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Inspiring Conversations with Katrina Nakao of Pathways Midwifery

Today we’d like to introduce you to Katrina Nakao.

Hi Katrina, thanks for sharing your story with us. To start, maybe you can tell our readers some of your backstories.
This is a hard question for me to answer – it feels like I have always been, in some way, around birth! I think my interest in birth probably started because of my mother who is a rare natural-minded OB/GYN.

I worked summers doing office support in her practice in high school, and from there started learning about all of the different facets of birth support that are so woefully unpublicized to most of the American public. In college, I furthered my education by becoming a doula (a certified labor companion) and attending births as a volunteer with a hospital-based midwifery practice at my university.

It was only after my time as a doula that I realized I wanted to be more hands-on – I really feel strongly that all families deserve personalized care and a truly two-way, trusting environment with their providers.

I also realized that I feel very strongly about birth education: as a midwife, there is so much more collaboration with clients than can exist in a hospital-based setting. To use a term that has become more popular lately, midwifery really is a ‘concierge care’ service for everything you could need related to your pregnancy.

Now, as a midwife, I have operated my own private practice for about 3 years and I feel I am still learning and falling more and more in love with the profession every single day.

I’m sure you wouldn’t say it’s been obstacle-free, but so far would you say the journey has been a fairly smooth road?
In general, as with any small business, there have been a few bumps on the road, even if we’re still getting where I want to go!

One of the biggest challenges is that everything falls to me – I am doing all of the administrative work, all of the business work, and all of the care to provide well-rounded pregnancy support for my clients.

That being said, it gives me a great advantage in that I can develop a truly wonderful relationship with my clients. One of the biggest strengths of this kind of care is that when you hire me, you get me – you don’t have to deal with any other parties.

Another challenge is that babies come in waves – if you have four babies due in a month, they’re likely all going to be delivered within a week of each other. For instance, last summer, I had a relatively normal schedule of a few babies in June, a few in July, and a few in August.

(I take only about 2-4 clients a month so that I am able to give personalized care.) It ended up that I had nine births in July alone because babies like to stick together – midwifery can be challenging to schedule around!

Lastly, of course, I have to mention the pandemic. I started my business in the late summer of 2019 and had my first birth in early 2020. When the pandemic hit, we had people flocking to home birth in droves because they were fleeing the hospital.

That is wonderful because it has caused this huge expansion of people that are learning about home birth for the first time and it’s bringing in some new voices into the community, but it is also driving midwifery care up to and even beyond capacity given the number of midwives we have working in the area.

Alright, so let’s switch gears a bit and talk business. What should we know?
I believe in transparency, so all of my information is included on my website,

My package includes all standard prenatal care and post-partum care (with most visits in your home), regular availability for all routine questions, 24-hour availability in emergencies, in-home blood draws for lab work, and of course labor and birth support. All of this is geared toward providing the best care possible for low-risk pregnancies, which is what I serve as a midwife.

A big focus of my practice is what I call shared decision-making. I believe strongly that all people deserve to have evidence-based, personalized care.

I also see my role as a midwife as one of communicating evidence-based information and answering questions people may have so that we can work together on the best decisions for my clients and their pregnancies.

Do you have any memories from childhood that you can share with us?
I love to swim, and I grew up spending lots of time during the summer on a lake near where my family lived. I have a memory of a time when I was maybe 7 or 8.

I was in the water swimming near where we were camped; my father kept calling and calling me in for dinner saying that it was getting late. Finally, with the light failing I ended up listening and running up to where he had prepared dinner – spaghetti.

I ravenously ate something like 3 full bowls of food and, in the end, marveled at how hungry I was. My father told me I had been swimming for almost 8 hours straight!

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