We had the good fortune of connecting with P Fadwah Halaby and we’ve shared our conversation below.

Hi Fadwah, how do you think about risk?

The concept of risk plays a central role in my life as well as my career and business. I’ve always been a willing risk taker and for the most part it has payed off for me. For example, after extensive research into the state of birth in our culture back in the early 80’s, I chose to provide my own prenatal care (knowing I was a healthy, young woman with a natural, healthy lifestyle) and birth my baby at home with just myself and my partner. This is now known as ‘free birth’, although I didn’t realize that what I was doing would eventually become a movement among dissatisfied birth consumers. And, as a Certified Nurse Midwife who provides assistance for people to birth outside the system, I cannot condone free birth as I believe the risk is too great for some who don’t realize the risk they are taking. In our current practice model we take on the risk with our clients after providing in depth prenatal testing tominimize the risks by knowing as much as we can about the status of their health. In addition, we educate our clients regarding what to expect and what they can do to prepare themselves for the event. In my case, I sustained a severe vaginal laceration that had to heal on its own without being repaired. If I had had a capable, knowledgeable birth attendant, I would have had the opportunity to have the repair and subsequently a more comfortable post partum healing experience. My baby didn’t need any resuscitation, and I did not suffer an extreme amount of blood loss – both fairly common events at a birth.

There are other instances of risk taking in my life: I packed up everything I owned at the young age of 19 and drove across the country to start a new life in Olympia, Washington where I was able to establish residency and enter college at The Evergreen State College – a newer, alternative, state college where I obtained an amazing education in basic sciences and nutrition. Evergreen was an experiment that still exists and is now a strong, respected institution.
In the mid 90’s I lived a homesteading, mountain lifestyle with my native American partner and our blended family of 9 children. We built a 40ft geodesic dome home with the help of friends and neighbors and raised our children in a natural, roots existence with a Native American spiritual foundation and very little finances. Our kids are all now adults; amazing individuals who benefitted from our taking the risk to struggle in that way and who have thanked us often for the experiences they had growing up in the mountains.
I started Midwife360 in 2014 with no experience of running my own health business and no examples of others doing what I wanted to do – a full scope nurse practitioner practice offering not only home and hospital birth services, but holistic GYN care as well. This was a huge risk at the time. Women have flocked to me because our health system does not value treating them with respect and love – helping them to trust their bodies and learn to take care of themselves in a more natural way, a key component of what we offer at Midwife360.
Risk taking is something we all do every day – every time you get into your car, or an airplane, every time you speak to a stranger, every time you try something new. We cannot avoid risk. And if you think you can, then you definitely should not even think about getting pregnant! Having a baby is fraught with risk, so your best bet is to minimize that risk by educating yourself, choosing a provider who you can trust, and shifting into a natural, healthy lifestyle!

Can you give our readers an introduction to your business? Maybe you can share a bit about what you do and what sets you apart from others?
Midwife360 has been my brainchild and my baby for the past 7 years. I have had help from several amazing women along the way who have held down the administrative assistant position – Vanessa and Sandra for the longest time. They made it possible for me to provide the clinical care and spend the time with women birthing their babies in their homes or at the hospital. It has been a long road, and extremely difficult at times. The hardest part was learning about insurance billing, and I have wished more than once that I had never started down that path. I believe that our system of health insurance is broken and does not serve anyone except for the trifecta of insurance/pharmaceutical/hospital industrial complexes. So it has been a struggle to find a way to benefit from taking insurance. I finally have a fairly good system that employs the efforts of my admin assistants along with a billing service that understands the nature of the work we do and we are successful in our efforts. We get about half to three quarters of our self pay rate, and that is an improvement from the early days. I am not proud of participating with this broken system, but most of our clients come in with insurance and want to make use of what they are already paying for, so we do our best to make it work.

In the early days, I was a solo provider – taking care of all of the clients by myself and attending all of the births. In 2018 I was able to add another Nurse midwife who trained and worked with me for about a year and a half. I still went to all the births as she was a new grad who needed hands on experience to become confident in the role as primary provider. She did gain that experience and confidence, but business was slow and she was eager to move on to greener pastures.  We agreed to part ways in early 2020 – just prior to the arrival of COVID and all of the changes that has brought to our world. After about 8 months working for another practice in the area, she came back to me and has been an integral member of the team – providing excellent well-woman and primary midwifery care to our lovely clients. In May of this year I was able to add a third CNM who moved from southern California to join us. She is also an excellent clinician and midwife and it is only with the addition of the 3rd midwife that I am able to concentrate on how to successfully grow the business as it seems to be needing to grow. I no longer attend every birth, as we have a call schedule that allows for some time off for each of us. I have seen that our clients are still quite satisfied with the level of care they are getting no matter which midwife is caring for them. This is reassuring as the business owner who has worked hard at building a reputation of safety and excellence in the care we provide.

COVID has taken Midwife360 to a new level of busyness – we have triple the number of pregnant clients in care at any one time. And we have gotten to the point of starting to turn people away due to reaching the maximum number of people due per month that our team is comfortable caring for. This has not set well for me as the business owner. While I want my team to be happy, I also want my business to grow as it is naturally trying to do. So I am now working with a business coach to develop a revolutionary concept of providing care to more people, adding more midwives to the team, and still maintaining the level of intimacy required by both our clients and the midwives. I am super excited and working through all the steps so that we will no longer have to turn people away. Our service is Community Birth (birth outside the hospital). So it makes sense for us to also be in the business of building community for our clients – that is going to be a big part of our new paradigm.

As the risk taker that I am, I also support clients that cannot otherwise get the support they want for a natural vaginal birth. I have cared for clients with a history of one or more cesareans, those with twins or a breech baby, and those that want to birth in nature. I have also served clients who are over 40, who have a high BMI, or other medical diagnoses and can’t find a provider to support them in a natural birth or don’t trust the system for one reason or another. We don’t take these scenarios lightly, maintaining our high standards for healthy lifestyle and otherwise normal pregnancies is a prerequisite for helping them. This is something that I cannot ask anyone else on the team to take on, so I will do these births myself. I consider myself courageous and I trust women’s bodies and the birth process itself. This level of courage and trust has not failed me as we have had zero bad outcomes in all of the hundreds of women and babies we have supported.

Let’s say your best friend was visiting the area and you wanted to show them the best time ever. Where would you take them? Give us a little itinerary – say it was a week long trip, where would you eat, drink, visit, hang out, etc.
I really love downtown West Palm Beach for eating and night life. Avocado Grill is one of my favorite restaurants, and ER Bradleys often has good, danceable music. Now that Clematis By Night and the West Palm Farmers Market have reopened, things are beginning to feel more normal. Leilas Cafe has good Middle Eastern food and there are so many places to get good, vegan food. Planta and Christophers Kitchen are two of my favorites. Celis cafe makes the best Acai bowls I’ve ever had! An amazing hidden gem is Sunsport Naturist Campground where folks can find a safe, non-judgemental place to soak up sun in the nude and enjoy their pool, sauna and hot tub anytime, day or night. Another favorite activity is canoeing in the Everglades at Arthur B Marshall wildlife refuge in Boynton Beach or kayaking and hiking at John D MacArthur state park in North Palm Beach. Our new office is in a great area called Antique Row in south West Palm Beach and we keep finding new great cafes for lunch or dinner – 3 Natives, Aioli, Belle & Maxwells, Nomad all come to mind. I am moving to the area as well and am so excited to explore and find more wonderful, amazing locations.
Don Victorios farmers market has been a favorite of mine for years for affordable organic produce and they are not far from our new office as well.

Who else deserves some credit and recognition?
My story would be totally different if I had not been handed a copy of Spiritual Midwifery by Ina May Gaskin. That book has launched the careers of probably thousands of women into the natural birth world as doulas, professional or lay midwives, and nurse midwives. I am also appreciative of Frontier Nursing University for the excellent education they provide for nurse midwives and introducing them to community birth and birth centers. Finally, to the American College of Nurse Midwives (ACNM) as my national organization always striving to bring nurse midwifery into the limelight as a legitimate work force who support women and babies in our birth culture. I also would be remiss if I didn’t thank my children for supporting me, putting up with me, and sharing me with my passion to care for women and babies through the birthing process. My passions took me away from home and prevented me from attending some crucial activities while they were growing up. They still love and support my efforts and are my biggest cheerleaders! Saba, Xochitl, Senya, Kamal, Delia, and Amanda – I love you all and am forever grateful for the wonderful humans you turned out to be!

Website: www.midwife360.com

Instagram: instagram.com/midwife360

Twitter: twitter.com/midwife360

Facebook: facebook.com/midwife360/

Image Credits
1-3: Argon Agency https://argonagency.com 4-5: Jordan Brennan Photography https://www.facebook.com/jordanbrennanphotography 6: Anthony Bethel https://www.facebook.com/anthony.bethel.98 7: First Light Doula & Birth Photography https://www.facebook.com/firstlightdoulaservices 8: property of P Fadwah Halaby, interviewee

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