A community-based birth is a birth that takes place outside of the hospital—either in your own home or in a freestanding birth center. These settings offer a warm, familiar environment and are rooted in the Midwifery Model of Care, which emphasizes physiological birth, individualized attention, informed choice, and respect for your innate wisdom.

A freestanding birth center is a comfortable, home-like facility that is not located within a hospital and is managed by Licensed Midwives. Care is grounded in the Midwifery Model of Care and designed specifically for healthy, low-risk people who desire an unmedicated birth. Many families describe it as “a home birth in someone else’s home.”

The American Public Health Association describes a birth center as “a health facility that is not part of a hospital, where planned births occur after a normal, uncomplicated pregnancy.” Midwives lead the care, offering continuity, privacy, and the space to labor intuitively.

Freestanding Birth Center Summary

Wildflower does attend births at freestanding birth centers.

• Who they serve: Low-risk, healthy people
• Philosophy: Midwifery Model of Care
• Birth style: Supports uninterrupted, physiological birth
• Pain relief options: Movement, intuitive positioning, hydrotherapy (tubs/showers), nitrous oxide
• Care team: Licensed Midwives, Birth Assistants, Student Midwives
• Surgical options: Not available (no forceps, vacuum, or cesarean)

A hospital-based birth center is physically located inside a hospital and operates under the medical model of care. It offers expanded monitoring options and can care for both low- and high-risk people.

Hospital-Based Birth Center Summary:

Wildflower does NOT attend births at hospital-based birth centers.

• Who they serve: Low- and high-risk people
• Philosophy: Medical model of care
• Birth style: Supports both physiological and medically managed birth
• Pain relief options: Epidurals, IV pain medications, additional pharmacologic tools
• Care team: Nurses, Certified Nurse Midwives, Physicians
• Surgical options: Yes (forceps, vacuum, cesarean)

Community-based birth is ideal for people who:

• are generally healthy and considered low-risk
• wish for an unmedicated birth
• desire a familiar environment with continuous, personalized care
• prefer an approach that honors physiological birth and minimizes unnecessary intervention

Wildflower Midwifery & Fertility does NOT accept clients with a history of prior cesarean, chronic hypertension, type 1 diabetes, or blood clotting disorders.

We partner with Labcorp services and offer labs in our clinic space. We can also send out lab orders if you’d prefer them to be drawn at a Labcorp facility- whichever is more convenient for you!

We do not perform ultrasound at our office, but will write a referral for you to have them done at radiology facilities.

No! We are your medical care providers for your prenatal visits, birth, and postpartum visits. You do not need to also choose an OB.

If you can make a baby in the space, you can have a baby in the space! We have supported births in studio apartments, tiny homes, and yurts. All we require is:

• electricity
• running water
• a clean environment
• a heat source in winter

Absolutely! Warm water is an incredibly effective tool for comfort during labor, and it is safe for babies. Families may use their own deep tub, buy their own birth tub, or rent one from us. The Puget Sound Birth Center suites also offer spacious built-in tubs.

For healthy, low-risk people, research consistently shows that home and birth center births with qualified midwives are as safe as hospital birth, with fewer interventions and higher levels of satisfaction!

Safety begins long before labor—through nutrition, movement, stress management, consistent prenatal care, and attending to your physical and emotional well-being. We monitor you closely throughout pregnancy and evaluate your risk status at every visit.

A large study of planned, midwife-attended community births have found that:

• 89.1% of families who plan a community birth have one
• 93.6% have a vaginal birth
• 97.7% are exclusively breastfeeding at 6 weeks
• Transfers for urgent reasons (such as fetal distress) are rare
• Only 5.2% of planned community births result in a hospital cesarean

A Washington State–specific study also found that adverse outcomes were low when community midwifery was well-integrated with local hospital systems.

Your and your baby’s safety is always our top priority. If something outside of our scope of practice develops, we have a clear protocol to follow:

Prenatal Complications

We consult with, co-manage with, or transfer care to:

• Eastside Maternal Fetal Medicine
• Hospital-based certified nurse midwives (CNMs) or obstetricians (OBs)

Labor Complications

For labor complications or if you desire medical pain relief, we typically consult or transfer to:

• UW Northwest; CNMs when possible or OB hospitalists when necessary
• Evergreen Kirkland; CNMs when possible or OB hospitalists when necessary
• Providence Everett; CNMs when possible or OB hospitalists when necessary

In the rare event of an emergency at your birth we are trained in CPR and Neonatal Resuscitation, and we carry the following medications:

• Anti-hemorrhagics (Pitocin, Misoprostol, Methergine, TXA)
• Epinephrine
• Magnesium Sulfate
• Terbutaline
• Oxygen
• IV fluids

Postpartum/Newborn Complications

We consult pediatric or OB hospitalists and transfer care as needed.

We are proud participants in the Smooth Transitions program, a quality-improvement initiative dedicated to ensuring seamless and respectful client transfers from the community to the hospital when necessary.

We encourage a variety of non medical pain relief options in labor, and if you choose to give birth at Puget Sound Birth Center they offer nitrous oxide gas for pain/anxiety relief. We do NOT give epidurals or narcotic pain relief. These options are only offered in hospitals, as they require additional monitoring for the safety of your baby.

Yes! Birth is deeply personal, and many people feel strengthened by the support of loved ones. We welcome the presence of family and friends who contribute to the calm, grounded environment you wish for your birth.

We love doulas! Both midwives and doulas play valuable roles, but their responsibilities and training are different.

Midwives are trained healthcare professionals who provide medical care during pregnancy, labor, birth, and the postpartum period. We can perform clinical tasks such as monitoring the health of you and your baby, conducting exams and administering medications when needed, and delivering your baby. As your midwives, we are present for active labor, birth, and postpartum and while we provide some emotional support and comfort measures in labor, our top priority is the safety of you and your baby.

Doulas, on the other hand, are non-medical support professionals. They focus on emotional, physical, and informational support—helping with comfort measures, birth planning, and advocacy—but they do not provide medical care/recommendations or deliver babies. Doulas can be great support for your entire labor, birth, and postpartum-especially when you are in early labor and it is not medically necessary for us to be with you quite yet.