Help me make this choice!! RE: switching midwives and how to tell them about it

[happyma]

oh hi. 

Edited by happyma - 3/14/11 at 12:50pm

[Youngfrankenstein]

I think you already have your answer!

[zookeeper]

I'm kinda in the same situation (except not twins!) It's not really anything I can put my finger on, but dh and I decided this weekend to switch. I'm really dreading telling the other MW!

[happyma]

Dude.

Edited by happyma - 3/14/11 at 12:52pm

[kcparker]

Go with your gut. If you are not comfortable with your care provider (for trust, skill level/training, or personality reasons), it will hinder your birth process. And at least in my state, the family can't be prosecuted for an attempted homebirth, but direct-entry midwives can be prosecuted/fined for practicing medicine without a license. At the end of the day though, you want a good, safe birth for these babies, and if your little voice is saying to switch, listen to it. There are no do-overs with a birth, and you don't owe the midwives anything any more than you'd owe a car mechanic or insurance agent an explanation for switching to another service provider - they will keep whatever fee you have paid them for prenatal care to date, right?

[Youngfrankenstein]

I can understand! I am not usually an advocate of lying, but could you make something up? Insurance change?

I've met one midwive on the phone out of 3 we're interviewing and I'm already 99% sure she's "not the one for us", OTOH, I'm sure she's the one, just based on her personality, who will give me a hard time.

[kcparker]

Originally Posted by happyma

Overall I am satisfied with the care that I have recieved... However, DEMs aren't legal in my homebirth un-friendly state and the fact that with twins I have higher rate of hospital transfer. My big fear is transfering to a hospital in labor or after and having illegal midwives and no back-up care. So obviously, this has been weighing heavily on my mind.

I would say just this, let them know that you would like to switch to a CNM (who can also bill insurance companies, right?) and have shadow care with an OB or whatever you are arranging, that you'll need your records and thank them so much for caring for you in the first half of the pregnancy. You could let them know that the bad press story doesn't have anything to do with your decision and that you had been considering switching care providers before it came out, but needed time to make sure it was the right decision.

[maotmsmi]

.

Edited by maotmsmi - 5/21/11 at 2:23pm

[Mamatoabunch]

You don't owe any care provider a reason for switching, you employed them and now want to change, simple as that. You don't explain to Ford why you now bought a Honda.

[happyma]

Originally Posted by kcparker

Go with your gut. If you are not comfortable with your care provider (for trust, skill level/training, or personality reasons), it will hinder your birth process. And at least in my state, the family can't be prosecuted for an attempted homebirth, but direct-entry midwives can be prosecuted/fined for practicing medicine without a license. At the end of the day though, you want a good, safe birth for these babies, and if your little voice is saying to switch, listen to it. There are no do-overs with a birth, and you don't owe the midwives anything any more than you'd owe a car mechanic or insurance agent an explanation for switching to another service provider - they will keep whatever fee you have paid them for prenatal care to date, right?

Yes, it is my little voice telling me to change. This happened in my last pregnancy too, towards the end because of some conflicts that arose with that midwife (different midwife) and I decided to stick with her. I ended up regretting that choice nearly every day after that birth. I have not paid for our prenatal care/ homebirth with them yet. They do a global billing type thing and bill for all of that together. But I will be paying them for the prenatal visits I have had thus far.

Originally Posted by kcparker

I would say just this, let them know that you would like to switch to a CNM (who can also bill insurance companies, right?) and have shadow care with an OB or whatever you are arranging, that you'll need your records and thank them so much for caring for you in the first half of the pregnancy. You could let them know that the bad press story doesn't have anything to do with your decision and that you had been considering switching care providers before it came out, but needed time to make sure it was the right decision.

Yes, the CNMs can bill our insurance company and she does have a better relationship with area hospitals and physicians. That is a good point about telling them that the news story didn't affect my choice. Thanks!

Originally Posted by MommyKrista

Definitely sounds like you have your answer! You don't have to give your current MWs any reason for YOUR CHOICE to leave. But, I think it's reasonable to say that since you are having twins, and concerned about a higher rate of transfer, you'd prefer to go with someone who has a backup DR available at the hospital for you (I'm assuming since she "illegal" there is no backup DR she works with at the local hospital). Sounds perfectly reasonable to me. I'd definitely go with your gut. If you're really non confrontational you could always cancel your next appt., switch, and then write your previous MWs a letter about your reasons for leaving.

Good Luck!

No, the DEMs do not have a backup OB. A letter is a good idea, or the phone. I just get so nervous in these types of situations.

[xixstar]

I agree that you should be comfortable with your care providers. If you're not comfortable, then you should switch. I'm glad that you have a CNM option available for a twin homr birth, not everyone get's that luxury.

I would let them know that you're switching and that you just feel it's a change you need to make. Because of the media coverage, if it truly isn't a factor in your decision, I would also let them know that because I'm sure they'd be wondering if it was.

I'm sorry that the news has also had an impact on your feelings and family's reaction since I'm confident I know which stories you're thinking of and know that the midwives still provided excellent care to the family mentioned (and the family was happy with their care as well). Sadly, birth is unpredictable and when you're in a tentative legal situation, the media can be very harsh and not always factual. Heck, even for those with full legal standing, unfortunate outcomes in a non-traditional (out-of-hospital) birth can have the same negative attention.

[badgerbaby]

I would definitely switch. You have instincts for a reason and need to protect yourself and your babies. It's likely that everything would work out fine, but if you can't have total peace of mind during your care and your birth, it's not worth it.
I had a CNM and a hospital birth with my #1dc and it went exactly as we wanted, according to our birth plan. All our wishes were respected. It seems you're confident you can get that type of care with your CNM. That would be my decision in your case.

Blessings!

[mbhf]

If you feel like you need to switch, just do it. I have switched providers late in the came twice now, once from hospital MWs to a homebirth MW, couldn't have been more happy with the results. The second time I had moved, went with the first MW I met, had funny feelings about her for a long time and then something happened that just told me I *had* to switch, nothing as major as your news story but something none the less. I remember being in my tub, with my new MW standing just outside the door, thinking how incredibly happy I was that she was the MW standing there, and not the first MW.

[Hezzie]

Listen to your heart. I firmly believe that when we hear that "little voice" and we hear it repeatedly, it's something telling us what we should be doing (I believe it's God guiding me, but you can call it whatever you want ).

Like the others have said, you DO NOT have to explain to them. Just call to cancel your next appointment, state you'll pay for whatever prenatal care they've provided up to this point, and request a transfer of records to your new CNM. If they ask you for a reason, politely saying something like, "I do not wish to discuss my decision to switch at this time, thank you."

I think you'll feel a lot better under the CNM's care and you'll have peace of mind in case something goes wonky with the twins. I'd probably switch, too, if I were in your shoes. Best of luck!