Frequently Asked Questions

A community-based birth happens outside the hospital, either right in your own home or in a freestanding birth center, with licensed midwives who know physiologic, low-risk birth like the back of their hand.

This kind of birth is built on real relationships, steady care, and a whole lot of trust in the birthing body. Families get thoughtful, unhurried prenatal visits, steady support through labor in familiar, home-like spaces, and caring follow-up in those tender days and weeks after baby arrives.

The focus is on informed choice, minimal intervention, and working smoothly with the medical community anytime more care is needed. For healthy, low-risk families, community birth offers a safe, empowering, and deeply connected way to welcome a brand-new little somebody into the world.

Community birth, whether at home or in a freestanding birth center is a wonderful option for folks having healthy, low-risk pregnancies who are hoping for a natural, unmedicated birth with a steady midwife by their side.

You’re likely a good candidate if you:

• Are in good overall health with no major medical concerns
• Have a pregnancy that’s cruising along without complications
• Want a physiologic, low-intervention approach to labor and birth
• Plan to come to your prenatal visits and take an active role in your care
• Appreciate clear information, consistent support, and real relationships with your midwifery team
• Feel comfortable birthing outside the hospital while knowing we’re always ready to transfer if the situation changes
• Feel comfortable transferring to a hospitals if complications arise 

At VCM, risk assessment is ongoing. We continually assess your health and your baby’s well-being throughout pregnancy to ensure that community birth remains the safest and most appropriate option for your family. 

Choosing community-based care doesn’t mean you’re missing out on modern medicine. At VCM, we make sure lab work and imaging are smoothly woven into your prenatal care, so you still receive all the important screening and monitoring you’d expect anywhere else.

We partner with Quest Diagnostics for routine and specialized prenatal labs, making it easy to get blood work done close to home, with results sent straight to your midwifery team.

For ultrasounds and other imaging, we provide referrals to Legacy Imaging, PeaceHealth Southwest, or Vital Care. These trusted providers offer comprehensive prenatal ultrasound services so we can keep a close eye on your baby’s growth, development, and placental health whenever it’s needed.

Once results are in, your midwives go over everything with you, answer your questions, and fold that information into your personalized care plan  bringing together the best of modern diagnostics with the steady, relationship-centered care of community birth.

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Absolutely. Babies don’t need a mansion to make their grand entrance. If you were able to make a baby in your home, chances are you can welcome one there too.

What really matters isn’t how big your place is, but that it’s safe, workable, and feels good to you. All we ask is that your home has:

• Reliable electricity

• Running water

• A clean, sanitary space

• A heat source during the colder months

Your midwives will help you choose the best spot for labor and birth and will bring everything needed to support you. From snug apartments to tiny homes, families welcome their babies in all kinds of spaces — it’s the care that makes it powerful, not the square footage.

Absolutely. Water birth can be a wonderful way to labor and welcome your baby.

Warm water helps take the edge off contractions, encourages your body to relax, and gives you the freedom to move in ways that feel right. Many babies make a gentle transition when they’re born into water going from one warm, cozy place straight into another. And the best part is that they won't be covered in birth goo the first time you hold them!

Some families already have roomy tubs at home that work beautifully for labor or birth, while others choose to rent or buy a birth tub. We’re happy to point you toward trusted local options. And if you’re birthing at the Bridge Birth Center, each private suite is already set up with a deep, comfortable tub made just for this purpose.

Whether at home or at the birth center, water can be a steady, soothing partner throughout your labor and birth.

Birth is a beautiful, wild event but it’s not the disaster zone people imagine. We show up with all the right supplies to keep your space protected, so your house won’t look like a crime scene when it’s all over.

Once your baby is here, your only job is to snuggle, stare in awe, and maybe cry a little. We’ll handle the cleanup, pack up our gear, and leave your home calm and cozy so you can start life with your brand-new tiny human without lifting a finger.

For healthy, low-risk families, giving birth at home or in a freestanding birth center is generally just as safe as giving birth in a hospital.

Safety doesn’t start when labor begins. It starts long before that first contraction ever shows up. Eating well, moving your body, tending to stress, coming to your prenatal visits, and getting ready for birth and parenthood with intention all help keep you strong and steady. At every appointment, your VCM midwives keep a close eye on both you and your baby, checking for any changes and making sure you continue to be a good candidate for community birth. At VCM, safety is never an assumption — it is a continuous, thoughtful process grounded in relationship, clinical skill, and evidence-based care.

The largest study of planned, midwife-attended births found that community-based birth, at home or in a birth center, is safe for low-risk families when attended by skilled providers.

Some of the study’s findings include:

• Nearly 89% of families who planned a community birth were able to give birth at home or in a birth center
• Over 93% had a vaginal birth
• Almost 98% were exclusively breastfeeding at six weeks
• The most common reason for transfer during labor was slow or stalled progress
• Urgent transfers for fetal distress were uncommon
• Only about 5% of families planning community birth ultimately had a cesarean birth in the hospital

Washington State Research on Community Birth

Washington State has some of the strongest data in the country on community-based birth. A large study published in Obstetrics & Gynecology examined 10,609 planned community births between 2015–2020, including both home births and freestanding birth center births attended by licensed midwives.

What the study found:

• The overall rate of serious complications was low for people planning community birth.

• Outcomes were similar between planned home births and planned birth center births when midwifery care was well-established and integrated with hospital systems.

• Cesarean rates were low, particularly for families who had given birth before.

• Transfers to hospital during labor were more common for first-time parents, most often due to slow or stalled labor rather than emergencies.

• Intrapartum and early neonatal mortality was rare (0.57 per 1,000 births).

This research highlights that in a state like Washington  where community midwives work closely with hospitals and follow strong professional guidelines  planned home and birth center births for healthy, low-risk families are associated with low rates of adverse outcomes and strong overall safety profiles.

When a Higher Level of Care Is Needed

If anything outside the ordinary shows up during your care, we don’t hesitate — we consult promptly with higher-level providers and arrange transfer when appropriate. We are not “community birth or bust.” We are empowered, safe birth or bust. Your safety, and your baby’s safety, always come first.

During Pregnancy

If complications arise in the prenatal period, we first consult with the Certified Nurse Midwife (CNM) group at The Vancouver Clinic to explore a smooth, respectful midwife-to-midwife transfer. If your situation requires physician-led care, we coordinate directly with Legacy Maternal-Fetal Medicine.

During Labor

If challenges develop in labor — or if your comfort needs change — we consult with the CNM group at The Vancouver Clinic whenever a midwife-to-midwife transfer is appropriate. For more complex situations, we work closely with the OB hospitalist teams at Legacy Salmon Creek or PeaceHealth Southwest to ensure a timely, coordinated hospital transfer.

After Birth — Parent & Baby

If concerns arise for either parent or newborn postpartum, we consult with pediatric or obstetric hospitalists and arrange transfer to the appropriate level of care.

Building Strong Medical Partnerships

Since our founding, VCM has focused on building respectful relationships with the medical community. We helped launch the Smooth Transitions Program at Legacy Salmon Creek and PeaceHealth Southwest — a quality improvement initiative designed to improve communication and outcomes when labor transfers are needed. We also partnered closely with The Vancouver Clinic CNM group to create protocols for seamless midwife-to-midwife transfers.

Emergency Preparedness

In the rare event of an emergency, our midwives carry essential life-saving medications and equipment, including:

• Anti-hemorrhagic medications: Pitocin, Misoprostol, Methergine, TXA

• Epinephrine

• Magnesium sulfate

• Terbutaline

• Oxygen

All VCM midwives maintain current certification in CPR and Neonatal Resuscitation, so you can trust that skilled, prepared hands are always close by.

Absolutely. This is your birth, and you get to choose your cheer squad.

Whether that’s your partner, your kids, your best friend, or the one aunt who keeps everybody calm, we’ll help you decide who belongs in the room and who might be better cheering you on from afar. Your midwives will work with you to keep the space peaceful and focused, so all the attention stays right where it should: on you and that brand-new baby.