Holistic Midwifery Care with Beth Arcese, LM

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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. 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.

All prenatal care including blood, urine, and genetic testing and ultrasounds offered. Reasons for any and all offered tests are explained and you have the opportunity to make informed decisions for yourself. Routine visits include monitoring of your baby's growth, heart rate, your blood pressure, and comprehensive visits that tend to your emotional and physical wellbeing. With lengthy appointments available every time, we can deep dive into questions, solutions to symptoms, planning for your birth, recovery and feeding your baby. Some people want more, some want less. It's your journey and I accompany you as a partner in providing the kind of care you seek. I'm on call for urgent concerns through your pregnancy and of course, for your birth and postpartum recovery. Once you're in active labor, I stay with you through the birth and a few hours postpartum. If a higher level of care is needed prenatally, in labor, or postpartum, I respond to your needs as they unfold and initiate the level of care your circumstances call for. Should you transfer in labor, your care resumes with in depth postpartum care. Typically postpartum care includes two home visits and one office visit, all in the first week! Then I see you at 3-4 weeks and 6-8 weeks. I can provide routine newborn care for two weeks.

Beth provides care to those planning to give birth at home or the Bellingham Birth Center. While they are very similar, there are some nuances that lead people to choose one location over the other. You don't have to decide when you start care if you're not sure. Questions about either option are warmly welcomed any time. In cases where a hospital birth becomes necessary, Beth is still a partner in your experience and resumes care after your discharge.

Generally speaking (and certainly in Bellingham), Licensed Midwives (LMs) work independently or in small practices. Midwives are health care providers licensed and regulated by the Washington State Department of Health. Our educational pathway focuses on the childbearing year including newborn care. A strong focus is recognizing normal, variations of normal, and risks that are better addressed with hospital-based providers. Our professional association (Midwives Association of Washington State), provides guidance for risk stratification using scientific evidence to guide recommended protocols. We are often referred to as community midwives because we provide care in the community, including in homes and birth centers. LMs provide comprehensive prenatal care with all routine testing and imaging options, support through labor and birth, newborn care, lactation support and in-depth postpartum care for up to 8 weeks after birth. LMs are able to accept your insurance just like other health care providers in Washington.  A core tenant of community midwifery is fostering and maintaining relationships between midwife and client so that every stage of the journey you're accompanied by someone who knows you well.

Certified Nurse Midwives (CNMs) come to midwifery via nursing. After obtaining an RN, they go on to become advanced practice nurses specializing in maternity care. CNMs usually work in larger groups and provide hospital-based care. Appointments are brief and you may or may not know the person who attends your birth. Once your baby is born, they go under the care of a pediatric provider in the hospital. Like LMs, their patients are limited to low risk, but they have a bit more wiggle room since they deliver babies in the hospital. They are VBAC friendly and have overall fewer interventions than OBs. However, they have high epidural rates, making medicated births more common than not. After your discharge from the hospital, CNMs typically see patients for one follow up appointment around 6 weeks (again this may or may not be with the person who was present at your birth).

Most people don't think much about prenatal and a birth care until they need it. Sometimes this leads to starting on a pathway that doesn't quite feel right. Beth has had many people switch care well into their pregnancies when they realize they are not getting what best suits them. Pregnancy and birth are experiences we have a limited number of times in life, making how you experience them even more important. If the pathway you're on isn't right for you, I welcome you to reach out for a free consultation. If your pregnancy is low risk and we still have time to get to know each other, transferring care can be a great investment in your self, your birth and your future.

Safety is paramount to every family. A primary responsibility of a midwife is to continuously screen clients for risk status. This is implemented as an act of care, not an expectation that something will go wrong. Beth believes in the body's wisdom and likelihood that your birth will unfold as it should.  For low-risk women who desire low-intervention, little-to-no medications, and agency in how they navigate their birth experience with a known birth attendant, having a licensed midwife at your side in close proximity to the hospital is a safe option. Beth is so committed to finding any holes in our approach, that she spent countless hours working alongside researchers to explore our own Washington state LM outcomes and to create a new data repository to assist in tracking outcome data to provide research opportunities well into the future. It is really something to see your own clients' data represented in ACOG's Green Journal! 

You can view the article here https://journals.lww.com/greenjournal/fulltext/10.1097/aog.0000000000004578~birth-outcomes-for-planned-home-and-licensed-freestanding

Other articles published on the safety of community birth can be found here https://www.washingtonmidwives.org/scholarly-articles.html

Smooth Transitions is a program Beth helped implement at St Joe's hospital in Bellingham to help ensure that client emotional and physical needs are met respectfully and compassionately when a transfer is required. Collaborating with physicians, nurses, EMS and hospital administration creates healthy pathways for everyone in our community. We PLAN on your birth going as desired, but we have back up plans in place in case it doesn't. Your safety is extremely important and is at the forefront of your care at Salish Sea Midwifery.

Beth is a big fan of doulas! The midwife's role is to be supportive, listen and observe, provide guidance and encouragement, but primarily to oversee your health care. Because she's your health care provider, she cannot also be your doula. Everyone has different needs for support at their birth. Beth is happy to answer questions and help you decide who to have along with you if that counsel is desired. But ultimately, who you bring into your birth space is entirely up to you and Beth's role is embrace the whole team, with a shared focus on supporting the person in labor.

Salish Sea Midwifery accepts health insurance. Inquire to see if your plan is accepted. 

Salish Sea clients have the option to set up back-up OB care with Dr Anna Dowling at Birth Story Obstetrics based on availability. This is a direct pay service that insurance does not cover. If you are interested in this opportunity, connect with Beth to learn more.