Martha Redpath, a CNM turned burnout and boundaries coach, joins Augustine to talk about what happens when the people who hold space for everyone else run out of space for themselves. Martha traces her path from home birth CNM in Vermont to founder of Provider Space Coaching — a pivot that came out of her own reckoning with alcohol, burnout, and eventually grief after losing her husband.

The conversation moves through the state of community-based midwifery today (closures, legal exposure, the pressure CPMs face that CNMs often don't), the martyrdom culture baked into midwifery training, and what it actually looks like to teach boundaries as a clinical skill rather than a personality trait. Martha and Augustine also get into nervous system regulation, the difference between CNM and CPM entry points into boundary-setting, and why the ability to disappoint people — kindly and clearly — might be the most underrated skill in this profession.

Key Topics

• Martha's path: nursing → home birth CNM in Vermont → 10 years in a small hospital birthing center → burnout, alcohol, and the pivot to coaching
• The current landscape for community-based midwives: closures, lawsuits, board investigations, and the Texas trend of using public social media posts as testimony against midwives
• Historical spikes in home birth rates (Ricki Lake's documentary, the ACA, COVID) and where rates stand now
• CNM vs. CPM pathways into professional boundary-setting — and why CPMs often enter the field less boundaried
• The martyrdom/"lone cowboy" culture in community-based midwifery, and generational shifts around it
• Martha's coaching framework: strengths-based reflection across eight life domains, nervous system regulation, "tiny habits," and discomfort resilience
• Grief as a parallel thread to birth work, following the loss of Martha's husband
• The value of one truly safe confidant ("marble jar friends") for midwives carrying constant on-call stress

Resources Mentioned:

Martha's coaching practice: providerspacecoaching.com — sliding scale fees, one-off debrief calls, and a six-week burnout package built around The Big Life Journal

Student Midwife's Keepsake Journal — the HIPAA-appropriate documentation journal mentioned in the mid-episode ad, with space for 100 birth records and built-in compliance guidance

Editor's note (09/04/2026): This episode was recorded in July 2026, before criminal charges were filed against Althea Hrdlichka in September 2026 related to her Fort Collins birth center. She has not been convicted of any crime. We're leaving this conversation up as recorded; you can find current reporting on the case through local Colorado news outlets.

Show notes:
Althea Hrdlichka opened a birth center in Colorado in 2020 — a state where CPMs were not legally allowed to practice in birth centers. She then changed the law. She opened a second location in 2026. She has attended over 1,000 births and she's far from done.

In this episode Augustine sits down with Althea for one of the most unfiltered conversations this podcast has had about what it actually takes to build midwifery infrastructure in a hostile system — the legislation, the license battles, the EMS protocols that she believes are being used deliberately against out-of-hospital providers, the rivals who tried to bring her down, and the moment she almost didn't keep going.

And why she kept going anyway.

In this episode:

• Four births that led her to midwifery — and the one that changed everything
• Opening a birth center she couldn't legally practice in — and changing the law
• A two-year license battle, $70,000 out of pocket, and what pulled her back from the edge
• The EMS "stay and stabilize" protocol and what it means for out-of-hospital birth
• Why she pays herself zero and what her sustainability plan actually looks like
• The homegrown midwife model — and why it's the only one that works
• What midwives eating each other is costing the profession

• Subscribe to our YouTube Channel: https://www.youtube.com/@MidwiferyWisdom
• Birth Center Incubator: https://www.skool.com/birth-center-incubator-4343/about
• Guest Contact: https://tendergiftsmidwiferyandbirthcenter.com/about-us/

When high-profile cases like Lindsay Clancy hit the news, public fear and sensationalism surrounding Postpartum Psychosis (PPP) spike—making clinical clarity and lived experience more vital than ever.

In this special re-released episode, we sit down with Aaisha Alvi, author of "A Mom Like That: A Memoir of Postpartum Psychosis." Aaisha is a two-time PPP survivor who navigated severe hallucinations, delusions, and several medical dismissals before finally receiving life-saving psychiatric treatment.

Community birth workers, midwives, and doulas are often the primary line of defense in the first 14 days postpartum. In this conversation, we break down:

* The clinical differences between Postpartum Depression (1 in 5) and Postpartum Psychosis (1-2 per 1,000).
* What hallucinations and delusions actually look and feel like from the inside.
* Why calling PPP "rare" leads to dangerous medical dismissals in emergency rooms and clinics.
* Exact red flags, key phrases, and emergency protocols birth workers must use when advocating for a client in crisis.

CONTENT WARNING: This conversation includes discussion of severe perinatal mental health crises, intrusive thoughts, and psychiatric emergencies.

RESOURCES & LINKS:
• Learn more about Aaisha Alvi & grab her memoir: https://www.aaishaalvi.com
• Follow Aaisha on Instagram: @AaishaAlviWrites
• Postpartum Support International (PSI): Call or text 1-800-944-4773 | https://www.postpartum.net
• National Suicide & Crisis Lifeline: Call or text 988
• Explore Midwifery Wisdom courses & resources: https://www.midwiferywisdom.com