Having It All (OB + MW)

[ncavillones]

I love, love, love my OB... she came highly recommended by my doula. However, we've decided to have a HB, so we're looking for a HB MW now. I want to maintain a good relationship with my OB, in case something happens (this birth will be a VBAC/HBAC), and because the HB MWs closest to me are still a schlep, for well woman care. Basically, if my OB did homebirths, I wouldn't be looking for a MW at all.

So, I have two questions:
1. Has anyone had their insurance cover both an OB and a MW, at the same time?
2. How do I tell my OB that I decided to have a HB? I'm pretty sure she'd be supportive but I don't know her well enough yet to be 100% sure about that!

Thanks!

[InstinctiveMom]

I'm no help, but interested in the same questions! Hope you find what you're looking for

[Sk8ermaiden]

This is what I plan on doing for the next birth, because there is basically no one to do a VBAC in my city except midwives. I was a homebirth transfer this time, and the treatment we received at the hands of the hospital was horrific. I will DEFINITELY have an OB chart next time.

I plan to use the OB my midwife transfers to, so she is insistent that I am honest with him about my homebirth plans.

What I did this time, was send my midwife invoice to the insurance as prenatal care (since her fee is less than the combined prenatal visits at an OB anyway). And then of course the hospital billed for the birth with no problems. Next time I will probably do the opposite. Use my normal insurance and copay for the prenatal visits with the OB, and then submit my midwife invoice under the "birth" code. I don't think it will be a problem.

But I'm pretty sure no insurance will cover tandem care if they know that's what they are covering.

[ncavillones]

Thanks, Sk8ermaiden. That is really helpful! Not sure how the MW will feel about me going to my OB for checkups, and only using her for the birth but it's another question to ask! (Though if I end up with a hospital transfer, it would be the closest one to me, and not the one where my OB is, so maybe it's kind of pointless... I just thought of this!)

[Sk8ermaiden]

Oh, I would never do that (LOVE my MW). It is just how I plan to apply it to insurance. Likely I will be doing two sets of prenatal visits, but I can get that $3,200 MW invoice (for ALL care) and have her billing person send it to the insurance company as payment for birth.

[ncavillones]

Oh! That makes more sense to me now. Thanks!

[womenswisdom]

Originally Posted by ncavillones

Thanks, Sk8ermaiden. That is really helpful! Not sure how the MW will feel about me going to my OB for checkups, and only using her for the birth but it's another question to ask! (Though if I end up with a hospital transfer, it would be the closest one to me, and not the one where my OB is, so maybe it's kind of pointless... I just thought of this!)

You're far more likely to transport for a non-emergent reason, in which case you could go to whatever hospital your OB has privleges at. Obviously, you'd go to the closest facility if there were a true emergency and have to take whoever you get.

[Sk8ermaiden]

I wanted to agree. My midwife has one emergent transfer every one or two years. Everyone thinks they'll only transfer in an emergency, but it just usually doesn't work that way. For instance, I pushed for over 6 hours and the baby did not descend one centimeter. It was clear she would not tolerate pushing for too terribly much longer. Yes, I needed an unplanned Cesarean, but baby was still OK and we had time to go to whatever hospital we wanted to.

And, before that we *almost* had to transfer for my blood pressure.

You never know, it's nice to have an OB lined up. And even if you don't go to your OB's hospital, I believe a physician and hospital will take you more seriously if you have current records with an OB.