Longmont midwife collective works to make home births affordable for low-income women

A relatively new midwife collective in Longmont has started a unique pricing model and fundraiser to help women who couldn't usually afford their services access home births.

The Community Roots Midwife Collective comprises four midwives who have been working separately for several years in Boulder County — Rachel Engel, Lauri Hughes, Nichole Didelot and Lo Kawulok.

A year ago, they got together and formed the collective. They took on their first clients in February and, in September, the collective helped welcome five new babies to the world.

In late November, the collective launched their Generosity Campaign, a fundraiser to benefit their Birth Service Fund. The Birth Service Fund allows the collective to fund about two low-cost births per month in order to allow lower-income families to access their services. Anyone can donate to the fund at bit.ly/2idZrAO.

They said they feel that access to midwifery services and home births rather than the modern alternative of a hospital birth is important.

"Some people say midwifery is preventative care in a sense because it is so comprehensive and we spend a lot of time with our clients," Kawulok said. "We take care of every aspect of their health care from their physical needs but their mental, emotional and spiritual needs as well."

A midwife is different from a doula. Midwives are vetted and certified by the state and function as primary care providers throughout a pregnancy. Doulas, on the other hand, function more as birthing coaches and not as medical professionals.

Low-risk pregnancies where the woman feels most comfortable at home are ideal for midwife births, the midwives all agreed. If there are any complications in the birth, the woman's midwife accompanies her to the hospital.

The midwives also check in on their clients several times postpartum to make sure the health of the mother and the infant are on track and answer any question the woman has about lactation or postpartum care.

Kawulok said that checking in with new mothers shortly after they give birth lowers the risk for postpartum depression, making the surrounding community at-large healthier as well.

"Their well-being post-birth and their ability to care for their babies directly affects their children, their families and all of our communities, which is why we believe that every mom, or every birthing person really deserves individual care and the care of a midwife if possible," Kawulok said.

The collective also hosts events such as lactation circles and new mom socials to ward off the isolation that can affect some new mothers.

"If moms are held in those first couple of weeks and they aren't stretched beyond what they can do and they have people checking in on them frequently and caring about them, they have a continuity of care and a lower risk for postpartum depression," Didelot said.

Hughes said it really helps to create a sense of community and support among the new moms.

"People don't feel so isolated because they know they have other parents they can talk to and they're not alone with the experience that they're having at home with their newborn," Hughes said.

Because midwife care is paid for up front and often not covered by health insurance, the collective operates on a sliding pay scale for services.

The sliding scale is unique in that it doesn't require any tax documents or proof of income, but rather functions on the honor system and women's self-evaluation of their resources. It's a much larger version of the "take a penny, leave a penny" bowls on some cashiers' counters, Hughes confirmed.

The sliding scale information sheet asks women to think about their resources. Are they living paycheck to paycheck? Would paying a higher amount mean they aren't able to pay utility bills or that they would have to cut back on eating out and buying coffee?

The lowest end of the sliding scale is $2,500 and the information sheet asks people to exhaust other resources such as friends and family before committing to pay the lowest price. Currently, the collective can only afford to offer two $2,500 births per month on a first-come, first-serve basis.

The midrange on the sliding scale is about $4,000 and is for people who have a steady income and are not worried about meeting basic needs such as food, shelter or medical care.

The high end of the sliding scale ranges from $4,500 to $6,000 and is for people who own property or have savings. Women who pay the higher end of the sliding scale enable the collective to offer the lower end.

Didelot said that the midwives have been amazed that women are perfectly willing to pay the higher end of the scale in order to allow others to pay the lower price.

"We've had two of our current clients pay above the $6,000 rate in order to pay into the fundraiser so other clients can pay at the lower end of the sliding scale and we just think that's really remarkable that those with more resources are willing to do that," Didelot said. "It's mind-boggling. I'm like, 'Oh my God! People are really choosing it!'"

Hughes said that the collective is also passionate about reaching out to traditionally underserved communities, such as people who only speak Spanish or people in the LGBTQ community.

One way to do that is take on apprentice midwives from underserved communities, Hughes said.

Kawulok added that diverse midwives are important because someone with a language barrier or from the LGTBQ community will be most comfortable with someone who can represent them.

"We want people to feel comfortable with who is providing their care and also really be able to educate from the ground up in those communities about their options," Kawulok said.

Karen Antonacci: 303-684-5226, antonaccik@times-call.com or twitter.com/ktonacci

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