Building Against All Odds & the Cost of Calling with Althea Hrdlichka, CPM

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