How does one choose a midwife?

[sattygirl99]

When there are multiple choices??

I have NO idea which MW to go with... I'd like to make a choice so that I can start to build that one on one relationship.

One has higher coverage with my insurance but she takes 15 clients a month. She's very busy. She's wonderful at what she does but busy! A lot of time your visits are with one of her assistants (who also attend your birth). She does have an ob relationship to maintain due to delivery rights at a hospital. The ob doesn't have a say in her hb patients but she does have to be aware of her choices to not lose her rights. She never called me back from my first voicemail I left, I had to call a second time. Then when I called her back (I missed her call), she said she'd call me right back after rounds (she does have some clients who wish to deliver in a hospital but her group is a homebirth based group), she didn't call me back until 7pm last night. Then she got a call and said she'd call me right back... That was 7:30 last night!

Another is a cpm and she's really hands off. You call all the shots. You can even go to less prenatal visits than the norm. She's highly recommended. She's out of network so its covered at 50% after 1000 deductible. No affiliation with an ob/hospital and has no practicing rights at hospitals. She's not a big talker but listens and is supportive. I'm not sure if her personality is right for me... my doula highly recommends her, as does anyone who's delivered with her, but I'd like a MW that I can view as a friend, that I can have an easy, comfortable conversation with and not feel like it's one sided. She is VERY experienced, has delivered VBA4C and had a VBAC herself at home.

Another has been doing hb since 2007 (I think), worked in a birth center prior to that. She's a cnm and will go hands off or hands on, depending on what mom wants. She does prenatals in the clients home. If I decide I want testing, that's fine, if not, that's fine too. She takes 3 to 4 clients a month. She's also out of network but said she's had good results with my insurance before at getting nearly 100% coverage. She is not affiliated with any ob or hospital and has no practicing rights at any hospital. She's more of a friendly bubbly personality and we tallked for over an hr! She's never had a failed VBAC/VBAMC or a transfer for a VBAC (but I forgot to ask how many she's done).

How do I choose? This is HARD! I know in the end, the MW is only one peice of the puzzle and she doesn't need to be the "best' MW... Just supportive and willing to let my body and baby do what they need. In the end it's ME that matters...

Thanks...

[miriam]

I hope you get lots of answers, but from my perspective, I was lucky just to find ONE midwife when I had my children. I never had insurance and the one I found never dealt with health insurance.

I am so happy that things have changed so much that pregnant women have trouble choosing which midwife to attend their birth, and with insurance no less!

[MyFillingQuiver]

I tend to be really big on my intuition. The only times in my life where I've really "failed" at decisions is where I ignore that!

So, I met with my first midwife (other than CNM's in the hospitals/OB Offices previously) yesterday in my home. I was open to either liking/disliking her, choosing her or having to interview a couple. With me being a VBA2C (already had 1 VBA2C) I'm pretty much an illegal client in this state. So, that makes it tricky.

However, my gut said I LOVE YOU in regards to her, her practices, philosophy, level of care and personality. I will not choose anyone else. At this point, it's either the hospital birth or her. I just have to choose. Additionally, we have insurance with maternity coverage for hospital/OB only...so, it's not like we're saving a ton by having a midwife. Can't help you with that part.

I vote go with your gut, tempered with logic and facts.

[sattygirl99]

When I started searching, I figured I'd only have one or two... I had 4 all together but the one requires her entire $4K fee by 34 weeks and she'll send back your money if the insurance pays. I can't afford $4K by 34 weeks and her answer was to take out a loan. I can't do that, we don't have the credit on the finances to handle a loan. She is also highly recommended but EXPENSIVE. The third one above is also expensive ($3800) but is willing to let us pay $1900 and then wait and see what the insurance covers. THAT's more doable. The second one is $2500 for her care and is willing to do a payment plan beyond the birth.

CHOICES! CHOICES SUCK, lol!

[sattygirl99]

I know my gut says not to go with the first one... She's just TOO busy...

After talking to them all, my gut is saying the third is the best option. She has the ability/experience to handle emergencies if they come up, can do an IV, antibiotics if needed, etc.

It's just so hard to choose and pray I'm making the right choice. I suppose in the end, ANYONE who is supportive of my HBA2C will work. The MW isn't the one who really matters... I do. But I also want a midwife who can support me and become friendly with me and my family. Hands off is great but I don't want a hands off personality... Just don't want tons of testing!

I think I know who I'm choosing... Just second guessing if I'm making the right choice...

[Right of Passage]

I'd go with number 3, I need someone available to me, and someone where the conversation flows. It makes me more comfortable and the way you typed about each midwife I kind of feel like you're leaning toward her anyway.

[emnic77]

For me, like someone else, it was largely intuition based. She came highly recommended by a CPM here on mothering (that was too far away for me to have) and all it took was a bit of chatting with her to know she was the right "fit", and vice versa.

If it were me I'd go with #3 probably 15 patients a month sounds like A LOT...I would be worried about rushed appointments. A huge part of midwifery care, to me, is having that one-on-one time and building a relationship, which is next to impossible to do in 10-15 minute appointments. I'm not saying she should be hopelessly devoted to you and you alone, , but 15 really seems like a stretch, especially for births...that's one birth every other day really, each month. I would not be confident that she would be at my birth.

It sounds like you hit it off more with #3, so go with your gut

[xixstar]

It's a hard decision for who to pick and really needs to look at what you want. You mention looking for friendship and a more personal relationship, then perhaps the 3rd one is the best route. You might want to check on how many VBAC moms she's had, because saying she's never transferred one is a little unclear without knowing how many she's attended. But it sounds like you've already figured out who you want to go with.

I personally wanted a very hands off mw that believes in my body as much as I do, has lots of experience with variations of normal birth (breech, etc), and is willing to be patient as well. I didn't need a personal relationship, just confidence that she would help me have the birth I wanted.

I'm birthing with mw #2 on your list for the second time. I agree that the initial meeting with her did have me feeling like she was a little standoffish but I was very confident in her experience and her willingness to let me birth the way I want. After all the prenatal appointments, I feel we both warmed up to each other well. And now on the second pregnancy I feel even more comfortable with her - but still wouldn't consider her a close family friend. DH also loves her and I think he actually gets along with her even better than I do, but he found out she used to do sheetmetal work and he's a metalworking nut so that totally sold him.

and wow, I didn't realize how many births #1 attends in a month... and here I thought #2 attended a lot.

[iggymom]

If it was me, I'd also go with #3. I had several options as well, and the way I finally looked at it is "if I'm having a long labor, and the MW is at my home, who would I feel most comfortable just hanging out with"(including DH) and once I thought of it that way, the decision was easy.

[mamakori]

Have you met with all of them in person, or just talked on the phone? If you haven't met with them personally, I would make that a priority. For me, I went into midwife interviews with a huge list of questions, but it ultimately boiled down to who I clicked with more, and that wasn't something I could tell over the phone. I will say though that I'd be somewhat cautious about the midwife that takes 15 clients a month. That is a very, very busy practice. Most hb midwives in my area only take 4 clients a month.

[AustinMom]

I interviewed 9 different midwives before I chose which one I wanted. For me, If I had to choose between the three you listed, I'd choose the middle one. My MW has had a HBAC and my Doula and her have a great relationship. Our Doula, said she refers all her VBAC moms to the midwife we chose.

The first one I wouldn't choose because that's a lot of births a month and that REALLY lowers the chances of her being at MY birth. There is one here who couldn't even get me in for an interview till a month and half later, that's to me, a too booked practice.

It really boils down to who you feel you is going to best suit your needs at your birth. I need someone who can be there as a constant reassurance, has experience with VBAC, and can suggest positions and such if needed. I don't need someone who has a typical style of how THEY birth. Think about what kind of Doula you chose. For me, my Doula and MW are A LOT alike. Most importantly, neither of them doubt my body in ANY way. They know I can do this, and they don't make it a big deal of telling me every two secconds, it's just a natural, calm reassurance, and that is what I personally need with my HBAC.

Happy Birthing!

[sattygirl99]

Thanks!!

I think I am going to go with #2... My doula has a great relationship with her (delivered with herself) and my doula can pick up with that 'personal' relationship if I need it. She's been AMAZING and I haven't even given her a deposit yet!

[etsdtm99]

glad you figured it out! i was going to say #3 because that pretty much describes who i picked! but number 2 would be the 2nd choice .. i wouldn't want to deal with someone as busy as #1 ..

[xixstar]

I promise I'm not stalking your threads.

In picking the midwife I did, I also picked an awesome doula that I totally clicked with and had that great friendly relationship with. She is just awesome and I was more concerned with meshing with my doula than I was with my mw. And after the birth, it was totally my doula that was the one that really stood out for us and rocked the birth right along with me... in fact, dh teased that we should have paid our doula the mw's fee and the mw the doula's fee because of the inverse in how much work they did.

And if you're using Jessica as a doula (think you said you were on another post), you'll be getting tons and tons of personal and friendly support to totally make up for any feel-good emotions that might be lacking from the mw #2.