Women are not expected to comply with medical protocols, but they are encouraged to follow some basic midwifery protocols for birth rooted in tradition and safety.

All testing and procedures are discussed at length, including risks, benefits and alternatives. The woman is viewed as the best decision maker for herself and her baby. She is treated with dignity and respect and never coerced or manipulated. When a woman is the primary decision maker for herself and her baby, she
accesses her full range of experience. She and her baby are safest, and
mothering begins from a place of empowered knowing, triumph, and love. Women are much less likely to experience birth trauma or feelings of betrayal, shame, regret, disappointment, or failure when they have been consciously making informed, self-directed decisions throughout their care.

It is a woman’s birthright is to experience the joys and ecstatic power nature provides us through physiologic birth, should she choose.

A second primary difference between the models is time and intimacy. Prenatal visits with homebirth midwives generally last about an hour and mine tend to last an hour and a half. The clinical portion of a prenatal visit (taking mother’s vital signs, listening to heart tones, feeling baby’s position, etc.,) only takes about 7 minutes! The rest of the time we devote to getting to know our clients — their needs, desires, hopes, fears. Longer prenatal visits allow us to develop a relationship free from top-down power dynamics. Trust and intimacy grow with time, compassion, and respect for a woman’s inner wisdom.

Another key difference between the models of care is how we give postpartum care. The medical model doesn’t really offer routine postpartum care except for cesarean scar checks and a six week visit to confirm “proper vaginal healing.” Lactation support and social and emotional care is limited. In the midwifery model, the postpartum period, or fourth trimester, is viewed as a profound, vulnerable and sacred time. How women are cared for during this time, by both the midwife and the community, have a direct bearing on her healing, happiness, and long-term health. I provider approximately 6 visits in the woman’s home and one in my office over a six-week period.

Additionally, I provide pelvic bodywork at most prenatals and into the postpartum period. This work addresses problems in the pelvis that may hinder normal labor, birth, and postpartum healing. I will help optimize your pelvic mobility, encourage the best position for baby, and help your body with any of the typical pregnancy aches and pains. We may also work on the emotional body in preparation for birth. See the Pelvic Care page for details.

Take a look at Models of Maternity Care – Our Bodies Ourselves and Childbirth Connection’s guide to choosing care providers.

Is homebirth safe?

Scientific research on maternal and neonatal outcomes over the last four decades clearly demonstrates that planned, low-risk homebirth and birth center birth with trained midwives is at least as safe, if not safer, than hospital birth attended by OBs. The use of routine interventions and cesarean section are considerably lower with midwives at home, reducing the risk to mother and baby. No study has ever demonstrated that hospital care is safer for low-risk women. There are no studies demonstrating that births attended by obstetricians are safer than births attended by midwives for normal pregnancy and birth. Most other developed nations including Canada, the UK, Australia, New Zealand, Japan, The Netherlands, and most Scandinavian countries use midwives as the primary care providers for the childbearing year. Midwife-attended homebirth is common in these places and promoted as excellent care. About 20% of babies in the Netherlands are born at home with midwives. The UK national health care system is working to get low-risk women out of the hospital and into homes and birth centers to have their babies; The obstetricians are recognized as specialists in high-risk pregnancies and the midwives are recognized as experts in normal birth. The Midwives Alliance of North America (MANA) has a user-friendly Annotated Guide to the studies on midwifery care and homebirth.

What if there is a complication during my birth?

Most complications during labor and birth are not true emergencies. They are more like road bumps, and are easily recognized in advance by a skilled midwife and can be safely resolved at home. Occasionally, more specialized procedures and treatments in the hospital are helpful or necessary for these non-urgent complications. Skilled and thorough prenatal care also greatly diminishes the chances of more urgent complications in labor (hemorrhage, breech, preeclampsia, etc.). 

In rare instances, urgent complications can arise. During your consult visit I discuss with you the nature of various rare complications and how they are handled. Midwives are trained and prepared to manage and stabilize emergent situations. This is, of course, why most women hire birth attendants — to recognize and assist conditions and complications that warrant quick intervention. There are very rare instances in which being at come could delay access to needed medical care. Choosing to give birth at home means accepting the risks and benefits of being at home.

When transfer to the hospital is necessary, I always accompany mothers and families to facilitate their transition to either a nurse-midwife or physician. Every attempt is made to transfer to local homebirth-friendly providers. (All clients are assisted in making a hospital transport plan toward the end of pregnancy). At the hospital I am no longer the primary care provider but I do attempt to provide collaborative care with the physician or nurse-midwife when appropriate. I continue to advocate for your safe and humane treatment and discuss with you the risks and benefits of any proposed procedures and treatments. I stay with mothers through the birth and first hours postpartum.

It is important to recognize that complications arise in the hospital as well. In healthy, low-risk women, these complications are often the direct result of some intervention, medication, or protocol. We we must look at the whole picture. There are risks inherent in childbirth no matter where a woman gives birth. There are risks at home and there are risks at the hospital. Each place possess a different set of risks. For example, when a woman gives birth at home she faces the very rare possibility that an emergent complication may arise necessitating NICU care after birth, or a cesarean. These risks are extremely small for low risk women. When a woman gives birth in the hospital, she faces many risks for trauma and morbidity including a 1 in 3 chance of having a cesarean section which carries a much higher mortality and complication rate than vaginal birth. Our local hospital also does not care for sick babies. All babies who need ongoing evaluation and special care are transported to Boise, often by helicopter. Ideally every pregnant woman will consciously assess these risks for herself in a neutral context without pressure.

Will insurance or medicaid pay for homebirth?

Some insurance companies will pay for out-of-hospital midwifery care. Some states have passed laws requiring private insurance companies to pay for any and all licensed providers in that state. Idaho does not have such a law; I recommend clients with private insurance verify coverage with their carriers. I no longer bill insurance directly because of the very deep flaws in the system. I do provide you with a superbill after the birth to submit on your own should you choose. Sometimes with lots of dedicated follow-up women can get reimbursed and there are guides online to walk you through this. Medicaid does pays for homebirth and birth center birth in Idaho. If you are committed to having an homebirth, but cannot pay out-of-pocket please discuss with me. Usually we can find a way to make it happen, between a sliding scale payment plan or trade.

Are you against doctors and hospital birth?

No! I am grateful for medical care when needed. In fact, I chose to use medical assistance during my first birth. As a surgical specialty, the field of obstetrics has contributed life-saving procedures to maternity care, namely cesarean section. These procedures and surgeries can save lives and improve outcomes for a small but significant percentage of women and babies.  Obstetrics is a vital and necessary part of the maternity care system.

I am also grateful for the availability of hospital birth for any woman who wishes to be there, and for the women and babies for need to be there for the safest possible outcomes. In my years of attending births I have witnessed many beautiful hospital births, most of them occurring at the University of New Mexico Health Sciences Center. I am fortunate to have had supportive relationships with physicians in the past and I hope to continue to develop new relationships with physicians and CNMs in the future.

What I am opposed to, is sacrificing normal, healthy birth and women’s autonomy in favor of institutional or physician protocol and convenience. So often this leads to the cascade of interventions that befall most birthing women, driving up the rate of unnecessary cesareans, and leaving women feeling traumatized, victimized, disabled, or just without a healthy sense of capacity to start their mothering. We can do better, and women deserve better.

Birth is a normal physiologic process that takes time. The vast majority of healthy women do not need medical assistance to give birth safely. You can read more about my birth philosophy here.