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Interview with a Midwife (or two): Vashon Island Midwifery



Katelyn Costley and Lauren Strain are two midwives who have just formed a nonprofit organization on Vashon Island. I interviewed them about their ambitious and exciting plans to serve the island community. Read on to learn about their plans and how midwifery can play an important role in community health!

Hi Lauren and Katelyn! I am excited for your new organization and what it will be bringing to Vashon Island. In your own words, can you summarize what Vashon Island Midwifery does?


Lauren: We provide accessible perinatal health care, education and support to Vashon families.


Katelyn: We have created an accessible model of healthcare that promotes health equity. Our Collaborative Health and Education Center focuses on perinatal, reproductive, newborn and child healthcare so that everyone in the community can receive necessary services directly on island.


Can you both tell the readers about yourselves? Who are you, what experience do you have, what led you to birth work?


Lauren: I have been involved in birth work for just about 20 years now. I started out as a massage therapist with a specialty in pre and perinatal massage, and from there began teaching infant massage, offering doula services, teaching childbirth education classes and facilitating parent support groups. I had midwifery care and homebirths with my own children, and it was life changing to be so seen and supported. I decided to take the plunge and become a midwife after seeing the difference in the care my doula clients were receiving. I wanted to give back, or rather, pay forward the love and support I had received. I also really approach this work from an activists point of view, and reproductive justice is a huge passion for me. I feel that midwives are in a position to be able to make change in this area, and I want to serve the larger community in that way.


Katelyn: I became inspired by birth work and midwifery after the birth of my eldest child. It was in that experience of pregnancy and childbirth that I began to understand the importance of this time in an individual’s life and how that moment of birth forever impacts the current and future generations of our society. I was living internationally at the time and became a placenta encapsulator, childbirth doula and childbirth education instructor. When we moved back to the United States, it was to the hometown of my partner, where he was born and raised, here on Vashon Island. I graduated from Bastyr University with a Master of Science in Midwifery and have since become a Certified Professional Midwife. I have had home births with my other children, here on Vashon, and am particularly moved by the experience of home birth in a community like ours. I feel fortunate to raise my children in a small, island community, and I am extremely passionate about eliminating barriers to the positive, long lasting benefits of high-value perinatal healthcare for all of our neighbors.


What inspired you to start this organization?


Lauren: There are really two compelling reasons for me. The first is what I mentioned before about reproductive justice. I want all people to have access to affordable, equitable, trauma informed and consent driven health care! I also know that private practices on Vashon struggle to stay afloat, and it seems that what we need is a community effort. What Vashon does best is to come together as a community and support each other, and our non-profit brings another opportunity for that to happen here.


Katelyn: Over the years of living here on Vashon, I have seen brilliant people with beautiful ideas bring forward various offerings to the community in regards to perinatal and reproductive healthcare, including: Vashon’s women’s center, prenatal yoga, childbirth education classes, support groups- and more! I have seen these offerings be extremely valued and at the same time, not sustainable for long term viability in the community. I became very inspired to create a sustainable, dynamic and flexible community center that could bring all of these brilliant minds together in support of the birthing families on Vashon. This nonprofit model, with four related focus groups (perinatal, reproductive, newborn, and children), allows us to offer a wide range of programs and services, that supports our providers and educators with a viable practice model and our health consumers (clients) to receive the care they need, while utilizing gifts, grants and contributions to further support the organizational cause and compensate for the unique disposition of giving and receiving healthcare on Vashon.


How did you meet each other and decide to work together?


Lauren: Katelyn and I met when we were both students, and knew our fates were bringing both of us to this island. It was really just destiny! Our collaboration makes midwifery care on Vashon much more sustainable and having two licensed providers on island isn't just smarter, it's also safer.


Katelyn: Midwives come into partnership for many different reasons; for Lauren and I, the seed was planted simply due to geographical proximity - we both had a shared vision of providing midwifery on Vashon. With that seed, grew a beautiful partnership between the two of us, where we both were able to see that by working together, not only would we be able to increase access and safety to the Vashon residents directly with our midwifery clients, but we would also be able to create a model of healthcare that is much larger than any one person can hold alone. This nonprofit organization would not be possible without the collaborative dreaming and work of us both together, and it is the result of our teamwork that our mission may be realized.


How will your services be unique in the world of midwifery and medical care?


Lauren: We have been able to be really creative and innovative in our approach to making midwifery care sustainable on Vashon. One of the areas we knew we wanted to address was mental health. It plays such a big role in building strong, healthy families, and yet most people's mental health needs go unmet. We have created an integrated mental health program so that all of our clients have access to a mental health provider for preventative or therapeutic health care. Due to our non-profit model, and being eligible for grants and donations, we are able to accept every client into care. No one is turned away from any program or service for lack of funds. We are able to provide sliding scales and scholarships as well as accept insurance plans, including Medicaid. Another thing that's a little different about us is that we are able to provide on-island prenatal and postpartum care for families giving birth in hospitals, we aren't just limited to home birth families, making us far more accessible to all families on Vashon.


Katelyn: Lauren summed this up well… I would say the current elements that make us unique as a midwifery and healthcare organization are the following:


-Health Equity: We are able to provide healthcare and education services to everyone on Vashon, despite financial means or other barriers. We do not have medicaid caps, we are contracted with most all major insurance companies, we provide scholarships through our Health Equity Fund for all programs and services, and we have a no questions asked policy around community members receiving scholarships for their care. It is our priority to ensure that the resident’s of Vashon have access to high-value healthcare needs, as a basic human right.


-Integrated Mental Health Program: We have a Clinical Marriage and Family Therapist who specializes in the perinatal timeframe (preconception to postpartum/parenting) who provides mental healthcare to our midwifery clients routinely, as an integrated part of their routine midwifery care.


-Viable Practice Model of our Specialty Island Healthcare Providers & Educators: With health equity as a priority in our organization, all services provided through the Vashon Island Midwifery center become accessible to all island residents by way of the Health Equity Fund. The contracted providers/educators receive their fee for service rate, despite what the client is able to pay. This model helps to ensure that our resident providers and educators are able to continue making their services available on Vashon, by ensuring that they are compensated appropriately.


- Two Different Midwifery Programs: While we offer a comprehensive home birth midwifery practice model here at Vashon Island Midwifery, we also offer a Collaborative, or “Co-Care”, model of midwifery that is specifically designed for our ferry-access-only population. This model of care is designed to create accessibility and convenience for island families who desire or require an off-island birth at a birth center or hospital. We have invested much time and energy in creating relationships and contracts with off-island providers and facilities for a seamless prenatal, birth, and postpartum experience. Our co-care clients are able to receive prenatal, postpartum and newborn care on island, from their home and the clinic, and then transfer to their delivering provider in their third trimester in preparation for their birth. Who doesn’t want to save money on ferry rides and urban traffic in their pregnancy, and then postpartum, with a newborn?! We also offer doula services for this model which allows the client to have myself attend their birth in a doula capacity, for continuity of care all throughout the experience.


What are your long term goals for Vashon Island Midwifery?


Lauren: We hope to expand the number of Vashon families we are serving, and to expand the services we provide. We are currently negotiating contracts with providers who can offer well-person (gyn) care, and we are looking for a pediatrician who could offer a couple days a month on island.


Katelyn: We would love to have a centralized center in town, that can house larger educational classes, groups, and host various providers in different clinic rooms. This larger center will help us to realize the vision of a central “hub” for all perinatal and reproductive professionals to come into and bring their services forward to the Vashon community. Additionally, we would like to be the home of a resident pediatric practice, continue to serve any and all Vashon birthing families, despite their desired birth location, and expand our reproductive healthcare and education offerings to meet the needs of the teenage population on Vashon.


What has been the most surprising thing about starting a nonprofit organization?


Lauren: Twofold: the amount of paperwork, and the amount of support. The community has been so thoughtful, supportive and excited for this venture, it really warms my heart.


Katelyn: It is a monumental feat to start a nonprofit organization. There are some days where I cannot believe how many pieces are in place to hold this nonprofit together. Yet, in the same way that all of this feels impossible at times, it also feels entirely possible because it requires so many people’s involvement and thus I feel entirely held and in community with this group of leaders who have elected to step in, in support of a shared vision for the Vashon community. To see one’s personal passions paralleled by others who have unique experiences and gifts to bring forth this organization, creates endless possibilities and exponential avenues for growth.


What does community mean to you?


Lauren: Community to me is the acknowledgement that we will all face challenges in our lives, and those who are on stable footing reach out a hand to those whose ground has gotten a little wobbly. Community is the safety net that sustains us all!


Katelyn: Community is a place; it is a home. This community, the Vashon community, is where I live and raise my children. This community is the soil that our food grows from, the water that we drink, and the culture that we think. We are Vashon and Vashon is us by simply residing here. We are fed by living here and we will continue to show up as active participants here so that this community continues to be a place that feeds us ALL. It is a great privilege and it is a great responsibility to be of a community that cares for one another. That is how I see the culture of the Vashon community, one that has great capacity to care for each other. So, as we create a community center, Vashon Island Midwifery, we apply that very mindset in our effort and our action. We are here to care for others and by the very nature of that, we are in return, taken care of.


What is one thing you love about Vashon Island?


Lauren: I love that living here has given me the opportunity to feel friendly with our resident and transient whales, and the wild creatures with whom I share my property! I love that there are several deer I know by sight, and families of birds we have watched raise generation after generation. And I love that when I go to Thriftway, I usually see a family or two I have worked with and helped to grow. That's the best feeling in the world!


Katelyn: I would say that my very favorite thing about Vashon, is this community’s capacity to care for one another. In addition to that, I feel so grateful every day for our neighborhood farmers who grow our food, the body of water that surrounds us, and the views of Mt. Rainier. Also, I love the opportunities my children have to run in nature and explore their curiosities of the wild world.


Where are you located and how can interested folks make an appointment or view your offerings?


We offer home visits for some services and the rest are provided in our clinic space, north of the town, close to the Vashon Highway. Our clinic is open by appointment only.


Offerings change frequently, but a detailed list is always available on our website, where we provide access to online bookings. www.vashonislandmidwifery.com


[Current classes and support groups include a childbirth preparation class, preconception & fertilify workshop, pregnancy and postpartum support groups, lactation lounge, and more - meeting virtually for the time being!]

Thanks again to Lauren and Katelyn for agreeing to be interviewed and offering information and insight into their wonderful new organization! I am excited to see them grow. I especially love Lauren's quote: "We have created an integrated mental health program so that all of our clients have access to a mental health provider for preventative or therapeutic health care. Due to our non-profit model, and being eligible for grants and donations, we are able to accept every client into care. No one is turned away from any program or service for lack of funds."


I would love to see other care providers provide a similar approach to healthcare - prioritizing the whole person (including mental health!), the community, and equity in their care. If you feel inspired by what Vashon Island Midwifery is working on and have the means to contribute financially (or otherwise), please consider donating on their website!


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