Hello. New to Homebirth

[Chembrlee]

Hi everyone. I am 5w pregnant with my 7th baby and we want to plan a home birth. We found a great MW but found out that our insurance will not cover her because she is a LM. We were given names of two CNM who do home births but I don't know what their type of care is.
We fell in love with the first midwife because she just seemed very caring and gentle and the holistic type of care appealed to us.

Can you tell me in general the type of care I would get with a CNM? I have only ever had OBs and hated that I waited over an hour just to be seen for 10 minutes.

What have been your experiences with CNMs?

[Youngfrankenstein]

Hi!
I think all of your questions really depend on where you are geographically. I am in Ohio and homebirth (with an attendant) isn't legal so everyone who has a homebirth uses a lay midwife. CNMs here only can work in hospitals.

How much is the LM going to charge you? How would that compare to the cost of the CNM? Here, we only paid $1500 for our homebirth plus a little more for the birth supplies. I know in other areas, the costs can be up past $5000. That makes a big difference.

Welcome!

[S.Elise]

Welcome!

I have a CNM for my current pregnancy (planned HB), as CNMs are the only kind of midwife that is licensed in my state. I have found her to be great for what I was looking for. She does total midwife-style care (one hour appointments with no waiting, testing only that I want to do/nothing pushed, birth will be at home, recommendations are based on current evidence of benefits vs. risks), but also has prescription privileges, the ability to order ultrasounds and other tests, and even admitting privileges at the hospital in case something goes mildly wrong whereby I need to deliver in the hospital but don't need a surgeon. This means that I have absolutely no need to parallel OB care, unless of course I encounter a complication that would rule out an HB anyway.

The laws are different everywhere, and all midwives are totally different, but I would think that any MW -- even the more medicalized CNMs -- who does homebirths is probably pretty open-minded and worth a meeting. I've found that MWs are also fairly willing to let you chat with past clients, so that mnight be a way to get to know what her care would be like.

Best of luck,

[MegBoz]

Originally Posted by stella.rose

I would think that any MW -- even the more medicalized CNMs -- who does homebirths is probably pretty open-minded and worth a meeting.

Yes, very good point! Of course there are some CNMs out there who practice in a totally medical-ized, high-tech manner, but I can't imagine they'd do so if they're doing HB! (Not possible to have cEFM, constant blood pressure cuff & epidurals at home anyway!)

Here in Maryland, CNMs are able to attend HB, but we have only 1 & she's swamped (Well, I'm glad she's busy, but it's unfortunate for my friend who didn't have her as an option since she was booked solid.) We also have lay-midwife CPMs who practice 'illegally' - but many hold licenses in PA or VA since they are legal there. so silly.

Anyway, I had care of CNMs in a hospital for DS. 2 of the 3 were VERY laid back, non-medically minded (one of them even told me, point-blank, that she disagrees with hospital policy of routine induction at 42W and not allowing eating during labor (only clear fluids.)

So, point being, I think you absolutely definitely can get great midwifery care with a CNM!

That being said, you could also look into badgering your insurance to cover at least part of it. I'm told in Maryland many Mama's are told insurance won't cover HB, but they do end up getting some coverage after the fact.

[Chembrlee]

Thanks for the input!

I'm in Ca and from what I can tell, both midwives are legal. We were quotes $4,000 for the whole shebang.

We haven't talked to the other midwives yet since we just found out our insurance wont cover LMs today but I was really sad that we can't go with her because she was like a grandmother... just so caring. But we NEED to have the money reimbursed. I'm feeling better about this but it all just hinges on if they will do home births. It doesn't say on their web site but we were told they do. So I guess we will see...

Thanks. I'm very excited to be planning a home birth. I hope things come together smoothly.

[AustinMom]

The way I see it you have three options.

1. go through an OB, and have a hospital birth and pay what your insurance doesn't cover, with us, that was over 4K total for me and baby from hospital, pediatrician, OBGYN, etc...

2. Stick with the midwife you have an just pay her fee out of pocket. Here a LM is around 2-3K, still cheaper than hospital

3. Interviews CNMs and pay thier fee with insurance. There are a lot of CNMs who practice like LM. In my experience, I haven't found this to be true. We are having a HB, and I interviewed around 9 midwives, some CNM, some CPM, some LM, and I even spoke with the few who work as CNM in hospitals. I found that CPM and LM are more laid back and hands off, what I want. The CNMs here are a little more clinical, (like the don't let me refuse any of the prenatal testing, even though I know I don't have any stds, and are much more weary of VBAC, which we are) The CNM in the hospital, I don't think I would ever go through, unless I had a transfer. There are way too many good midwives who are much more of what I am looking for.

Also, most midwives bring an "assisting" midwife to the birth, maybe look in to having the LM be that midwife and a CNM as the primary so insurance will cover it, or ask the LM to be your Doula and see if you can work out something there.

[Chembrlee]

Thank you AustinMom,

One of the midwives has home birth experience and now works at a free standing birthing center. This is the one that we were told will do home births. It just doesn't say specifically in the web page.

I can't really find anything on the other midwife yet but I'm looking.

My main issue is I have very quick labors. My last one I didn't know I was in labor because the contractions I was having weren't regular nor was I having any pain with them. The only reason I went to the hospital because I was exhausted from contracting on and off for 2 weeks and not getting any sleep. I got there and found out I was 5 cm. I was in triage for about an hour not feeling much of anything but I was admitted. The Dr came in and broke my water and my daughter was born 15 minutes later. I didn't have anything hooked up to me because there wasn't any time. Most of the time they were trying to get my contractions to register on the monitor.

Now we are in a different city with the option for home birth and I would feel a lot better if I didn't have to worry about getting somewhere on time and possibly having the baby in the car. I would much rather be home if I happen to spontaneously deliver. I'm ok with that and waiting for the midwife to come.