Bloom Spokane, a three-year-old nonprofit that provides childbirth resources, is blossoming itself with more than 3,300 visits a month to its website and almost 90 health care providers listed as members.

The group grew from founder and executive director Tine Reese's initial desire to offer online information to parents about regional maternity care choices. Soon after Reese moved with her family to Spokane from San Francisco in 2008, she became pregnant and tried to find childbirth options.

"I didn't know a lot of people, so I was trying to search the Internet to find pregnancy and birth resources here, and well, there wasn't much listed at that point," Reese says. "Once I started digging, there were a lot of resources here in Spokane, but they weren't easily found online."

Her second son was born in February 2009 at Deaconess Hospital with the services of a midwife. The website she developed, www.bloomspokane.com, came into the world a few months later.

In fall 2010, Bloom Spokane became a chapter of BirthNetwork National, a Birmingham, Mich.-based nonprofit that promotes scientific evidence-based maternity care. The local group now has five volunteer leaders including Reese to oversee regular health forums for providers, a free birth-options class, and informational resources that also cover early childhood.

The group most recently added a scholarship program to help parents in financial need pay for childbirth education and services, such as doulas.

"The U.S. spends more on maternity care than any other country in the world, but we don't always have the best outcomes in terms of wellness of mother and babies," Reese says. "There is a lot of debate about why that is. It's also at least partially because people don't have accurate expectations of childbirth."

She adds, "Our objective is to provide information and encourage people to have conversations with their care providers and form realistic expectations about what they want to have for their birth."

Reese, who doesn't have medical training, is a marketing communication consultant focusing on website usability and works for her husband Ed Reese's Spokane company, Sixth Man Marketing Inc. She has worked as a marketing consultant for a number of nonprofit organizations, such as the Bay Area Red Cross and YMCA of San Francisco.

She says Bloom Spokane raises its operating revenues from fundraising efforts as well as donations, and gets about half of its income from health provider memberships that start at $50 for a sole proprietorship or small group, which makes up the bulk of its members. The professional member fee is higher for a large group practice, at $500 for a basic listing and up to $1,000 for a number of categories of care. Health care providers include lactation consultants, children's dentists, physicians, midwives, and doulas.

Additionally, Bloom Spokane offers a voluntary annual membership fee of $25 for consumer members such as parents, which enables them to support the nonprofit and receive some provider discounts.

Another Bloom Spokane leader, doula Xylina Weaver, says several topics have emerged through increased dialogue in the community about childbirth and what she calls mother- and baby-friendly care. The nonprofit has held forums attended by health professionals that have discussed such subjects as breast feeding, breech presentation at birth, and postpartum depression.

"We're always looking for ways to bring people together to make birth more positive and safe," Weaver says. "We try to be a resource for the entire birth community. We don't take a stance on much of anything except mother-baby friendly care and evidence-based care."

Adds Tyana Kelley, a doula who acts as a Bloom Spokane leader and its scholarship coordinator, "Our mission is to build a better birth community," which includes educating people about different birth options, she says. "Because not every woman has high risk and needs to have a hospital birth."

Bloom Spokane offers blogs, tips, and articles about different birth experiences. Parents who learn about options can then decide if they're more comfortable with a birth at home, at a birth center, or at a hospital, Weaver adds.

The group offers its free birth-options class monthly, usually at Sun People Dry Goods Co., at 32 W. Second near downtown, at 2 p.m. on the second Saturday of the month, Weaver says. In the near future, the group hopes to offer the class at other times and locations.

"We're very careful to explain in our class the medical model of care and the midwifery model of care," Weaver says. "Most women who are healthy are low risk. The important thing we teach is when you're pregnant and having a baby, you may go to the hospital to be safe and have a lifeguard, but it is not a medical event; it is a normal life event."

On Sept. 22, Bloom Spokane will co-host a new event called BabyFest, which will be held at CenterPlace Regional Event Center in Spokane Valley as part of Valleyfest. BabyFest will include exhibitors and educational workshops, Reese says. Bloom Spokane's co-host for the event is Inland NW Baby, another nonprofit that provides diapers and baby clothing to social service agencies.

Meanwhile, Kelley says the new scholarship program was launched after several parents said they needed help paying for services such as a midwife, doula, or additional birth-education classes.

Doulas aren't medical professionals, but they are educated about the birth process and provide emotional, physical, and informational birth support, Weaver says. She says the cost to hire someone in that role ranges from about $200 to $600, depending on additional services such as breast feeding consultation and the number of appointments scheduled.

"Insurance is starting to reimburse for doula care," she says.

A childbirth education class typically ranges in cost from $75 to $250, Weaver adds.

Bloom Spokane awarded its first scholarships in June in the form of free services. One was for the services of a doula who donated her time and the other was for a "hypnobirthing" class that teaches relaxation techniques and mental tools to manage labor pains.

The group also plans in the next few months to provide up to $250-a-month scholarships to be used toward birth-support services or classes, Kelley says. The scholarships will be awarded based on financial need, with information provided on the group's website or at some health clinics, she adds.

"At our classes, women would say, 'I'd really like to hire a doula, but it's between that or buying food and paying rent,'" she adds.

The group also holds professional forums, and a recent Bloom Spokane session on postpartum depression brought together about 25 providers from different disciplines, Reese says, including physicians, midwives, doulas, and mental health therapists.

Bloom Spokane leaders had heard from frequent postings on its Facebook page that Spokane didn't have any postpartum depression support groups. Following the forum, at least one local therapist group is planning to start one, Reese says, and other groups are being considered with the help of Postpartum Support International, based in Portland.

"It may not make sense for us to be the vehicle," Reese says. "We're the aggregator that sees the need. Sometimes the best solution is for another group to take it forward."

She adds, "I think Bloom Spokane is one of the few places where there is an ongoing conversation between parents and care providers, and professional-to-professional conversations, surrounding birth."

Reese says that growing dialogue is having an impact. She contends that some local hospitals are changing their standards of practice for births, partially based on requests from insurance companies, but also from what she says are changes because more parents are asking for them.

She says one example is parents requesting that hospitals allow immediate skin-to-skin contact between the baby and mom unless a medical emergency prevents it.

"Research says skin-to-skin contact is what's best for mom and baby, and hospitals are saying OK, because a lot of their consumers are asking," Reese adds. "Change is going to happen because women are educated, and they're going to demand it."

Reese says Bloom Spokane initially focused more on natural births and at-home births, but it now seeks to reach across all health care disciplines and childbirth options.

"My whole goal is to give other parents starting down that path a way to find information and understand what scientific evidence is telling us about childbirth and what our rights are, and how to make educated decisions," Reese says.

She adds, "Hopefully, Bloom Spokane is a way for parents and professionals alike to know they can get trustworthy information."