The founding of Loudoun Homebirth & Healthcare is a dream come true.  We are finally able to offer the personalized level of care that women and their families deserve, and current research supports. 

Our team of midwives and nurses have been involved in maternal and infant health for over 20 years, and have often been required to work and counsel within a medical system that is unable to provide holistic care or offer “continuity of care.”  Prenatally, women are commonly passed among practitioners, never certain of who will be attending their birth or who will be caring for their baby afterward.  Artificial time constraints, facility protocols, and unfortunately, a lack of respect make it challenging for the process of physiological birth to unfold. 


As a small independent practice, whose scope of practice includes newborn management, we are able to provide care to both mothers and babies – prenatally, during labor and birth, and postpartum. To provide the appropriate level of care and attention, we see a limited number of clients each month. Prenatal visits focus on not only your pregnancy, but also your daily life and overall well-being.  A genuine and intimate relationship is established long before your little one comes, and hopefully continues for a lifetime.  This type of personal care is a cornerstone of the practice.


As a nurse-midwifery practice, Loudoun Homebirth & Healthcare is also a part of the overall healthcare system; so if and when needed, we consult, collaborate and possibly refer to other team members to provide optimal care to our clients and their babies.

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Our Midwives

Hilary Biesecker

  - CNM, APRN, Founder LH&H

I began my path to midwifery in 1999, attending births as a certified doula, teaching childbirth classes, and serving out-of-hospital birthing families as a BirthCare birth

assistant. When my youngest child began school, I went back to school as well, earning an undergraduate nursing degree from George Mason University.  I then practiced as a Labor and Delivery nurse at Winchester Medical Center while earning my graduate degree in Nursing (midwifery) from Shenandoah University.  I have had the privilege of attending more than 600 births since the beginning of my midwifery journey.


As a Certified Nurse Midwife (CNM), I worked alongside my friends and colleagues at BirthCare and Women's Health, serving families all over the DC metropolitan area.  I am so thrilled to now be serving the women and families in my own community.  The recent compilation of our team is truly the epitome of maternal and neonatal healthcare at it’s best.  Heather, Andrea and Leslie are not only loving friends, they are like-minded, professional care providers equally committed to serving LH&H families.


My husband and I live in Purcellville with our four children; all of whom were born naturally, two at home into the loving hands of midwives

  • MSN, Shenandoah University
  • BSN, George Mason University
  • American Midwifery Certification Board 
  • Neonatal Resuscitation Program (NRP)
  • Cardiopulmonary Resuscitation (CPR)
  • Midwife,  Loudoun Homebirth & Healthcare (Founder), 2015-present
  • Midwife,  BirthCare & Women’s Health, 2014
  • Labor & Delivery Nurse, Winchester Medical Ctr., 2013 - 2014 
  • NICU Nurse, Winchester Medical Ctr., 2013 - 2014
  • Birth Assistant, BirthCare & Women’s Health, 2005 - 2012
  • Certified Doula, 1999 - 2010
  • Certified Childbirth Educator, 2005 - 2009
Professional Organizations
  • American College of Nurse-Midwives (ACNM)
  • Midwives Alliance of North America (MANA)
Heather Swartz


I have worked as a CNM in this community primarily in the hospital setting since 2014.  Attending births in these years has brought me so much joy, but providing

care in the home setting is my dream.  I feel so fortunate to join Hilary and to now be able to offer individualized, evidence based care without external constraints and arbitrary policies.My path to midwifery began with a lifelong wish to be a nurse and a mother.  Once I realized both of those dreams, it was obvious to me that maternal newborn health was a beautiful way to help women have birth experiences as positive as my own.  My last child was born at home while I was in school to be a midwife and I hoped to someday offer those services to my own clients.  


As a new midwife I joined a busy hospital based midwifery practice in hopes of learning as much as possible and to be mentored by experienced midwives.  Through the years I attended many births and met so many wonderful families.  However, I also witnessed complications from intervention and occasionally felt that policies did not reflect evidence based care.  My core belief was validated, and I felt confident that I could offer quality care out of the hospital.  Evidence and experience has proven to me that if a woman is allowed to birth in a place that she feels comfortable surrounded by those she trusts, she will have the best outcome.

  • MSN, Frontier Nursing University
  • American Midwifery Certification Board 
  • Neonatal Resuscitation Program (NRP)
  • Cardiopulmonary Resuscitation (CPR)
  • Midwife,  Loudoun Homebirth & Healthcare, 2019-present

  • Midwife, Loudoun Community Midwives, 2014-2019

  • Midwifery Director, INOVA Loudoun Natural Birth Center, 2016-2017

  • Labor and Delivery Nurse,  INOVA Loudoun, 2011-2013

  • Labor and Delivery Nurse,  INOVA Fairfax, 2010-2011

  • Postpartum Nurse, INOVA Loudoun, 2007-2010

  • Telemetry Nurse, INOVA Loudoun, 2006-2007

Professional Organizations
  • American College of Nurse-Midwives (ACNM)

Our Registered Nurse Birth Assistants (RNBA)

  • Registered Nurse, Certified in Neonatal Intensive Care (RNC) 
  • BSN, Mary Washington University
  • Washington Hospital Center School of Nursing
  • Maternal Newborn

  • International Board Certified Lactation Consultant (IBCLC)

  • Basic Life Support (BLS)

  • Neonatal Resuscitation Program (NRP)

  • Neonatal Nurse, Washington Hospital Center, 1980 - 2000
  • NICU Nurse, Inova Loudoun Hospital Natural Birth Center, 2001 - 2015
  • Family Support Coordinator, Inova Loudoun Hospital Natural Birth Center, 2015 - present
  • Rose Award 2018 ILH for philanthropy and leadership.
Leslie Brundage


My career began in 1980 as a neonatal nurse caring for and loving some of the tiniest babies and most vulnerable families at Washington Hospital Center.  My plan

was to eventually study midwifery; however, the birth of my own 5 children filled such an enormous part of my life there was little time to pursue that goal.  I would not have wanted it any other way.

In 2001, I followed my passion for delivery and birth to Inova Loudoun Hospital (ILH). As a NICU nurse, i had the opportunity to attend not only high risk deliveries, but also the deliveries of very healthy mothers. When the Natural Birth Center opened at ILH, I was fortunate enough to attend their very first delivery.

While at the Birth Center I was able to participate in many innovative programs to better the experience of the birthing process, including increased skin-to-skin time, the uninterrupted “golden hour”, timed cord clamping, delayed bathing, and tub rather than sponge bathing newborns.  I initiated changes including a neurodevelopmental committee in conjunction with our physical and occupational therapists to study and present the most current evidence based practices in the care of the neonate. 

In 2012 I became an International Board Certified Lactation Consultant (IBCLC), and worked closely with the lactation department to assist breastfeeding mothers undertake what is sometimes a daunting but very important gift to their babies and themselves. This was especially important in the NICU where it was often weeks before mothers could put their babies to the breast. 

Attending conferences, doing research studies and receiving certifications has kept my education current. My interest in reducing a mother’s need for pain medication and increasing their relaxation levels led me to undertake research on the effect of music therapy on new mothers. My results were presented at a national AWHONN conference.

The last few years I have been working as the Family Support Coordinator for the NICU.  I formed a strong group of mothers from the NICU to support families and friends.   I am still actively involved with fund raising for the new NICU at ILH. 

By the most wonderful stroke of luck, I was able to meet all of the amazing women in Loudoun Homebirth & Healthcare while working at Inova Loudoun Hospital. When my daughter gave birth, Hilary and I became much closer as there could be no one more qualified to bring my granddaughter in to this world. We were all thrilled to have a homebirth with Hilary and Andrea, it was a peaceful miracle. Andrea was my first choice for the birth assistant out of the many nurses I know. I have attended numerous deliveries with Heather and I am always awed by her calm and caring demeanor, learning from her thoughtful ways. 

Despite attending more than 1,000 deliveries my excitement and passion for birth has never dulled. The opportunity to work delivering compassionate care with Loudoun Homebirth & Healthcare is truly a dream come true. So, I may not have become a midwife, but I now get to work with the best.

  • Registered Nurse (RN)  
  • BSN, Shenandoah University
  • Cardiopulmonary Resuscitation (CPR)

  • Neonatal Resuscitation Program (NRP)

  • Neonatal Nurse, Inova Loudoun Hospital, Natural Birth Center, 2008 - 2018
Andrea Gioia

   - RN

The natural world has fascinated and awed me since I was a child, especially reproduction and birth.  My passion for pregnancy, birth, and the postpartum period

was illuminated when I gave birth to my own babies; I knew my calling was to care for women and their families through the intimate and transformative experience of giving birth.  Closely observing nature throughout my life has instilled a deep foundational belief within me that women, their bodies, and their babies’ bodies can do the most amazing things and that we can and should trust their ability to do what they were designed to do. 


In 2008, I graduated from Shenandoah University with my Bachelor’s in the Science of Nursing, became licensed as a Registered Nurse, started maintaining CPR and NRP certifications, and began working in the Natural Birth Center at Inova Loudoun Hospital (ILH).  The experience I gained as a postpartum, well-baby, and newborn receiving nurse during my 10 years there is invaluable, but from the outset, I knew that my heart and soul’s destination was really in the home and not in a hospital.  I believed that women, infants, and their families can be effectively and safely cared for in their homes through pregnancy, labor, and birth and that the best provision of care would be given by a Certified Nurse Midwives and Registered Nurses. 


In 2017, another nurse at the hospital told me her daughter was pregnant, wanted to have a home birth, and that Hilary was caring for her.  The nurse asked me if I would be her birth assistant, and of course I said YES!  That nurse was Leslie Brundage, my other half on this dream team.  Our partnership with Hilary could not have started in a better or more appropriate place – Leslie’s loving home caring for her daughter and granddaughter.


Bearing witness to the power of women and their bodies bringing new beings earthside is an honor and privilege.  I could not be more blessed to work with Leslie and the outstanding midwives of Loudoun Homebirth & Healthcare!

Our Approach