Wednesday, January 29, 2014

Midwifery Alumnae Build Practice that Fits Their Values

Emi Yamasaki McLaughlin and Caitlin Wheaton develop a plan to expand access to midwives.

Midwives with parents and infant
Yamasaki McLaughlin (holding child) and Wheaton with new parents.

Emi Yamasaki McLaughlin, LM, CPM, MSM, and Caitlin Wheaton, LM, CPM, MSM, had almost everything they needed to launch their midwifery practice. They had office space and equipment. They had earned degrees from the midwifery program at Bastyr University. They knew the values they wanted to represent. They just needed a name.

They went out for dinner to bat around ideas. After a drink, they each confessed that they loved the song "Don't Stop Believin'” by the rock band Journey. What about "Journey"? It would reflect their journeys becoming care providers. It would reflect the sense of honor they felt in joining clients on the personal journey of giving birth. A former client from their student training came into the restaurant and happened to sit at the next table. She loved the name, too. And so Journey Midwife Services was born.

The two opened the practice in January 2013, committed to providing education, counseling, prenatal care, and labor and delivery care to birthing mothers and their families. They follow the Midwives Model of Care, which emphasizes the physical, psychological and social well-being of mothers while seeking to minimize technological interventions.

"What drew me to midwifery is the fact that, for low-risk healthy people, there are really simple things you can do to support them in pregnancy, labor and birth," says Yamasaki McLaughlin. "Birth doesn't necessarily have to be this medical event."

Her mother gave birth to her three children at home, so she knew early on that there were alternatives to hospital births. When her sister became pregnant 10 years ago, she asked Emi to provide labor support. Emi began reading about birth care and discovered she was drawn to it.

She enrolled at Seattle Midwifery School, which merged with Bastyr in 2009 to become the University's Department of Midwifery. There she met Wheaton, who chose to study midwifery after reading Spiritual Midwifery by Ina May Gaskin.

Repairing Inequities

Wheaton and Yamasaki McLaughlinIn school, the two learned that midwifery means not only imparting knowledge but also helping clients find their own goals. They learned that the fundamentals of health for birthing women are much the same as for anyone else: nutrition, exercise and rest. They also began the program's extensive clinical training, observing and then assisting in births at homes and birthing centers around Puget Sound. The Master of Science in Midwifery program requires 1,500 hours of clinical work and participation in 60 births (see more on the curriculum and the combined bachelor's-master's option).

They learned that caring for birthing mothers requires putting everything else second when labor begins.

"If you don't enjoy midwifery, you're not going to last very long," says Wheaton. "The hours are long."

"When you're a senior student, you're doing a lot of clinic and a lot of on-call time," says Yamasaki McLaughlin. "So it's really hands-on. I felt really confident in my clinical skills coming out of that."

The two found they agreed with the Department of Midwifery's emphasis on social justice. Midwifery, like most forms of health care, has long reflected social inequities, with wealthier, older,whiter and more-educated families finding better access to the pregnancy care they prefer. The two knew they wanted to help change that.

"We're trying to bring midwifery to communities that don't necessarily know that home births and birth center births are an option," says Wheaton.

Establishing an Office

Midwifery officeAfter graduation in 2012, they met with a retiring Seattle midwife and agreed to buy much of her equipment: examination table, delivery and suture kits, body and pelvis models and books. They found an office on a busy block of the city's diverse Capitol Hill neighborhood.

To pursue their goal of reaching underserved communities, they accepted that many of their clients would be insured through Medicaid, which reimburses at lower rates than private insurance.

"We think we'll be able to sustain our practice on that," says Yamasaki McLaughlin. "We just may not be driving BMWs."

As they build a base of clients, Wheaton says she is learning that growing a business is a process that happens on its own timeline. Like growing a child.

"I'm learning I need more patience at times," she says. "Especially with starting a new business and wanting to be busy right away and having lots of work to do to get to that point. I can be patient at a birth waiting for a baby to come, but being patient with myself can be harder."

They both say that the freedom of charting their own course outweighs the stresses.

"We get to work with people at a special time in their lives and make it a really special experience," says Yamasaki McLaughlin. "It's not the same as walking into a doctor office, getting your checkup and leaving. We build a bond with our clients, and that's part of why the midwifery model works."

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Learn more about Bastyr's midwifery program and Simkin Center for Allied Birth Vocations.

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