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Portland Birthing Center Recommendations

Although we have had some recommendations of Midwives & Birthing Centers and for Natural Hospital Births, we can always use more.  Carly is looking for any of your experiences to share:

My husband and I will be moving to Portland soon and are expecting our first baby in July. I am hoping to get a recommendation for a good birthing center in the Portland area. I saw the thread about natural hospital births, but I am specifically hoping to find a non-hospital birth center. I found the Andaluz Waterbirth Center and Natural Childbirth and Family Clinic online, but not sure if they are good, or if there are others in the area that I haven't discovered yet.



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I can't recommend Alma Midwifery enough. The website does not do the birthing center justice.


From our first visit to our most recent--4 weeks postpartum--they've made us feel so comfortable and at home. Our midwives are incredible, and so attentive. We had a midwife, an apprentice midwife, and a Certified Nurse Midwife taking care of us, and we have not hesitated to call with any number of questions or concerns and they've always responded promptly and with such care it's been great.

I've posted this before, but if you'd like, please take a look at our daughter's birth story and there is a link to some pictures from the birthing center:


I had my daughter at Natural Childbirth and Family Clinic. We had such a wonderful birth experience. However, our midwife/naturopathic doctor moved to Idaho. She sold her business to Adeline Kell, who is also a midwife/naturopathic doctor. Not only will she be delivering our next child, but she is our doctor for all our medical needs. It makes for a very trusting relationship. And I think thats key to a beautiful birth. You can contact her at (503)753-6352 or at A Better Choice, abetterchoice.com


PS I also posted our birth story, on 'Share Your Birth Story' in January. I can't do a link, but you should check it out!

I also had a fantastic experience through Alma (we chose a home birth). Another positive aspect of Alma if you're new to town is that in addition to your perinatal care, there are also lots of opportunities to meet other pregnant and new moms through the center--prenatal and postnatal yoga, a free weekly new parents and babies group (pregnant women can also attend!), and free monthly parenting seminars on different topics (vaccinations, how to catch a baby, herbal medicine, etc).

Best of luck!

Unlike the other posts I would definitely NOT recommend Alma. I had my first daughter there a little over 2 years ago and while we loved them for our pre-natal care and thought we had found the perfect place, we were very let down with our birth experience. Not only that but the health of my daughter was put at risk due to their negligence. Our midwife and the owner, Laura, outright lied to us when she said she we be attending the entire birth. She didn't show up until 16 hours into it, and I was an emotional mess at that point. I have since met 3 other women who had very similar frustrations/dissapointments with Alma. I won't go into any more details but if you have any questions you are welcome to contact me at jes@j-lux.com
We had our second baby at home and used A Gentle Beginning (Nora and Catherine) midwives. They were absolutely fabulous and having experienced both a birth center and my own home, I wish we had done both births at home. I had initially thought a birth center was a nice middle ground between hospital and home birth but in reality there is no difference between a birth center and home except that you don't have the comfort and familiarity of your own home and you have to travel.
I hope that's helpful and congratulations!

Johanna, I'm sorry you had such a difficult experience. With my first daughter I had a difficult experience with Andaluz, one that continued to be dissapointing well after the birth, so I know how that feels. It's been almost 5 years and I'm just now over it. Mostly. After several years of hindsight, I've come to the conclusion that midwives are human, often busy working mothers themselves, with incredible pressures and little support.

So that said I had an amazing experience with Alma. After my letdown with Andaluz it took me a long time to trust my midwives (there were two, and one apprentice) but when I got there we had a great closeness. I still miss them, especially Laura. I found them to be especially great when I got to the end and needed some guidance. Laura knew when to let me make my own decisions (which is the model of midwifery--moms are in charge of their decisions) and when to give me a push, like when she said, "Get some childcare and go take a nap." ;)

The birthcenter is like a bed and breakfast. Gorgeous. My post-partum care at the center was great, and they visited me at least three times at home afterward. I felt totally taken care of.

Carly, I know lots of people who love Andaluz, so you should also check it out, and use your gut as a guide.

We did look at the Natural Childbirth and Family Clinic and it was fine. I just didn't click with the midwife and I wasn't as excited about the facility. It wasn't as pretty as Alma. What can I say. I guess I like to be pampered. ;)

Good luck with your move and your decision. Fortunately, there are lots of midwives in this town.

Our daughter was born at Alma 15 months ago, and it was a wonderful experience for us. I would encourage you to take a tour and see if you connect with the midwives and the space...I also found the whole community surrounding it a great way to meet other new mamas and families. Best of luck!

I have heard bad things about Andaluz, and its pretty far from OHSU (where they transfer if necessary).

Johanna - I am so sorry that you had such a difficult time at Alma and so glad that the second time around went so much more smoothly for you.

Like Katherine, I had a truly wonderful experience with Alma (http://www.almamidwifery.com/)and I recommend it whenever anyone asks me about it.

My older daughter, who was born in Boston, was premature and spent two weeks in the NICU, followed by three additional hospitalizatons -- all within her first two months of life. Thankful as I was to all of the doctors and nurses who took such good care of her, the entire experience left me exhausted and pretty "hospitaled-out."

When I learned I was pregnant again last year, I was torn between having a hospital bith just to be "safe"(I strongly considered the OHSU waterbirth program and thought Ellen Tilden was wonderful) while really wanting to have a birth center birth. Laura met with me, listened to my concerns and really put my mind at ease.

My prenatal care was fabulous - all three of the women on my team were kind and nurturing. When I had a bout of preterm labor at 31 weeks and went to Emanuel thinking that a second premature birth was inevitable, they helped me relax and believe that all would work out for the best. Labor stopped, I went home, and my baby was born at Alma several weeks later, a very happy and healthy 7 pound 6 ounce, full-term girl. Her birth was all I had hoped it would be.

Our post-natal check-ups were done at our home (no worries about bring a tiny newborn to a germy pediatrician's office), and since then I have taken advantage of several of Alma's classes, including a really fantastic one on baby-wearing. Best of all, insurance covered most of the costs after a small deductible. I wouldn't hesitate to use Alma again in the future if we ever choose to have another child.

I have friend who birthed happily at home with A Gentle Beginning:


and I understand that Andaluz is in the process of opening a Portland location:


Best of luck to you and your little one, Carly!

I too highly, highly recommend Laura at Alma. I had my first baby at home with Laura 4 years ago and it was an amazing experience. I am due with my second in May and planning on having a homebirth with Laura. Laura is very calming, attentive, nurturing, hands-off, and most importantly experienced. It is such a personal decision and not everyone likes the same kind of care. My husband and I interviewed 5 different midwives and when we met Laura we know instantly she was the one. I suggest you do the same and meet as many as you can and then go with who you feel the most comfortable with.

Good luck!

Both of my children were also born at home with Alma midwives attending. I cannot say what the birthing center experience would be like, but I can say that the midwives I had were professional, caring, warm, and fabulous. They have several different certified midwives there now so if one doesn't click you can try another one. I had Laura and Melissa as part of my birth team for both births. During the pregnancy with my first child, I interviewed several midwives as well.

What I especially loved about Alma was that they empowered me to make decisions about my care. They spent a lot of time with me at each appointment nurturing my body and supporting me emotionally, and the follow-up care was thorough and supportive.

I had a so-so experience at a birth center. Can I "blame" the midwives/center, or would I have had a bad experience anywhere due to my personality & situation? Or both? Hard to say.

We interviewed & researched (& researched, & researched) many options. Taking both Birthing from Within classes and the usual course thru our health provider helped us work thru the decision. (We went w/Alma.) Enormous financial commitment leading to ongoing debt yrs later, and as I said I do not, and perhaps never will, see my birth as this amazing, transformative, ecstatic event (which I was hoping for), and that makes me sad -- but, I'm still ambivalent--perhaps we did make the "best" decision for us?

Each woman will connect w/different midwives, & have different needs! One (very unsolicited) suggestion: stay strong. You're the one carrying & birthing the baby. If you need to do so in order to find your own path, tune out your husband/partner/spouse/mom/sister/friend until you find that inner voice.

Good things about Alma: Laura is smart, experienced, picks a good team, is calm, communicates clearly. The physical beauty of her center is lovely--& yup, my 3rd-trimester self was swayed by that! although, gotta tell you, when in labor, I didn't care! Their "customer service" is **great** (lending library; team approach; clear contracts; basic stuff for sale; nice to have takeout food after delivery & an overnight stay. PP at-home checkups were superlative.

Why I can't recommend Alma wholeheartedly: The team made decisions/calls during my labor that were distinctly questionable. One of these lead to months of serious problems for me and I'm still conflicted about it. A few of the decisions had no lasting impact at all but were either stupid & careless, or seriously disruptive & upsetting at the time. All were preventable.
(Except for one "negative" thing that was 100% our responsibility: we turned out to need extra support early in labor when we got to the center but couldn't (for whatever reason?) ask for it until the pushing started & I demanded it; that I'm upset about that is irrational, I know)

Could all this have happened elsewhere w/different people, and was I destined to be sad & angry regardless? Of course! Would I hire Alma/Laura again? Sadly, probably not.

Unfortunately, there aren't a lot of options for birthing centers in the area. It's unfortunate there aren't more birthing centers, as I think it's the perfect compromise between hospital and home births. I had a home birth, because I wanted to eliminate driving somewhere when in labor, and didn't see any benefit to being at a birthing center instead of my own house. I had to pull together some extra supplies that I wouldn't have had to otherwise, but other than that, I think the benefits were the same. Of course, if your house isn't optimal for giving birth, that's another thing to consider, and would be an added benefit to having the option of a birthing center.

For me, choosing my midwife was a personal decision, and one each woman & their partner needs to make for themselves. If you really want to birth at a birthing center, I would make a list of all the ones in our area and interview each one separately.

I had a homebirth and went with NW Community Midwives & we had a great experience. I interviewed with Alma, but Laura wasn't the right fit for my personality, but of course, might be right for you. I would try to formulate your own opinions by doing your own interviews. You'll know which center & midwife is right. Having said that, I've heard fantastic things about Alma. Know several women who have had babies there, and one in particular who had a great VBAC experience. Trust your instincts. You'll know what's right for you & your baby! Good luck!

i can't recommend Alma enough.... i had the best pre-natal and post natal. my first was a c-section in germany... while my 2nd did end up in a c-section, and we had to transport- i never felt more calm and protected. i just wish they could of gone into the operating room with me!! i know this is a bit different then most midwife stories, but this is just an example on what good care they give- they took control upon arrival at the hospital and remained my advocate thru out the whole stay. even though my 3rd (if i have one) will most likely be a c-section, i will still use Alma for pre-natal

We are very lucky in this area to have the number of birth centers we have, many places have none. That does not mean that we could not use more but we are so lucky to have choices...

I can speak very highly for Andaluz, while I do not speak from the birthing Mom perspective I am a Birth Doula. I have not had a birth at Alma yet.

I do know that the most important aspect is how connected you feel to the Midwife and team, how comfortable you feel in the environemt. So just going to all of the centers and interviewing will be the best way to make a choice.

Also there is one other new center I have not seen mentioned... Bella Vie http://www.gentlebirthcenter.com/contact.htm
They are in the Hopewell area so may not be convenient for many upper Portland people, but for those in Lake O or more south it may be a good option.

Has anyone had any experience with Vivante Midwifery or A Gentle Beginning (N. Curtis Ave)?

What are some good questions to ask when I go in for my first interview/consultation?--especially with regard to homebirths? This is my first child and I am clueless!

If you might be interested in homebirth, Ina May Gaskin has a great book that will answer all your questions. I believe there is a section in the book that has a list of question to ask a midwife. It's called 'Ina Mays Guide to Childbirth'.
I'll be interviewing midwives all week, as well. I'll keep you updated!

Thank you Lea. I have set up interviews with Alma, Vivante and Andaluz. But would like to get feedback from others.


'Ina Mays Guide' has a list of questions on pages 308-309 to ask a) a homebirth midwife or birthing center b) a hospital-based midwife and c) an OB or family-practice doctor.

There is a 'zen' garden at 'A Gentle Beginning' and it is just lovely. Seems like a great place to labor!

I interviewed Ellie at Balanced Birth, today. Just four blocks from my house! She seemed great. I'll also be interviewing Carol Gray from Two Rivers Midwifery, Adeline Kell at A Better Choice and Sara Ohgushi. All have been recommended highly!
I think that most birthing center and homebirth midwives in Portland have a similar model of care. It's just about finding that one that you feel especially connected to!

I am currently going through prenatal care with Gentle Beginnings. I chose them due to their experience as well as their background in Naturopathic medicine. I've only met with them twice and have felt like they're very professional and like I'm in good hands. My only stipulation at this point is their recommendation to take a pre-natal. I prefer to eat a varied diet rich in vitamins and don't like taking supplements other than herbs (unless absolutely needed!). This isn't that big of a deal though, and I am pleased otherwise. They took a very extensive background history (2 hours!) and I've not had that before with any other prenatal app.
It truly is a personal choice, go with your instincts.

Does anyone have any experience with Nest Midwifwery? Or vivante?

As a NICU nurse in Portland, I feel obligated to state that Alma and Andaluz have all transferred babies in extreme distress as a result of negligence. These occurances are frequent. While they may state statistics which make them seem to be safe providers I see several cases every year of preventable birth injuries, infections and other complications which have lead to profound handicaps and death in very beautiful babies.

I do not trust either Alma or Andeluz. They do not have the means to effectively resusitate a baby that has suffered a prolonged dystocia or aspirated mecomium.
Please ask your lay midwife about the frequency of maternal hospital transfers and the health of these babies. Also, ask about the outcomes of babies they have deliveres and had to transfer to hospital.

Please consider the nurse-midwife staff at Emanuel. They delivered my baby girl and were beyond wonderful. I have nothing but praise for them and the work they do. Also, they have the best back up available.

I had a miscarriage at Emanuel, and they could not get their act together. They tried to tell me to go to another floor as I fainted from the pain, then they let me suffer in pain for over two hours because they needed to fill out their paper work. There was an awkward moment where the nurse wouldn't even help me put my gown on. It was HORRIBLE, they were insensitive and I felt like a prisoner. I would NEVER trust them to deliver a baby, or treat a women in labor with care. I wonder how many babies in their NICU are there because of their own fault.

To the Portland NICU nurse,
Please provide the statistics on morbidity and mortality of the babies who are birthed in your hospital before bashing the care of homebirth midwives. There is inherent risk in birth, just as there is in any life event.
Homebirth midwives are certified in neonatal resuscitation just as you are, and carry full equipment with them to all births.
As a hospital-based CNM student, I find your comments irresponsible.
Your job is to care for sick neonates. Of course the transferred babies are sick - that's why they're there.

This is slightly off topic, but anyone with experience delivering at a Portland Kaiser Permanente hospital? My husband receives cancer treatment at Kaiser and he is reluctant to switch doctors and insurance to cover a birth center delivery. Thanks!

My daughter was born at Kaiser Sunnyside almost 3 years ago and I had a wonderful, completely natural, intervention-free birth with the midwife on call. I didn't know that midwife at all and think it would be nicer to give birth with someone you have a relationship with but it went completely fine for me. My husband and I went in with a birth plan and were very well-informed about what we did and didn't want (unless necessary of course) and our wishes were completely respected but the entire staff.

That said, if you really want a home birth/birth center birth, you should look into the costs. It costs SO much less than a hospital birth and may not be too much for you to pay out of pocket. This time around we don't have kaiser and all home birth midwives are out of network for my plan so I may end up paying for most of the costs out-of-pocket but it's worth it to me. My Kaiser birth was fine but I want something different this time.

To the Portland NICU Nurse,
As you look over all those NICU beds please notice that very few and often none of them are neonates from birth centers or home births. Most of them are preterm babes. While serving as midwife of 26+ years, only a couple women gave birth before 36 weeks. I have never lost a baby to prematurity. This includes several sets of twins.Alma's mortality rate is low, as is our morbidity rate. We know how to prevent most prematurity with nutrition, tending vaginal flora,lifesyle coaching and sometimes reducing hypertension. Having hour long prenatals allows us time to give unique and thorough care.We love the staff at Emanuel. The CNMs (some of them even had homebirths) and hospitalists are very open to receiving our transported clients and many have even toured Alma. I'm not sure where you got your information, JPB but I would love a chance for you to tour Alma and review our statistics.
JPB, You may be surprised to learn that several physicians, nurses, and CNMs have given birth at Alma!
Laura director of Alma Birth Center

To The Families who have had pre-term births, I know that your pre-term birth may have been too complicated to be haulted by nutrition, herbs, acupuncture, building healthy flora and all the other midwifery methods of preventing prematurity. I also understand that the people who choose midwives tend to be the healthiest women.We don't work with smoking women for instance. So,I just wanted to honor those families who have been through the heartbreaking event of having a preterm baby.

I won't even get into all the medical aspects of this convo as we are all intelligent woman that know that healthy woman have been birthing babies on there own and with the help of midwifery forever- with out the aid of hospitals. I would assume that if you are searching for a midwife and or birth center you are healthy and fall into the population that does not need the care of a more medicalized environment. I have visited both Alma and Andaluz and they are beautiful. I think it is funny that many of the posters mentioned certain midwives and not clicking with them- both locations have many modwives. We are all strong woman who are taking charge of our bith- take the time to meet more than one if the place feels good but the personalities don't mesh. I have had two homebirths and would have home borth again. If I had to go to a birth center I would have to say that it would be Alma after seeing both. My point- check out all you options and don't close the door because of a random post on a message board. Go midwifery!!!

Katherine, you may never read this as you posted 2 years ago... however I just read your post about birthing at Alma with your second baby and I want to say that I'm SO happy for you. I think Alma and Andaluz rock, no matter what some of the medical community thinks (they have NEVER supported out of hospital birth so they love to slander home birth and birth center midwives... I don't see that changing any time soon!).
I still think of you on occasion (even though I wasn't your midwife, but how I wish I had been!). You gave birth 5 days after I did so we both have a child the same age. :)
Sometimes I wish you and I could chat because I have some things in my heart about your birth.
Hoping you read this.
Jennifer Gallardo
Director Andaluz Waterbirth Center

Jennifer - it's lovely to blame the medical professionals for the cavalier attitude of your midwives to the lives of the women and babies in their care. What a convenient position that you can take with no need to justify the bumbling incompetence of your midwives.

I agree with other reviewers that the midwives at Andaluz are very empathetic and obviously love their jobs, also that their consultation rooms are very comfy and reassuring, I found their competence and capacity to act as safe practitioners for the delivery of my child to be completely unsatisfactory.
I wanted nothing more than to have a natural waterbirth without medical intervention. That said, throughout my pregnancy I became concerned about the level of care at Andaluz. Several instances of strange behavior on the part of my midwives raised red flags. At one appointment, one of their most senior midwives had to have me self-insert a speculum because she did not know how to. This was just one such example. I also called the board that oversees midwives (along with estheticians and pedicure places) and they were very ominous in their responses about Andaluz. The contact said "there are no ACTIVE investigations into Andaluz midwives", several times, with great emphasis. Ugh.
Based on experiences like this throughout my pregnancy, I actually went to Emmanuel at 36 weeks and talked to their nurse midwives with an intent to transfer, but talked myself out of it ... thinking I was being irrational because of my hormonal state. I really wish I had listened to my intuition.
At the time of my delivery, the midwives at Andaluz recklessly allowed me to become dangerously dehydrated (to a life-threatening degree). I was throwing up, wasn't drinking fluids... They had NO CLUE about what was going on with my labor and often I was left alone for hours at a time even though I was very obviously not doing well. At one stage, the midwives had the "book of Midwifery" open on the bed and were flipping through it. In front of me. After two days of labor.
When, after over 48 hours of intense labor, I finally demanded to transfer to a hospital, they delayed and hemmed and hawed and eventually insisted that we use our own vehicles. I rode in the back of my husbands car to Emmanuel in extreme distress and agony. Upon arrival, the Nurse Midwives were shocked at my dehydration and general condition and horrified that I was not transported in an ambulance. I was given 6 bags of IV fluids and was still very dehydrated.
I suspect that Andaluz avoided ambulance transportation as it would have been officially recorded as a transfer. I furthermore believe they deceived me when I asked a very specific question about the number of transports they make in a year. It is my opinion that they are endangering women and babies with their arrogance and their sloppy, unprofessional care.
I felt as though a hospital was the last place I wanted to celebrate the life of my baby - more fool me. The Andaluz schtick is that they empower women to make their own decisions. In truth, they are so poorly informed and so fanatical about being anti-intervention of any kind that they completely lose sight of the health of their patients. The difference in the nurse midwives at Emmanuel is immediately obvious... they know what the hell they are doing. I just wish I had gone there in the first place and had competent care throughout the pregnancy and birth.
It has taken me some time to be able to even write this review. I was so upset and traumatized by the experience that I shied away from revisiting it, however I feel as though I would be remiss if I did not make other pregnant women aware of my experience

Oh, and before you say how sorry you are that you were not my midwife, I'm actually quite glad of that. You were the midwife at my friend's birth several years ago and failed to realize that her baby was breech. The baby died as a direct result. Obviously incompetence is not just limited to your employees.

Hi all--
Does anyone have more information/reviews/stories of the midwives at A Gentle Beginning? We're relocating to the Newberg area from California, and I'm looking to get set up for a home birth. Any information or recommendations are greatly appreciated!

I have experienced three homebirths and one c-section. My first two births were at home with Pat Edmonds, my c-section was at Providence in Newberg and my last birth was with midwives from Andaluz. I personally know several women who have successfully birthed at Andaluz. While I did not call Pat for my last birth, I highly recommend her. At the time I thought she was retired and I had heard so many things about the waterbirths with Andaluz that I wanted to try it their way. There a many aspects of Andaluz that I appreciate. They are very much about the natural process of birth and helping women to learn to listen to their own instincts. We have had much of that taken away from us and I am a strong believer in it, especially after my 3rd child which required the c-section. That said, I am not convinced that they should be quite as hands off with first time birthers in particular as they are, and maybe a little more interaction with the mothers during labor would be a good thing. I did like my midwives, each of which had varying gifts in the birth process.

Midwives are people and as such, you will find some a better fit than others. Pat was not as good a fit with my sister as with me. Catherine of A Gentle Beginning was a better fit and also delivered my brother's children.

Midwives are careful to screen their prospective clients for risk. They will avoid taking Moms that they feel are likely to need more care than they can provide. This includes VBAC. I wanted a VBAC, and Andaluz did take me. But many others will not. This was a choice I made and I was glad to have the option.

I would also recommend Tarrin Fletcher, CPM, LDM of Happy Belly Midwifery. She was an assistant at my last birth. She is now certified and is exceptionally gifted, in my opinion.

To Anon of Cleves, I have seen your same post now in a couple of places. I noticed that you do not tell the stories of the two sad births you mention. It is hard for me, with successful good home births from good midwives, to feel very confident with your arguments when there is information missing. Did you speak with Mom's who had those bad experiences? I am sure there are sad outcomes at home & birth center, as there are in hospital, but I have heard way more happy home stories than I have hospital stories, many many of them were in person, but you also find them on YouTube and throughout the internet. If you have had a personal bad experience, please do share that and I would encourage others to do so too, but also be open minded and read the positive ones. Birth with midwives goes back way farther than with doctors. Birth is not an illness. We are happy that there are so many options now that we did not have before.

WE LOVE ALMA!! When searching for birthing centers in the Portland area, we wanted to find a comfortable space with midwifes that we trusted to help us have a healthy, natural birth. From our very first meeting with Laura, we felt at ease. She cared for us as individuals, always answering all of our questions and listening to our concerns. She was geniunely kind and knowledgable throughout each visit. When our son went past the 41 week mark, Laura spoke with us about many natural options to encourage labor. We were a little concerned, but Laura made us feel confident that everything was going to work out. And sure enough, less than 24 hours later (after an accupuncture session), I went into labor!

During labor, I was able to move around & have my husband stay involved while the midwifes were in and out of the room to monitor me & the baby. They also encouraged me through some tough times in labor. It was a great combination of having privacy while also feeling extremely supported and well taken care of. We trusted them 100% & felt very comfortable throughout my labor.

Laura and Caroline continued to be a great support after Jake's birth as well. They came to our house the day after Jake was born as well as at 3 days and 1 week. Then we went to the office for a checkup at 2 weeks, 4 weeks and 6 weeks. It was so great to have someone that we trusted to help us in the first few weeks as new parents. We feel truely blessed to have Laura, Caroline and Clare be apart of our birth experience and our journey into parenthood. They are HIGHLY recommended :)

My dear friend interviewed at Andaluz and Alma. She did not find Andaluz to be a good fit. She highly recommends Alma. She had a long, difficult labor due to a compound fetal presentation (nuchal arm). She suffered a very bad tear and slight uterine prolapse. However, she considers her experience there to be very positive and found the midwives knowledgeable and able to appropriately address issues as they came up. At no point was her baby in distress. She is very thankful that she had the option of a vaginal birth because it is very likely that she would have been pressured into surgery in a hospital setting. She feels very confident in the care she received at Alma and despite what would have been traumatic for many women, still considers herself to have had a beautiful, magical birth experience.

Check out oregonmidwifeinfo.com.

Well, having been a CNM in hospital practice for twenty years, I can tell you that there are many unfortunate outcomes in hospital births--they are just successfully covered up by layers of hospital bureaucracy. Most lawsuits are settled "out of court", with the requirement that the circumstances not be discussed. Although I recognize that there are some mothers and babies who need hospital care, most do not, and industrialized world statistics show, for many years now, the safety of home birth.

My education as a CNM was pretty poor. If it hadn't been for a friend who had been a midwife in Costa Rica, who sheparded me through the program, and the caring, competent Mennonite midwives at FNS--and the fact that I stayed through the vacations to be able to catch more babies--I would not have learned much of anything at all. We learned nothing about helping breech babies be born, for instance. Then, last spring, I attended a breech continuing education workshop at Andaluz, presented by Jessica Dolan. It was fantastic, and I realized finally how deficient my education was. And I remember that most physicians/midwives/nurses don't know anything about how to help a breech to be born normally, especially now, when everyone is sectioned--except the 'surprise' breeches,which still happen, often with disastrous results--because ignorance reigns, and everyone freaks.

One of many stories--I have seen such a freak-out happen, when a young, inexperienced obstetrician just happened to be the only surgeon in the hospital, the day after Thanksgiving, and my regular, fabulous back-up was out of town. A gravida 2 p 2 woman at 39 weeks with a diagnosed complete breech, who wanted vaginal birth, and was very prepared presented to the hospital in active labor, 5+ centimeters dilated, lots of dark meconium, and progressed very rapidly, baby sounded great. I located the obstetrician, who sharply commanded that she"did not believe in vaginal breeches"(!), and to get her into the OR for stat Cesarean. So, I got mom to labor on the toilet, while the puzzled nurse started an IV, and by the time she was literally THROWN on the gurney by two hulking aides, she was complete and pushing, and I was reassuring her that she was doing everything just right, just like we'd talked about, that the baby was coming down quickly, and that all boded well for a birth soon. So, the baby's butt was crowning through by the time she got on the operating table, and this foolish young doctor cut an episiotomy(!!), and PULLED on the breech, as I was entreating her to PLEASE DON"T TOUCH THE BREECH!--remembering the immortal words of Maggie Myles. Thanks to all the gods and goddesses, the baby fell out(weighing probably six pounds),and started crying, but the shaking, frightened obstetrician insisted she be INTUBATED and suctioned for meconium! And the baby was pink and screaming, so I just hung back and waited a sec, until the mom got to yelling at the doctor for being such an idiot....

A couple hours later, my back-up doc returned, and the mom and baby left AMA in a few hours, and didn't pay her bill.

So there's one breech bomb story from the hospital, "managed" by a board-certified OB/GYN, who I understand is now doing "aesthetic surgery" in Idaho. There are many. You just don't hear about them, because the hospitals have all the power to tell the story of how dangerous birth is, and how they're there to help. Which they sometimes do. But it's not a sure thing. Nothing is.

So, you go, out-of-hospital midwives! Keep learning and challenging the birth machine!

Sue Skinner

sue skinner - why do you have to frame this as a 'renegade midwives vs the big bad birth machine' issue? There's no excuse for midwives being poorly educated and incompetent.
As Jennifer Gallarado- director of Alma (who is responsible for several deaths PERSONALLY and has been investigated and sanctioned several times - see http://oregonmidwifeinfo.com/jennifer-gallardo/ for details of her appalling safety record) states, with refreshing honesty for a homebirth lay midwife - birth is inherently dangerous and risky.Sorry ladies, but it's true. Your body, and your baby, don't always know what to do. Nature can be cruel. Bad things happen - but most of them are preventable with competent, timely intervention.
We're lucky to be born in an era where childbirth has been made incredibly safe by modern medicine - but people are getting too complacent and forgetting that until the advent of modern obstetrics, childbirth was a MAJOR cause of death in mothers and babies.
No-one is saying modern medicine is perfect, there are cases of bad practice in hospitals for sure and the 'birth experience' isn't always great. but if something goes wrong, the safest place to be is in a hospital, surrounded by competent and educated medical professionals. Why take chances with your baby's life?
As someone who has lost a baby, I can tell you - you always think it won't happen to you but sometimes, it does.
As for the 'hospital cover up' thing - it doesn't matter if a hospital tries to hush up a case, it'll still show on their statistics. MANA are refusing to release their death stats for homebirth midwive, and the best evidence we have, on a like for like basis (i.e comparing low risk homebirth with low risk hospital birth) shows that lay midwives are dangerous, and far more babies die under their care.
I'm not saying ALL lay midwives are no good - but the USA should be ensuring that all our midwives are properly trained and experienced, and held accountable like all other medical professionals are when things go wrong.

Get your facts straight, Jennifer isn't the director at Alma.
I'm not going to even reply to the rest of this, because it's so full of BS. Take your whining elsewhere, and let mom's make their own educated decisions.

As I did 34 years ago, when I was pregnant with Jesica Dolin (identified above as Jessica Dolan) who is a breech educator as well as a properly accredited midwife, I still find the "most vocally negative" in the medical community lacking in logic and facts. I fully intended to have a hospital birth the first time until meeting with a young pretty CNM at Kaiser in Beaverton in 1978. I asked what my options for birth were at Kaiser and before I could explain that I meant less/no drugs, no cutting, my husband with me - she stood up and place both hands on the desk, leaned forward and yelled at my husband and I "You are not considering a homebirth are you?" We promptly left knowing that someone who was so emotional about something we were not even talking about could not be trusted to make clear headed decisions if there was an emergency - something everyone should consider when choosing any kind of care. We had never considered a homebirth, but my grandmother had unattended homebirths and felt people made too big a deal about giving birth (she had 9 children). My mother had 6 children, all with horror stories of what she endured in the hospital, cutting followed by tearing on the first 4, and drugs that interfered with her laboring and being forced (yes, forced) to lay on her back. We asked around for ideas and heard about a Harvard Medical grad who was doing births in all settings. We met him and his CNM wife and loved them and had an excellent experience at home. We had originally planned to have the birth in a hospital setting and 2 months before Jesica was born, it became clear that was not what we wanted. The next baby was with 2 CNM's in a Birth Center that is now closed and had a reasonable experience - nothing to complain about except the car ride to the birth center). We had changed care providers as the previous doctor had moved to an emotional place that we did not want to deal with. Then for our third we had a home birth with a great direct entry midwife and her hubby an ND. Best ever! Was it because we moved away from medically oriented people? - no, third babies are just usually easier and we knew what we wanted and how to get it. Though it is easy to be swayed by window dressings of nice looking birth centers, many hospitals did this also to attract patients - even while increasing their c-section rates. The implication that hospital births are safer in general than a birth center birth is not true for full term babes and healthy moms. Statistics bear this out. I am currently in NYC to care for twin Grandbabies (of second daughter who is a Family Nurse Practitioner). In her neighborhood another twin mom died as a "complication" of her C-section. The father is raising the twins alone, it made the "list serve" but not the newspaper or TV coverage. Though C-sections are sometimes necessary, many moms have long term problems from C-sections - many of which were not necessary but done because of fear and not sound medical judgement. My second daughter, herself gave birth to twins vaginally at a hospital with nearly a 50% C-section rate while her doctors (who specialize in high risk and multiples and have an 8% C-sec rate) had to fend off those with scalpels readied and shush the nurses who constantly were telling my daughter that she was unrealistic to want to vaginally birth twins, because even if she could successfully birth the first, the second, no doubt would be C-section. Luckily she knew how to pick a qualified OB from her medical experience and her sister (midwife at Andaluz) so she was not recovering from surgery as well as labor and birth. So if someone is using scare tactics instead of helping you discover what it is you want and need, they are working on a personal agenda and do not have your needs in mind. Even the best health care provider will not anticipate all problems or respond properly, so pick one who makes decisions the way you want and then together go forward! Life comes with no guarantees - except negative people make us feel bad - so stay away from them!

I would say if you plan to use Vivante Midwifery, you should seriously consider their transfer policy to OHSU and ask for freedom to transfer elsewhere if Linda Glenn can not provide you with continuity of care. My transfer to OHSU resulted in a very traumatic experience. I would not have chosen to agree to transfer to OHSU if I had realized that the odds of not having the continuity of care they market themselves as providing, would be so stacked against me. The midwives were great but most of my labor I was alone. I didn't know I needed a more hands on approach. I'm also very much in my head which hindered my progress, I believe. But I didn't have anyone talking me out of my head.
I think Vivante is a great group of midwives but, I think you have to be willing with any midwives to lets your demands be known. You can't be passive or submissive and you have to make sure your needs were met. I have many grievences with Vivante but what I do like about them is that they are a bit conservative, down side of that is they have the highest transfer rate in Portland. You have to be willing to accept that possibility.
My recommendation if going with them would be to avoid OHSU for transfer, have it in the contract that if you won't get continuity of care, that you be transferred to a more home birth transfer friendly hospital like Emanuel.
Also, Linda Glenn is great but her delivery sucks. (bedside) Very knowlegable but can really unintentionally be rude/mean.

I have been working with karen dewitt at Canyon Medical (formerly natural childbirth center) and I highly recommend them. They are naturopath midwives, and helped me along every step of the way of my pregnancy with wonderful suggestions for herbs, supplements and care for myself. My birth was amazing-- and I had the wonderful midwives to thank for that.
They are very open, there was never a question about any of the choices we had made, and they have forward thinking, relevant thoughts on newborn care. The aftercare has been wonderful, so caring, I think everyday how thankful I made the choice that I did.

What does everyone feel of the difference between a birthing center birth and a water birth at a hospital with a midwife?

I had a rough birthing experience with my first (in a different state) and am pregnant with my second. Already I'm fearful if I go into a hospital they'll not respect my wishes BUT make sure the baby is safe. If I go with a birthing center they'll respect my wishes but cannot necessarily ensure the safety of me or the baby. I'm closest to Andaluz and am meeting with them (my first meeting with a midwife I didn't hit it off so I'm going in a 2nd time to try and "pick" one). I'm open to Alma but have also heard negative comments.

Home birth is not an option for us - FYI. I also want to be nearby a hospital should I need a transfer b/c of complications similar to my 1st.


The midwives at OHSU have a very crunchy rep and an excellent track record for safety. ( http://oregonmidwifeinfo.com/midwives/) Maybe try a meeting with them? http://www.ohsu.edu/xd/health/services/women/services/midwifery/our-team.cfm

These are relatively recent numbers from Oregon that might be helpful in your decision making. Oregon hasn't had the ability to do this kind of analysis until this year.

I was also intrigued by a comment on this blog post (the comment is by the author of the blog post) that is well down in the comments - on March 27, 2013 - about why Oregon's statistics are the way they are. The writer is related to someone on the state's midwifery board, (http://www.oregon.gov/OHLA/DEM/pages/biographies/james_di_properzio.aspx) so I think she might have some knowledge re birth centers and safety that the general public has not seen? Maybe contact her re who has relatively safer practices? http://www.jennifermargulis.net/blog/2013/03/when-obstetricians-hate-homebirth-midwives-birth-becomes-less-safe-for-everyone/

Given your experiences, HappyMama, I would not recommend Andaluz (sadly, because, in theory, it would be nice to). They have a higher transfer rate than other stand-alone birth centers and homebirth midwives, in part because they happily take higher risk and more complicated cases. I'm not a fan of hospital births (for the usual reasons) but if it's hospital vs Andaluz, go hospital....

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