FIND A MIDWIFE OR
A BIRTH CENTER
Visit the MAWS Directory of Midwives to find midwives in your region

FIND A MIDWIFE-FRIENDLY BUSINESS
Visit our Associate Member Directory

Collaborative Care Models

Licensed Midwives (LMs) collaborate with Physicians and Nurse Midwives as needed to provide optimal care to their pregnant, birthing, postpartum and newborn clients. LMs engage in an ongoing process of risk assessment that begins during the initial consultation and continues through the completion of care. When presented with a significant deviation from normal, LMs seek physician consultation. Midwifery is an autonomous profession, but midwives work interdependently with each other and other health care providers to promote the optimal health and well-being of women and babies. Read on for some examples of Collaborative Care Models that work in our community.


Audrey Levine, LM, CPM – Thurston County
Since 2005, I have been able to offer collaborative care with Dr. Phoebe Ho, an OB-GYN in Tacoma with privileges at St. Joseph Medical Center, for my clients with twin pregnancies and for those seeking a vaginal birth after cesarean (VBAC). This innovative arrangement has enabled my clients to have midwifery care throughout their pregnancies and planned hospital births with doula support from their midwife, followed by comprehensive postpartum care, including extensive breastfeeding support. Of the care she received, one of my clients wrote: “Having collaborative care for our 2nd VBAC could not have gone any better. The hospital environment provided us with the base comfort of knowing that we could clinically handle anything that might happen. However, having our midwife provide collaborative prenatal care and act as our doula provided the comfort, confidence, knowledge and support to have a birth experience that was not only amazingly wonderful for myself and my baby, but also encouraged and inspired the hospital staff for how pure and great a natural birth can be. There is no doubt – having our midwife as part of our collaborative care made our daughter’s birth wonderful beyond expectations.”

Cynthia Jaffe, LM - Island County
Ms. Jaffe is the first LM in the history of Whidbey General Hospital to be granted privileges to attend women needing or desiring a midwifery birth in the hospital. Currently, there is only one other hospital in WA state (Morton General) that has granted privileges to LMs. The hospital staff and administration whole-heartedly supported the idea of bringing licensed midwifery care to Whidbey General Hospital. Cynthia was the logical choice to partner with the hospital to provide that service. She received her midwifery license in February of 1991 and has been practicing on Whidbey ever since. In 1994, she opened a state licensed free-standing birthing center. She has delivered over 1200 babies. Click here to read more.

Michelle Antonich, ND, LM, CPM - Skagit County
I have been practicing in Mount Vernon for 10 years and enjoy collegial relationships with the local hospitals, OBs, and hospital-based CNMs. In November 2010 I opened the Mount Vernon Birth Center and over 3 dozen babies have been born there to date. In April of this year a CNM, Lisa Litton, with several years of birth center experience in Arizona joined my practice. She has been a great advocate for the midwifery model of care, birth center and home birth. She was encouraged by our primary consulting OB to apply for hospital privileges in Anacortes at Island Hospital. We look forward to being able to expand options for our clients who need a hospital birth or an occasional client who wants midwifery care in a hospital setting. Our eventual goal is to pave the way for another LM (myself) to have hospital privileges.

Jennifer Boelter, LM, CPM and Melanie Parsons, LM - King County
As Licensed Midwives, having been invited to join a Nurse-Midwife in her long standing solo practice, we have found that we all benefit greatly from our varying, yet complimentary training & experiences. In this practice model it is so nice to be able to offer our clients continuity of care. We see this demonstrated best in cases when a labor transfer is needed from home to hospital. We take pleasure and joy in bridging a gap between Licensed and Nurse Midwifery.

Heather Chorley, LM - King County
As a Licensed Midwife in Seattle I so value my relationships with CNMs. When clinically appropriate we transfer to CNMs in Seattle hospitals--to the Group Health Hospital nurse midwives and to Sally Avenson, CNM. Over my years of practice I have had the opportunity to return the favor for Sally, by covering her practice while on vacation or attending a home birth when she was tied up at the hospital. I have also had the great privilege to participate in the care of women who are CNMs planning to birth at home and in birth centers. The benefit of having a relationship based on mutual trust cannot be overstated--when I know and feel comfortable with the person I am calling to attend a birth, transfer care or if she is calling me to cover call for her own practice then our clients benefit. We can better predict for them how care will unfold and be secure in the knowledge that they will receive excellent midwifery care.