Steamboat Midwife Expands Care From First Period to Menopause

Steamboat Springs —The air in Steamboat Springs is crisp, a stark contrast to the warmth of the exam rooms at UCHealth Women’s Care Clinic. Inside, Aja Metzger is not just preparing for a delivery; she is managing the complex intersection of a patient’s reproductive history, current medication needs, and long-term health trajectory. For many women in the valley, this clinic has become a permanent fixture in their medical lives, not just for nine months of pregnancy, but for decades.

Metzger is a certified nurse midwife, and to hear her tell it, the role has evolved well beyond the traditional image of a provider who only shows up at birth. "Midwifery is a model of care that provides a holistic and relationship-based model of care across the whole lifespan, from menarche though menopause," Metzger said.

The scope of that care is extensive. According to the Steamboat Pilot, certified nurse midwives now handle well-woman exams, prescribe medication including contraception, manage acute gynecological visits, and provide childbirth education. They are present during pregnancy, pre-labor, labor, delivery, postpartum care, and lactation support. They also offer menopause support. The list is long, but the underlying mechanism is simple: trust.

"Midwives develop a lot of trust and foster shared decision-making with women," Metzger said. "We help patients make choices that are best for them, their families and their lives."

This emphasis on partnership is a core philosophy of the profession. Metzger explained that midwives walk alongside patients, presenting all available information on various healthcare needs so the patient can make informed choices. It is a departure from a purely directive medical model, one that many patients find more aligned with their preferences.

The question is whether this expanded role creates a strain on the healthcare system or strengthens it. Metzger argues the math holds up. In Colorado, certified nurse midwives have full prescription authority. They are registered nurses who have completed a master’s degree in an accredited midwifery program, often with extensive prior experience as labor and delivery nurses.

"We work together with OB/GYNs and have a solid team in the hospital," Metzger said. "We also build relationships with midwives in the community."

Midwives are on call for their patients, seeing them in hospitals for labor and delivery and assisting with C-sections when necessary. They function as independent providers but also serve as an extension of physician care. This dual capacity is increasingly recognized by insurance carriers, who are accepting midwives as part of their plans.

"Insurance companies are recognizing midwives as a needed community profession," Metzger said. "In the long run, it is very sustainable model as we can function as independent providers as well as an extension of a physician."

For the community, this means access. It means that a woman in Steamboat Springs can begin her relationship with a midwife at the start of a pregnancy, continue through delivery, and keep the same provider as she navigates menopause. Metzger noted that she is seeing younger patients who start their medical journey with her and stay for years.

The landscape of women’s healthcare in the valley is shifting toward this continuum model. It is a move that prioritizes relationship and consistency over episodic visits. For Metzger, the outlook is clear.

"I’m seeing younger patients," she said, "a lot who establish care early on in their pregnancy and continue care through the next."