Kaiser Permanente Redwood City provides around-the-clock midwifery services

At Kaiser Redwood City, its extensive midwifery services has established its prominent reputation attracting pregnant people from around the Bay Area, Westerlund said. Almost like a “little private practice,” the Redwood City location allows patients to see a midwife all the way through their care. 

“[Patients] can remember their birth story from 40 years ago, what happened,” Westerlund said. “So we’re really also about, ‘let’s make sure this experience is as best as it can be.’” 

As access to maternity care has wavered — 50 maternity wards have shut down in California in the last decade, according to CalMatters — and reproductive care remains at the forefront of political battles, the midwifery profession has seen a slight increase in attention. 

Just 30 years ago when Westerlund was first starting out, there were about 3,000 midwives across the country. Now, there are nearly 14,000, but many remain unfamiliar with what a midwife really does. Westerlund said the value in receiving care from a midwife comes down to one major ethos of the practice. 

“It’s not a procedure, it’s a life event,” she said. 

Not to be confused with a doula, who has no medical training, certified nurse-midwives have completed nursing school and also received a master’s degree. While few do home births, most work in hospitals. 

In addition to labor and delivery care, midwives also often do prenatal appointments and teach various classes across hospital locations. At Redwood City, the midwifery team also leads classes to address parent concerns before birth as well as the realities postpartum. 

The maternity care unit at Kaiser Redwood City “operates so well” because of its utilization of midwives and its collaboration among its care teams, OB-GYN Dr. Jennifer Isaacs said, who works out of the San Mateo medical offices. 

“They’re experts in this specific timeframe of people’s lives and they have a lot of experience seeing the breadth of changes and challenges that happen when people are pregnant,” Isaacs said. “You have to be passionate about this timeframe in order to want to do this.” 

As strong advocates for patients during this time in their life, Kaiser looks to promote their midwives as much as possible. While many obstetric-gynecological physicians may work in labor and delivery, having midwives available to care for “normal births” allows physicians to prioritize treating patients with more complications, Isaacs said. 

The goal of a midwife, Westerlund said, is to respect the emotional, educational, physical and cultural wishes of the person giving birth. 

“There might be a medical complication, something might go awry, but it’s still their birth,” Westerlund said. “We want to make it that special, and keep guard on that birth experience as much as we can.” 

Research has found that low-risk pregnant people with no known medical complications who deliver and receive care from midwives tend to have fewer interventions and cesarean sections than those who receive care from obstetricians.  

While those who seek care from midwives may already be more committed to having a natural, vaginal birth, Westerlund said most of the job is empowering the patient to trust in their body. 

“People transform themselves through birth,” she said. “Doing this experience and birthing their babies, they feel so powerful and empowered at the end of it and we want that to be able to happen for them.” 

When she first entered the practice, Westerlund said maternity care was approached through a mere delivery and procedure lens. The evolution and growth of the midwifery practice hopes to place the person who is pregnant at the center of decision making. 

“When something is being done to you like a procedure, it’s being done to you,” Westerlund said. “But your body is made to do this. We’re there to support you to help you feel good about your body doing this.” 

As mental and emotional health become more prominent discussions when approaching holistic health of patients across specialties, midwifery services at Redwood City have grown accordingly. 

Centering prenatal care is one service where interested patients can come in for their prenatal visits and work closely with midwives, or at times doctors who may lead a class, to prepare for birth. These visits allow pregnant people to connect with the midwives within the hospital, Westerlund said, alongside seven other couples who are in the same gestational period. 

While centering is a practice at many birthing centers, Kaiser Redwood City felt there were still needs that were not fully met. 

“This just comes from us looking to see what can we do better, what are our patients needing, where’s the gap that we could fill in,” Westerlund said, who felt the period after birth and the first postpartum checkup was a void of support. “Of course the bottom line is healthy mom, healthy baby — that’s baseline — but then there’s all this other stuff that you really want to add and think of to enhance their experience.”

Two classes more unique to the location include one called “Meet the Midwives” where interested patients who often come from other hospital sites can learn from the midwives at Redwood City. Another class addresses the realities of postpartum, from body image to depression, through honest and personal anecdotes from midwives who have birthed and breastfed. 

“They’re really talking about the reality of what it’s like, that it’s not all the glamor but what it really could be like,” Westerlund said. 

The Redwood City location was the first site to offer midwifery services at any Northern California Kaiser location. Three decades since this pilot program, each Northern California location now has at least one midwife at its facility, Westerlund said. 

“I’ve always been one to want to forge the path, to make things better, to get the word out because I thought what we do is so useful and helpful,” Westerlund said. “If we just let patients know what we do and we work well without doctor partners, we can be a team during this process.”