LA Midwife Interview Series: Catherine Williams, LM
BY: REBECCA BELENKY, BIRTH AND POSTPARTUM DOULA AT LOS ANGELES BIRTH
For the Midwives of Los Angeles interview series, I sat down with Catherine Williams, LM, owner of Home Birth Service of LA.
Catherine has been practicing midwifery for 25 years and has attended around 1,000 out-of-hospital births. She sees clients in her Sherman Oaks office for prenatal and well-woman care and attends home births throughout Los Angeles and Ventura Counties.
I met with Catherine in her office in August 2026 and was immediately struck by her warmth, her humor, and her deep respect for the families in her care. We talked about what safety really looks like at a home birth, when hospital transfer becomes the right choice, informed consent, VBAC, and why sometimes the most important thing a midwife can do is simply sit on her hands and let birth unfold.
What kept coming up in our conversation was trust—trust between a midwife and her client, trust in good information and honest conversation, and trust in birth without pretending that it’s entirely predictable.
Here is an excerpt from our conversation.
Midwife Catherine Williams at a homebirth in Los Angeles, CA
REBECCA: As a birth doula, I get to see midwives in action, so I deeply appreciate how different midwives show up for a home birth. I’m curious how you see yourself. If someone were observing you at a birth, Catherine, what would they see? How would we see your philosophy playing out in the birth space?
CATHERINE: That it’s not about me at all, I am in the background. What I would hope is that my presence at the birth creates a boundary of safety where the birthing woman feels the freedom to do whatever she needs to do to have the baby. For example, one of the great things about the handheld Doppler we use to listen to the baby’s heartbeat is that it’s so small. If the mom is on her hands and knees in the coat closet howling at the moon, I can get in there, listen with the Doppler, and sneak away without being disruptive. If the couple's working well together, or with their doula or other support, I really don't interfere. I'm respectfully observing and listening, setting up my gear, charting, assessing, and making adjustments when things seem to be straying from that path of normal.
REBECCA: Wait, that move you just did with your hands makes it seem like you chart on paper? Do you handwrite your charts?
CATHERINE: (laughing) Yes. I might be the last paper charter out there, but I hate that feeling of a screen being between me and the couple at appointments, or being at a birth and tapping on my laptop. It feels like a barrier.
REBECCA: Oh gosh. I have not even considered that; I just sort of accepted the tapping as necessary, but I agree it can be distracting. Hm. I think that is very considerate of you and speaks to how aware you are of the presence you bring to the space.
I am curious what people say they are surprised by when they have a home birth with you?
CATHERINE: As I was leaving a birth recently, the dad said, “Oh! That’s what all those appointments were about!”
How calm it is. How normal it seemed, how supported they felt, that it was hard work. The empowerment and pride that they feel, the moment when a woman is holding her baby for the first time, and she looks up at her partner and says, “I did it,” is exactly why I do this. It is an honor to bear witness to that transformative moment. Especially when I've done more than one birth for a family, when they come back for the second or third, I get to see the growth as a person and a mother, the wisdom that’s accumulated in the interval. The journey is so beautiful.
REBECCA: Yeah, having repeat clients is such a special experience. You have been doing this for a long time! How many births have you been to as a midwife?
CATHERINE: In 25 years of practice, I've attended around a thousand. I mean, that's all out-of-hospital births. My friend who was a labor and delivery nurse at Cedars texted me, "24 babies this shift,” and I'm like, I'll never again complain about having 4 in 48 hours.
REBECCA: First, that's cute how you are downplaying that, but you were with ONE THOUSAND babies as they came into the world. That is a TON of prenatal care, consulting, phone calls, text messages, labors. You have been woken up by a lot of people!
CATHERINE: It’s a LOT of conversation. Because, like all relationships, it’s all about the conversations, right? I schedule an hour for each prenatal. The medical part takes 10 minutes. The rest of the time we’re talking about where she’s at in the pregnancy, nutrition, lab work, preparation for the birth, what’s going on in her life… space for questions and concerns to come up. All of it helps me take better care of her. I want to be hearing about a woman’s preferences for her birth: who’s going to be there, if she wants pictures, water birth. What is her dream birth? I’ll do my best to make sure that happens so long as the answer to the question “is it safe?” is yes.
REBECCA: I think one of the big questions people learning about midwifery care have is about the safety of home birth. In the US, we are mostly acquainted with the OB model and GOING somewhere to have a baby, most often a hospital. How do you address questions of safety and homebirth with families? If you are pro-homebirth, do you have to be anti-hospital?
CATHERINE: As with most things, the data is complicated and nuanced, and couples have to be comfortable with a choice that’s outside the norm. Home birth is appropriate for healthy pregnancies if three factors are in place: that it is a planned home birth, meaning the baby didn’t just fall out, and the parents are saying “please breathe” if it is attended by a well-trained midwife or doctor that does home birth; and if the place of birth is within 30 minutes of a hospital. It’s a myth about home birth midwives: that we’re anti-hospital. Access to higher-level care is what makes what I do safe. We’re not taking unnecessary risks at home; if the baby’s heart rate doesn’t sound good, we’re going in. I’m not just going to wave sage over you and hope it gets better.
REBECCA: Right. That's really important for you to say out loud because I think some people assume every midwife is very woo-woo. My husband always asks me if I have my rain stick packed when I am heading off to a birth. (both laughing) I don’t actually have one, of course, but he thinks that is so funny. Can you share what medical tools you bring along to a birth at home?
CATHERINE: I mentioned the Doppler, that’s our main way of knowing the baby’s well-being. All birth attendants are trained in CPR and neonatal resuscitation and we bring equipment for that: suction devices to clear the baby’s airway, ambu bag to inflate the baby’s lungs if it’s needing some help to start breathing on its own, an LMA [A Laryngeal Mask Airway] to keep the airway open. Oxygen. We carry IV equipment for hydration or to administer antibiotics during labor for GBS if the mother chooses. We carry 4 medications for postpartum hemorrhage: Pitocin, methergine, misoprostol, TXA, also given by IV. We’ll do everything we can to prevent tearing but if stitches are needed we can suture and have lidocaine for that. There are a few other odds and ends. Pulse oximeter. Newborn medications. Really, our most important equipment: our hands and our knowledge, and knowing when to sit on our hands and do nothing.
REBECCA: Are those the same medications that would be used in a hospital or birth center setting?
CATHERINE: It’s fairly standard among home birth and birth center midwives. Hospitals have additional anti-hemorrhagics like hemabate. To be clear, none of this is used routinely; it’s there if we need it. Most of the medications expire before I have a chance to use them up. Some herbal tinctures are helpful, too.
REBECCA: Do you have a sense, let’s say out of 100 homebirths, how often there is an urgent situation that warrants these tools you outlined above?
CATHERINE: Maybe 10 out of 100 might need some kind of uterotonic, but there’s a lot of variation in there, from a single IM shot to full IV for pit or TXA, which may be 1 in 200?
REBECCA: You already mentioned that you feel like you can do your job because there are OBs and midwives in the hospital who you can transfer your clients to if they need tools only available in the hospital. How often does transfer to the hospital happen in your practice? Do you think of a transfer as an emergency?
CATHERINE: No, transfers are rarely emergencies. The practice has about an 8% transfer rate in labor. The vast majority of those are first-time moms. A typical transfer is a labor that goes on and on, a couple of days go by, her cervical dilation stalls at 6 cm, or she’s been pushing for hours with no progress. Most of the time this is due to malposition, like the baby is posterior or the head is asynclitic, meaning tilted to one side. We do what we can to prevent this during pregnancy but sometimes the baby is sucking on its hand, there’s nothing to do about that! These babies usually birth at home anyway but sometimes it makes for a really hard labor and we need some help. Then what the hospital has to offer are excellent tools that can still help her have a vaginal delivery. It’s disappointing but it’s not dramatic. We cry a little, gather phone chargers, get in the car, and drive over. I find that if we go in and get the epidural and augmentation, most women feel those interventions were really necessary. If the baby is born surgically, they know everything possible was done and that was necessary. Every intervention has its good use and, of course, its abuse.
So far as the term “emergency” goes, that’s really what you have the midwife there for. At the most basic level, every midwife is trained to handle the three big complications that can happen without risk factors or warning: shoulder dystocia, neonatal resuscitation, and maternal hemorrhage. We do a lot of other stuff, but those are the things that are very rare, but you don’t have time to get to the hospital for by car or ambulance.
REBECCA: Something that has been on my mind lately is the amount of information that most pregnant couples are bombarded with, and whether it is actually helpful. When we were talking earlier, you mentioned your early experience as a midwife at a hospital in Jamaica. What struck me about that was that those birthing women were probably not pouring over research and evidence of different birth choices. So many times I witness my clients getting caught up in the information and research, and they find it challenging to come back from the numbers with more confidence or trust in the process. I think humans are seeking certainty. They're craving something black and white, but it isn't always that neat. I think most birthworkers would agreen that “information is power,” but sometimes I think overthinking is the enemy of birth. Can you help me make sense of this?
CATHERINE: There’s a lot to unpack here. You’re right; how can we get out of our own way? That search for certainty is an effort to soothe dysregulation, right? It’s a legitimate response to obstetric care that has not respected women. And then the rise of social media muddies the waters even further and affects our trust in the process and our own intuition. I’d rephrase that as: quality information, not too much of it, is power. So we’re back to the importance of conversation, and having a provider that you trust to have that conversation with. If my client is seeing something that interests her or alarms her, let’s talk about it. I could learn something, too!
A good example is a few years ago when I was getting questions about the use of postpartum pitocin; it became clear that there was a lot of misinformation out there. Context is everything: explaining that it’s not always used, when it would be necessary, and what non-pharmacological options exist was really helpful. There is nuance and subtlety that is lost in a post or podcast. The conversation is essential and at the core of informed consent. At any point in the pregnancy when a test or procedure comes up, we’ll talk about the standard of care and why we do this test; here are the benefits of the test; the risks of not doing the test; here are your options for the test. And to present this information as objectively as possible and to also convey that the desired outcome is not guaranteed, the uncertainty. Whatever experience and expertise I bring to the table, I trust the woman to have experience and expertise in herself and what’s right for her, and my role is to respect her autonomy. In fact, that goes both ways; we both have to feel safe. Different midwives have different boundaries around choices their clients make, and that’s ok, too. We are lucky to live in Los Angeles where there are a lot of midwives; there’s a good fit for everyone.
REBECCA: How do you support families who want to give birth at home, who have had a cesarean before? Does that look any different? Do you consider someone who is pursuing a VBAC (Vaginal Birth After Cesarean) a high-risk pregnancy?
CATHERINE: This is a great example of different midwives having their risk levels. For me, it is a single previous cesarean and the reason for it. If they labored, I am fairly comfortable with VBAC. I attend one or two a year. We go over a detailed informed consent, and we rule out placenta accreta at the uterine scar by ultrasound. Also, I am being very conservative about midwifery induction methods.
REBECCA: I am glad we got to meet up today. Do you have any parting thoughts you want to share with us? Maybe it's something that is on your mind, or some thoughts that were sparked by our conversation?
CATHERINE: Well, I’m noticing the word “trust” coming up a lot in this conversation and what it means to me. It means feeling safe, and my hope is that every woman, no matter where she decides to give birth, feels safe with her care provider, that you’re in it together. We’ve talked about the beauty of home birth and times when it’s not so straightforward. Every birth is a teacher, and we can do everything “right,” and it still has its own path. I trust birth, I respect birth, and I listen to birth.
REBECCA: Well, thank you so much for talking with me today, Catherine. I could talk about birth with you all day long!
CATHERINE: Rebecca, I feel the same! Thank you for the opportunity.
Catherine Williams, Licensed Midwife
Catherine Williams is a midwife and owner of Home Birth Service of LA.
She sees families out of her midwifery office in the Pondella Building,
13743 Riverside Dr., Sherman Oaks, CA 91423
Website: https://homebirthservice.com/
Instagram: @homebirthservicela
✨ Continue Exploring Birth, Labor, and Support in Los Angeles
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An overview of hospitals, birth centers, and home birth options across the LA area.
Second Labors: What You Need to Know About Birthing Again
Learn about common labor patterns and how to prepare for your next labor.
Understanding Birth Doula Packages
Useful for understanding how doulas create their birth packages.
Supportive, evidence-based guidance for families planning a VBAC.
About Rebecca Belenky
Rebecca Belenky is a Los Angeles–based birth and postpartum doula, childbirth educator, and lactation educator who has been supporting families since 2014. Through her practice, Los Angeles Birth, she offers compassionate, trauma-informed care that helps parents to feel informed, grounded, and confident throughout pregnancy, birth, and the postpartum journey.
