Our Story
Welcome to our website and thank you for visiting!
My name is Nicole Werner, and I am the Director General of the Costalegre Cliníca de Maternidad. In this first blog post, I will tell the story of how this clinic went from being a vague dream of a student midwife to reality, and I will share a bit about the framework that will guide the care we provide at our clinic.
I was born and raised in Pennsylvania, and I attended university in the state of North Carolina. I fell in love with the field of psychology, and after graduating with my Bachelor’s degree, I entered a doctorate program in child psychology at the University of Minnesota. After getting married and giving birth to my first child (Lena, born in 2000), I accepted a professor position at Washington State University in 2002. For the next ten years, I taught classes on child development, family relationships, and prevention program development, and I conducted research that focused on children’s peer relationships. I also gave birth to two more children (Zoe, 2002, and Kai, 2004). I enjoyed my work, but after taking a year-long sabbatical in 2010, I realized that I was unfulfilled as a college professor and wanted to make a career change.
I always had a passion for childbirth, having birthed my last two children at home under the care of a midwife, and so I decided to train as a birth doula and childbirth educator. A birth doula is a person trained to support women, physically and emotionally, during pregnancy and childbirth. They are not medical providers, but nonetheless, research has shown that women who have a doula by their side have labors that are shorter and require fewer interventions, and these women are also more likely to have a vaginal birth. Importantly, doula support is linked to greater satisfaction with the experience of giving birth. From 2012-2019, I attended more than 150 births as a doula, and a I learned a great deal about women’s needs during pregnancy and birth. I also taught self-designed childbirth preparation courses, took several Spinning Babies trainings, and became an Evidence Based Birth Instructor. I loved working in these important roles!
A turning point came for me when I volunteered as doula for the organization Dar a Luz Honduras. I traveled to the city of La Ceiba and supported Honduran women who were birthing in a public hospital. It was there that I came face to face with the reality of childbirth for women in many places around the world. These women birthed alone, without support from their partners, family, or friends. They were forced to lie on their backs during labor and delivery. They were subject to countless interventions not supported by the research evidence for routine use, including episiotomies, fundal pressure, and the use of forceps to deliver the baby. Informed consent for vaginal exams and other interventions were not practiced, and women were often treated harshly by the medical providers. The hospital where I worked was severely understaffed and the facility was lacking in many basic provisions, such as privacy curtains, mattress covers, and toilet facilities for patients.
It was in Honduras that I realized that, if I wanted to be a part of real change in how women give birth, I needed to become a medical provider, someone who could work to improve conditions for women from the inside of the system.
I returned home from Honduras and resumed my work as a birth doula and educator, but in the back of my mind I had already decided that I wanted to return to school and study to become a midwife. It took me another 4 years to finally take that leap of faith, and at the age of 47, I enrolled in Mercy in Action College of Midwifery on track to earn a bachelor’s degree.
What is a midwife?
I want to digress a bit from my story to talk about what exactly a midwife is. I realize that some of our readers might not know how a midwife is different from a birth doula and an obstetrician. Whereas a birth doula is not a medical professional, a midwife is a trained care provider whose primary responsibility is ensuring the health of the mother and newborn. Midwives are experts in normal birth in women who are generally healthy and have healthy pregnancies.
The midwifery model of care
Midwives practice using the “Midwives Model of Care”, which takes a holistic approach to maternity care by monitoring physical, psychological, and social well-being of the expectant mother throughout pregnancy, birth, and postpartum. This model emphasizes individualized, women-centered care, and focuses on the rights and responsibilities of the client and midwife when making decisions about a client’s care. Midwives are trained in the use of medical technology, but they avoid the overuse of interventions, something that is common in most hospital settings. Finally, midwives are skilled in identifying and referring women who present with risk factors to obstetricians who are experts in high-risk pregnancy.
In the United States, there are two different types of midwives – one who attends nursing school first and then obtains a master’s degree in midwifery (a nurse midwife), and another that enters midwifery school directly (most schools grant an associate or bachelor’s degree) and completes a minimum of two years of practical training as a midwife under supervision (certified professional and/or licensed midwife). Nurse midwives may attend births in hospitals, birth centers, or home, whereas certified professional/licensed midwives may attend births in birth centers or home only.
Midwifery in Mexico
In Mexico, we see even more types of midwives, including traditional midwives, professional midwives, autonomous certified midwives, and obstetric nurses. Whereas traditional midwives have a long history in Mexico, the other types of midwives have emerged more recently. Despite Mexico’s progress in the last 30 years in reducing maternal mortality and advancing coverage and quality of services, significant gaps remain in the access to skilled maternal healthcare services. The Mexican government is responding, in part, by strengthening the role of professional midwives in the continuum of women’s healthcare. Research worldwide has shown that investment in a well-trained and well-coordinated midwifery system is a cost-effective strategy to improve the quality of care for women and newborns.
Returning to my personal story, I completed my bachelor’s degree in midwifery in 2022 and became a Certified Professional Midwife in early 2023 after completing a three-year long residency in four different states (Washington, Idaho, Oregon and Texas). My training was focused on global maternal and child health, and many of my mentors are global leaders in expanding midwifery care in low resource countries around the world. I began to envision opening a birth center in Mexico about half-way through my training. My parents bought a home in La Manzanilla in 2019, which is what brought me to this community for the first time. I quickly fell in love with the people, the way of life, and the beautiful nature.
The birth of Costalegre Clinica de Maternidad
I realized that this was the place where I could pursue my dream of building a state of the art, not-for-profit, midwife-led clinic, where women in the Costalegre region of Jalisco could receive care during their pregnancies. I met an amazing contractor, Juan Pablo Garcia of La Manzanilla Life, and we began to make plans to build the clinic. We started construction in August, 2023 after a lengthy period of networking, creating our architectural plans, and securing permits. The team is making excellent progress, to date, and our hope is that we will open the doors to the Costalegre Cliníca de Maternidad in early 2025.