Question about timing of first midwife appointment

[Nicole915]

I'm not certain if this is a total neophyte question, but when does a woman typically see their midwife / ob for the first appointment?

I called a local midwifery practice here in Ann Arbor that was recommended and explained that I was looking for a midwife, and wanted to check out the practice and learn a little more about their philosophy. They asked me to come in and fill out some paper work, then told me that I couldn't actually be seen by a practitioner until I was 10-12 weeks. I have a "Nurse Interview" via phone at 8.5 weeks to obtain my medical history and order lab work. This practice includes eight Certified Nurse Midwives who practice out of several locations and do deliveries in the birthing center within a local university hospital.

Questions:

• Is it within the norm not to see a midwife until 10-12 weeks?
• What do I need to know in the interim? (Cannot find any two books that agree)
• What insurance repercussions are there to setting up at several practices?
• Other than talking to people in the community, what are the best ways you have found to evaluate a midwife practice?

Thanks so much in advance for any wisdom. Feeling like I'm stumbling in the dark here.

[Jane]

It's a really common practice to do the following -
Assume no one wants to interview - they are either coming on or not.
Have women see a nurse who arranges labs, takes down history, does vital, explains how to page and what the practice does/doesn't do.
After the labs come back, there's an appointment with an actual midwife or doctor, usually at 8-10 weeks.

Personally, I recommend trying to interview every single option that appeals to you - including this practice. I like to have fewer than 8 people rotating - I might not meet all of them before the birth, after all - there's usually only 10-12 prenatals in total.

There isn't anything to "do" at 4 weeks, but there's no reason why you have to make women wait! Drives me nuts. You wanna come see me before you miss your period - let's do it! Wanna do a pre-conception consult - let's do it! Anything else seems mean - and counter productive. There are plenty of women that could use a chance to talk and get health-improvement advice or just be reassured that they're OK.

My advice for the newly pregnant is:
If you have on-going health issues, see your regular doctor ASAP - that's if you are diabetic, take thyroid medication, have a heart condition, are depressed/anxious, etc. If you have a family history of genetic problems, that means you, too.
Take a prenatal vitamin with iron if you do suppliments.
Eat well - if you can, of course. First priority is liquids, then calories, then nutrients. If you can only do sprite, do sprite. If you can eat balanced, whole foods with fruits and veggies, do it!
Avoid the "avoidables" - foods with a higher risk of food poisioning (deli meat, hot dogs, raw meats), alcohol, toxins like solvents, radiation, workplace gasses, etc. Limit mercury containing fish to once per week (tuna, swordfish). Wash your hands after gardening/changing the cat litter and wash your fruits and veggies to avoid soil born infections. Don't smoke.
Check out all herbs and medications for pregnancy. The biggie to switch from ibuprofen (advil) or asprin to tylenol for aches and pains.

[Boodah'smama]

At the practice i use you go for your first appointment whenever you call and tell them you got a bfp. They schedule you for a "confirmation appt" where they use their own pregnancy test, test your urine for infection, ect., and then you just meet with a nurse and do a little history/question/answer/information stuff. At that appt you schedule your first 'real' appt with a midwife for about 9 weeks.

However, if you have a confirmed bfp--at a planned parenthood or clinic or something, they just fax that to my practice and then you don't get to schedule anything until that first 9 week. But if you're trying to decided whether or not you mesh with a practice, i would request an appt now just to get established and ask questions.

[Andee]

Originally Posted by Nicole915

• Other than talking to people in the community, what are the best ways you have found to evaluate a midwife practice?

Thanks so much in advance for any wisdom. Feeling like I'm stumbling in the dark here.

:
Nicole, what practice did you call? The practice that I'm going to call on Monday is also in Ann Arbor.

[Nicole915]

Thank you all so much. Since this is my first, I'll probably have more inane questions, but you certainly set my mind at ease. Apricot, thank you for sharing your wisdom =)

Originally Posted by Andee

Nicole, what practice did you call? The practice that I'm going to call on Monday is also in Ann Arbor.

I contacted the Certified Nurse Midwivesat the U of M, they gave me the numbers to the clinics around town where their midwives see patients. I went to the East Ann Arbor Obstetrics over at Plymouth & Earhart.