Pregnancy Consultation Visit
In our one-hour prenatal consultation visit, please ask about our experience and qualifications, and anything else that may help you in choosing the right care providers for this very special experience. The following information will help you to learn more about what you can expect from your midwifery care.
CNM & LM Practice
Around the Circle Midwifery is combining the best of two types of midwifery care available in Washington: Certified Nurse Midwives and Licensed Midwives. This is a unique practice model, the only one like it in the South Puget Sound, bringing you the benefits of an expanded scope of care that may address the needs of families in birth and beyond.
Licensed Midwives in Washington have completed a comprehensive midwifery program at a state-accredited school, and have passed the state licensing exam. Program standards are based on those adopted by the International Confederation of Midwives and the International Federation of Obstetricians and Gynecologists. Licensed Midwives are trained and authorized to provide complete maternity services. Additionally, the licensed midwives at Around the Circle Midwifery are Certified Professional Midwives (CPM), a nationally recognized certification through the National Association of Registered Midwives.
Certified Nurse Midwives (CNM) are Advanced Practice Registered Nurses (ARNP) who hold advanced degrees in nursing and are nationally certified through the American Midwifery Certification Board. They provide care throughout the lifespan, addressing needs not just in pregnancy, but in all aspects of wellness to include fertility, routine gynecological care, and contraceptive management.
Our services include individualized and comprehensive prenatal care, instruction in self‑care, nutritional counseling, birth at home or in a free-standing birth center, breastfeeding classes, lactation support, postpartum care for you and your baby, fertility assistance, well woman care from puberty through menopause, and contraception care. We believe you should be an active participant in your healthcare and will make every effort to provide you with information and education regarding all options, so that you and your family may make informed choices about your care. We encourage you to bring your partner, friends or relatives.
We generally set aside one hour for each prenatal visit. We schedule monthly visits until your seventh month, at which time we will begin seeing each other more frequently. During your last month, until your birth, we will want to see you each week. For those planning a homebirth, we will visit you at your home during one of our weekly visits. In addition to our visits, we encourage you to attend childbirth classes focused on birth in the home or birth center setting.
Throughout your prenatal care we will be talking about your plans, hopes and concerns about childbirth and motherhood. We recognize the birth of your baby as your own special experience and we will be honored to provide the kind of care you desire. We can talk about relaxation techniques and different positions you can use to help you be more comfortable throughout your labor, as well as talk about the experience of labor and birth itself. In the last months of your pregnancy, we will talk about home preparation and the supplies you need to have ready in anticipation of your baby.
As the time of your birth draws near, we may have more frequent contact with you as you begin to feel more imminent. We stay on call 24-hours a day. We can always schedule additional visits if you feel a need. We will come to be with you during labor when your labor becomes active. There will be at least one trained birth assistant, in addition to the midwife, at your birth. During labor we will monitor your vital signs, check on your baby's well-being, and support you in the ways you desire.
After the Birth
After the birth we will continue to carefully monitor you and your baby as you adjust in the immediate postpartum period. We will also talk about care of the infant and mom in the days after birth. We will give your baby a thorough newborn exam by your side and share our findings with you. We will support you and your baby for breastfeeding success while honoring your family's need for bonding and privacy.
The following day we will check in on your new family, to see how you are feeling, how your baby is doing, and if you have any special needs or questions during this unique time of adjustment. We often will visit with you again a few days later to offer breastfeeding support, monitor your health and recovery, and to monitor your baby’s growth. We will offer at least two additional visits in the following six weeks to insure adequate support and a healthy outcome. If you are interested, we can explore the right birth control options for you during this postpartum period. We also offer standard newborn screening tests, follow‑up gynecologic screening, and continued well woman care.
We are able to bill most insurance companies and DSHS for our services. If you plan to pay out-of-pocket, we ask that your bill is paid in full prior to your birth. We have a payment plan and sliding fee scale for people in need. We would like to hear from you at the beginning of your care if you will have difficulty paying the full fees. Please make compensation your responsibility. We greatly appreciate it.
Read about our Payment Services . . . .
We look forward to getting to know you during the next few months as your belly grows round and you ready yourself, and those around you, for the birth of a new little person into your lives. Working with a midwife during pregnancy, labor and birth can be a very special and rewarding experience.
May all go well with you,
Carolee Hall LM, CPM
Michelle Madrigal, LM, CPM
Anneliese Langer, LM, CPM
Lyndsay King, LM, CPM
Heather Eckstein, LM, CPM, IBCLC
Tiffany Heiges CNP, ARNP
Families are strong, and capable of great and ordinary things – as care providers we must not stand in the way of their knowledge and inner wisdom, rather, we honor and nurture that strength which is inherently within. We believe that the birth experience belongs to the birthing person and their intimate family. We, as attendants, are guests and witnesses in the lives of others.
You are your primary care provider in your own life and often in the lives of your families. Midwives respect the dignity and rights of the person they serve and strive to work in collaboration with them, supporting people to make informed decisions about their care and to take responsibility for their own well-being.
Physical, emotional, social, cultural, and spiritual factors together contribute to the health of individuals, and play a significant role in childbearing. Each person has a unique experience of pregnancy and childbirth. To the best of our ability, we shall individualize our midwifery care to offer support in a manner which respects and addresses each person's unique needs.
Midwives recognize the value of a consistent care provider throughout the childbearing cycle and offer continuity of care whenever appropriate. We provide health care within a community context. Our practices reflect an awareness and integration of cultural standards, midwifery and medical standards and an ability to network with available social and health care services and resources.
There is an inherent perfection in childbearing and birth as a significant life process, one which does best without interference. We understand that attempts to control the process inevitably alters it, and frequently may harm the delicate balance. We embrace non-intervention consciously, quietly facilitating the spontaneous process of pregnancy, labor and birth, utilizing interventions only as truly necessary for the safety and well-being of parent and child.
Knowledge is to be shared freely – with students, other midwives and health care providers, with pregnant women and their families. Open collaboration creates an atmosphere of peers, co-learners, and community, one in which all participants hold a piece of the truth and all are of value.
We affirm that choice of birth place and birth attendant are basic rights of all birthing people and their families. For there to be authentic choice, we, as midwives will continue to educate and reach out to the public and the medical community, working to insure that safe, accessible and affordable out-of -hospital birth options are available to families regardless of race, ethnicity, socio-economic status, sexual orientation, physical disabilities and religious orientation.
Carolee (she/her) was inspired to become a midwife through her own birth experiences and the loving care she received from midwives during her pregnancies. Not only did they provide a beautiful model of care, but also encouraged her in a path to midwifery. A 2005 Seattle Midwifery School graduate, Carolee preceded her midwifery education with certification as a doula, childbirth educator and lactation educator. During this time she helped found a hospital-based lactation clinic. Breastfeeding support continues to be an important aspect of Carolee's work as a midwife. She returned to Bastyr University in 2017, earning a Master of Arts in Maternal-Child Health Systems where she focused her studies on breastfeeding accommodations in the workplace.
Michelle’s passion for midwifery started over ten years ago when her sister had her first baby. Although a cesarean delivery became necessary, it was this profound moment of witnessing her sister persevere with so much strength and beauty that Michelle’s path in life was forever changed.
Shortly after, she began pursuing her undergraduate degree with the goal to attend medical school. However, during this time Michelle ultimately discovered that community birth was where she desired to be. Michelle graduated from Seattle University in 2013 with her Bachelor of Science in Biochemistry. She went on to attend and graduate from Bastyr University in 2018 with her Master of Science in Midwifery. After school, Michelle took some time off to birth her third and final baby, but shortly came back to work as a birth assistant. She is now absolutely elated to become a part of the team here at Around the Circle Midwifery.
Anneliese (She/Her) was called to birth work while living abroad in Nicaragua. She felt strongly she wanted to have a skill set that transcended the language one spoke, culture one came from or religion one practiced. Being with families in this intimate, transformative and vulnerable time felt like the ultimate calling. Her path took many turns on her journey to Midwifery, including spending years in Alaska commercial fishing to save for Midwifery school. She finally was able to attend Birthwise Midwifery School in 2017, during which she worked across the country. Working with some ME and NH midwives, with the Amish in Western NY, the Cajuns in Lafayette, LA and finishing up her preceptorship at Around The Circle Midwifery in 2021. All the while having her first baby in June of 2020, during a global pandemic.
Tiffany (she/her pronouns) graduated with Bachelor of Nursing Science degree from the University of Alaska Anchorage in 2009 and immediately began a career as a labor and delivery nurse at an Indian Health Services hospital in Alaska. Assisting the births of the indigenous peoples of Alaska is an experience that she will always hold near and dear to her heart.
Lyndsay (She/her) reflects on her journey into birth work as a collection of many moments that drew her to this profession, as opposed to a singular defining moment.
In 2016, after graduating from ASU with a bachelors of science, Lyndsay began assisting for a home birth midwife practice in Arizona as a side job while teaching biology and working at a reptile sanctuary. It wasn’t until after having her first baby at home in 2018, following a multi-day labor, Lyndsay realized that she was ready to pursue midwifery full time. Reflecting on her own birth experience, she had the desire to be able to provide the same compassionate, patient care she received to other birthing people. Her background and passion for biology helped kickstart her midwifery education and in 2020, she became a Certified Professional Midwife and started her own homebirth practice in Arizona.