Marlee: Midwife, Advocate, and Beyond

Editor’s note: Be on the lookout for other writing from Marlee coming to the blog soon! And go ahead and schedule a consult call with her today :)

Marlee Nelson, Independent Patient Advocate at Lost Coast Advocacy

Hello, all! My name is Marlee Nelson and I am a former licensed midwife and current independent patient advocate with LCA. In my free time I enjoy going on walks, cooking, baking, and watching movies. I have a partner and three pets - two cats and a bearded dragon! Currently, I live in Humboldt County, CA.

Let’s chat a bit more about my background. Licensed midwives (LM) are a bit different than nurse midwives (CNM). LMs practice out-of-hospital, meaning we attend home births and births at freestanding birth centers. CNMs tend to practice in the hospital setting. 

I became a licensed midwife because it is a field that fills my cup and sparks my interest. I first discovered midwifery as a teenager watching a home birth video on Youtube. My eyes were opened to the vast possibilities of choice in healthcare. I realized that you get to choose your path. The way the midwives in the video supported the birthing person’s decisions was incredibly compelling and something that I hadn’t yet experienced or witnessed in healthcare. 

I value the holistic approach that licensed midwives take. To be able to blend allopathic (western) medicine with more holistic, integrative medicine just made sense to me. Using these modalities to support folks in their tender, childbearing year was an absolute privilege and joy during training and clinical practice. There is something very special about being one of the first people to hear a baby’s heartbeat and then hearing the baby’s first cries and seeing their growth as newborns. Simultaneously, seeing people transform into parents and witnessing labor as a transformative and empowering event was beyond powerful. During my time as a midwife I delivered approximately 200 babies. Each birth was unique and memorable in its own way. Patient advocacy can mirror these transformative changes as clients become more comfortable being their own advocates. 

I also witnessed flaws and inadequacies in our healthcare systems. These challenges were particularly glaring here in Humboldt County, a rural area with limited healthcare access. You’ll notice that I use the word client instead of patient. Patient inherently denotes a power imbalance. As licensed midwives and health advocates, we want to promote autonomy, so the term client is used to help soften imbalanced power dynamics. It is about shared-decision making, not control. 

The midwifery model of care involves informed consent at every turn. This means that we delivered the information - risks, benefits, and alternatives - and the client had the ability to make the decision that felt best for them. Hospitals do not always work this way, but we have to work with hospitals because not everyone is safe for out-of-hospital care. Seeing the differences between our care and hospital-based care (both in Humboldt and Seattle where I previously worked) was stark and sometimes shocking. Don’t get me wrong, there were many excellent hospital-based providers and interactions, but there were also many that were lacking and negatively impacted a client’s experience and care. 

All that to say that I’ve encountered the system when it works and when it doesn’t. I’ve worked outside of the system whilst supporting people who needed to be on the inside. Advocacy was inherently baked into my education and clinical practice. So, when it was time for me to leave midwifery due to burnout, independent patient advocacy seemed like a good fit. 

My primary interests as a patient advocate are with fertility, complex pregnancies and postpartum, newborns, and general women’s health. I also have a passion for mental health and wrote my master’s thesis on caring for pregnant people with bipolar disorder in the community midwifery setting. I created a curriculum for providers, as well as a tool to help plan for mood support during pregnancy and postpartum.

Much of my work with Lost Coast Advocacy involves records acquisition and management, synthesizing and summarizing medical records, organizational work, appointment accompaniment, collaborative problem-solving, and more. I enjoy this work because I still get to be involved with healthcare, but don’t have to worry about being on call or losing sleep! 

Going forward, I plan to develop my career with continuing education. I am planning to go back to school to be a nurse practitioner. This work will allow me to be an advocate inside of the system and return to clinical practice in women’s health. I still plan to work with LCA part-time while I am in school and post-graduation. I am excited at the prospect of providing clinical care that is truly enveloped in informed choice and shared decision making. My advocacy skills will benefit me greatly during this work. 

It is a privilege to be able to do this work. I thank everyone who has trusted me to participate in their care. Working on a team with Lauren has been great. As they say, two brains are better than one. I look forward to continuing to work with LCA and with every person who asks for our support.