Meet Nikki Larson, CNM

Nikki Larson, MSN, CNM is a board-certified nurse-midwife with over 12 years of experience in healthcare and three years of direct midwifery practice. Her journey began in cardiac critical care and grew to include roles as an antepartum and labor & delivery nurse before becoming a midwife. She holds a BS in Microbiology, an MS in Exercise Science, and pursued a PhD (ABD) in Exercise Physiology before earning her BSN and ultimately her MSN with the goal of becoming a midwife.
Nikki provides comprehensive women’s health services including annual exams, contraception counseling, family planning, and care for gynecologic concerns. She also offers full-scope midwifery care—covering prenatal visits, hospital-based delivery, and postpartum care.
Her philosophy of care is grounded in a holistic, patient-centered approach. She welcomes conversations about natural, herbal, and supplemental interventions and believes in shared decision-making where patients feel safe, supported, and empowered to take an active role in their care. For Nikki, midwifery is not just clinical—it’s deeply personal.
That passion was born from her own experience during pregnancy with her oldest son. With limited support around her, Nikki found strength and guidance through her midwives. That transformative journey inspired her to give back—helping women learn about their bodies, grow their families, and become their own advocates.
Outside of the clinic, Nikki is a proud mom of three—two sons and a daughter—and life is full of baseball games, family adventures, and “mom stuff.” She enjoys cooking, baking, sewing, and knitting, and is rarely far from her two dogs and two cats. Originally from the Midwest, Nikki spent 17 years in Virginia before moving to Washington, where she now feels right at home surrounded by the natural beauty of the Pacific Northwest.
As Nikki beautifully shares:
“It’s not just the making of babies, but the making of mothers that midwives see as the miracle of birth.”
She feels truly honored to be part of such intimate and life-changing moments in the lives of her patients.

Nicolette Nesbitt, CNM

Nicolette Nesbitt enjoys working in partnership with her patients, providing trusted information and inspiring them to make educated decisions about their reproductive health. She strives to create a woman-centered, respectful, compassionate environment. She wants women to feel empowered and heard as they move through major life changes.

She felt called to be a midwife from a young age. She sees pregnancy and birth as a natural process and enjoys supporting women through the experience. She has a clinical interest in family planning, mental health, and adolescent health.

Prior to becoming a midwife, she was a labor and delivery nurse in Spokane Washington. She earned her Bachelor of Science in biology from Saint Martin’s University in 2017, her Bachelor of Nursing from Concordia University Portland in 2019, and her Master of Science in Nursing from University of Colorado in 2022.

Outside of work, Nicolette loves spending time with her dog, cat, bunny, and two horses.

Erika M. Sace, CNM

Erika is dedicated to bringing inclusive and evidence-based care to midwifery. She strives to create a safe space where patients feel empowered to engage in informed clinical discussions and make decisions that promote their overall health and well-being. Her clinical interests include rural healthcare, adolescent care, contraceptive counseling, and vaginal birth after cesarean (VBAC).

Before becoming a certified nurse-midwife, she worked as a pediatric clinic nurse in Woodinville, Washington, where she developed a deep appreciation for caring for families through different stages of life. She is excited to bring that same passion for family-centered care to her work in midwifery, supporting pregnant individuals as they navigate pregnancy and birth, while also providing compassionate, individualized reproductive healthcare.

Originally from San Diego, the diverse and breathtaking landscape of Washington called Erika home. Erika earned her Bachelor of Arts in Educational Sciences from the University of California, Irvine, before moving to Seattle to pursue her nursing and midwifery education. There, she completed both her Bachelor of Science in Nursing and Doctor of Nursing Practice at Seattle University.

She is excited to serve the Tri Cities community and discover what the eastern side of the state holds. Her personal interests include volleyball, fashion, interior decor, and traveling. On the weekends, you can often find her at the local thrift stores or antique malls hunting for her next unique find.

MIDWIFE SERVICES

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Midwifery as practiced by Certified Nurse-Midwives (CNMs) encompasses a full range of health care services for women from adolescence beyond menopause. These services include primary care, gynecologic and family planning services, preconception care, care during pregnancy, childbirth and the postpartum period, care of the normal newborn during the first 28 days of life, and treatment of male partners for sexually transmitted infections.

CNMs are licensed, independent health care providers with prescriptive authority in all 50 states, the District of Columbia, American Samoa, Guam, and Puerto Rico. CNMs are defined as primary care providers under federal law.

While midwives are well-known for attending births, 53.3% of CNMs identify reproductive care and 33.1% identify primary care as main responsibilities in their full-time positions. Examples include annual exams, writing prescriptions, basic nutrition counseling, parenting education, patient education, and reproductive health visits.

Decades of research indicate that primary care services provided by Certified Nurse-Midwives compare favorably to those provided by physicians. In a recent systematic review of studies comparing midwifery care to physician care, researchers examined multiple outcomes. Results indicated that women cared for by CNMs compared to women of the same risk status cared for by physicians had:

Lower rates of cesarean birth,
Lower rates of labor induction and augmentation,
Significant reduction in the incidence of third and fourth degree perineal tears,
Lower use of regional anesthesia, and
Higher rates of breastfeeding

Medicaid reimbursement for CNM care is mandatory in all states. Medicare and most Medicaid programs reimburse CNMs at 100% of physician rates. The majority of states also mandate private insurance reimbursement for midwifery services.