Thank you for your interest in the Midwives' Association of Washington State!
Licensed Midwifery, as defined in RCW 18.50, is an autonomous profession. Licensed midwives (LMs) work interdependently with one another and with other health care practitioners to promote the optimal health and safety of low-risk childbearing people and babies during the normal childbearing cycle. LMs in Washington State have a duty to consult with licensed allopathic or osteopathic physicians whenever there are significant deviations from normal in either the pregant person or the infant. LMs also work closely with allied birth professionals in their local community including birth doulas, postpartum doulas, childbirth educators, lactation consultants, birth assistants, La Leche League Leaders and more.
Washington state law requires Licensed Midwives to complete 3 years in a state-approved midwifery educational program, which includes participation in 100 or more births and verification of clinical skills and didactic course work. To attain licensure, all LMs must pass a national and a state examination.
Other Midwives who also attend births in the home and freestanding birth center setting in WA state include some Certified Nurse Midwives (CNMs) and "ND, LMs" who are Naturopathic Doctors in addition to being Licensed Midwives (LMs) . Many of these midwives are also members of MAWS because they also practice independently as primary maternity care providers.
Smooth Transitions: A Quality Improvement Program at the Foundation for Health Care Quality
A childbearing person or newborn may, for any number of reasons, require transfer to a higher level of care at some point during the intrapartum or immediate postpartum period. This may occur between the community setting (home/birth center) and a hospital, between hospitals, or between practitioner types within a hospital. Improving relationships, protocols, and follow-up during these transfers will improve care, enhance the patient experience, and strengthen professional relationships among practitioners regardless of the setting and circumstances in which it takes place.
Smooth Transitions is a statewide quality improvement effort that began in 2009 under the auspices of the Washington State Perinatal Collaborative. The program seeks to improve maternal and infant outcomes through the development and implementation of clear transfer processes, with continued evaluation through education, data review, and relationship-building. Its first area of focus has been on transfers of care to hospitals from licensed community-based birth providers attending planned births at home or in freestanding birth centers.
In January 2018, Smooth Transitions moved to the Foundation for Health Care Quality, a 501(c)3 organization, based in Seattle, that is the home of and sponsor for several quality improvement and patient safety initiatives. The Obstetrical Clinical Outcomes Assessment Program (OB COAP) is one of these CQIP-protected clinical QI programs. Smooth Transitions will now operate as an initiative within the structure of OB COAP which will allow participating hospitals to engage in protected case review with community-based licensed midwives in their catchment area. It will also enable the program to expand its collection of both quantitative and qualitative data to inform and inspire change.
Learn more about MAWS and midwifery in Washington:
Learn more about MAWS and midwifery in Washington:
Banner photo by Charlee Haller, used with permission.