Choosing a care provider (or not) and/or hospital/birth center/homebirth

[sunwillshine]

Was wondering how many have already started thinking about this? I guess a lot of you veteran mamas may already have established care providers that you'll continue with, but I'm brand new to all of this!

I selected my current OB based on the recommendation of my PCP (whom I LOVED, but whom has moved to another practice not covered by my insurance... so I need to search for a new PCP. Anyway, this OB delivered all of his kids, so I figured, if he's good enough for my doctor, he's probably good enough for me. Right?

WRONG! At least, so far. And it's not the OB I don't like. I actually DO like him. But in the 5 times that I've been there since my initial appointment with him, I've not been able to see him (I've had to see other docs and/or nurses). And, they don't give me a lot of personal attention, nor do they care (or believe in) my fertility charting. I really don't think they run their practice with the mentality that every woman and pregnancy is unique and that a woman knows best about her body/baby, etc.

Sooooo.... I am meeting with a CNMW in my area (who has been recommended on MDC) early next month to see if that's a better fit with me. She's in private practice w/ another OB, and the office manager told me to plan at least a couple hours for my visit, because they "like to really get to know their clients."

This would work out perfectly, because the midwife and OB deliver at the hospital I like, which has five birthing suites, all with laboring tubs and one with a waterbirth tub. I'm seriously into researching waterbirth as an option, and DP is freaked out by the idea of a HB, so a hospital waterbirth attended by a midwife would be a GREAT compromise!

What about others? What are your thoughts and plans about care providers (if you're going to have a care provider) and location for birthing? I know we talked about it briefly in our introductions, but I wanna know more!

[Sihaya]

Lyndzies - Glad to hear you're looking into another hcp. The way you were treated by that NP still makes me shudder every time I think about it. I hope you click with the CNM and it works out for you!

I had a wonderful Hypnobabies home waterbirth with a fantastic mw for my first birth and am looking forward to another one with the same mw this time around.

I'm actually having a bit of a conundrum about my care right now. I don't want to go into too much detail because my mw's backup and apprentices all post on MDC. Short story is my mw had a family emergency and is out of the state for several months with no clear idea of when she will be back. She has transferred care of current clients to her backup mw and isn't taking clients right now (but probably will be once her family situation is resolved, most likely in time for her to provide prenatal care for me and attend my birth).

I know one of her apprentices fairly well and am comfortable having early checks with her but she just happens to be due in ~6 weeks and will be newly postpartum around the time I would have my first appt. I have a few options (her backup mw, one of her other apprentices, and the local birth center), but really don't know where to start and don't want to make any arrangements this early only to have a m/c and it all was for nothing anyway.

I feel so silly because last pg I didn't want to be seen until 20 weeks at the earliest and we never used the doppler with DS until the birth. But now, after a m/c, I want to try to hear a heartbeat with a doppler ASAP. I just feel like I need that reassurance, but also feel a bit ridiculous for not trusting my body anymore.

[APBTlover]

We are almost 100% up in the air right now. Which is fine, I guess, since I don't really feel in any mad hurry to be seen.

My options are:
A) Hospital birth at least 1hr drive away... I will NOT give birth in one of the local hospitals if I can possibly help it.

B) Birth center birth almost 90 minutes away. Reeeeally don't want to drive that far but it's on the table, and far preferable to a hospital.

C) Unassisted homebirth (or with some unlicensed midwife who will magically appear at my door because the pregnancy test fairy told her I needed her... unlikely). DH and I are both comfortable with UC, but as I said, we're still undecided.

I want to say hospital birth is a non-option (barring any issues that arise, of course). I actually got an OB recommendation from one of the birth center midwives, but I just don't think I'd be comfortable. In the past couple of years I have been involved with births at several area (within an hour's drive) hospitals and they have all just been bad, bad, bad. Healthy moms not seeing their healthy babies for hours postpartum, told they could walk during labor but forbidden once they're actually in labor, heavy induction pressure, nurses giving 12-hr-old newborns formula because "your milk isn't in and you don't want your baby to STARVE do you??" On and on.

[sunwillshine]

Originally Posted by Sihaya

but really don't know where to start and don't want to make any arrangements this early only to have a m/c and it all was for nothing anyway.

I feel so silly because last pg I didn't want to be seen until 20 weeks at the earliest and we never used the doppler with DS until the birth. But now, after a m/c, I want to try to hear a heartbeat with a doppler ASAP. I just feel like I need that reassurance, but also feel a bit ridiculous for not trusting my body anymore.

I hear you... it seems weird for me to be making all of these arrangements so early on (a am nervous of a loss too, as I experienced an early one this summer) but I also don't want to wait too long, because I know this CNM is popular, and that the hospital I like only has 5 birthing suites and 1 waterbirth tub... I have no idea how you actually make sure you're one of the mamas in the suites, but I figured part of the trick was probably getting on the ball early.

Good luck with whatever you decide. I can definitely understand wanting to hear the heartbeat of that little bean! It does sound like there are others in the practice available to provide early care, if you decide you need/want it, so that's good to hear.

[Jazzmin]

If you want to stick with a provider your insurance covers, start calling and asking for interviews. Find out what is the most important to you in terms of care and birth experience- see how they feel about your most important issues.

If you don't mind paying the extra out-of-pocket expenses, go the the "finding your tribe" forum and ask for recommendations in your area.

I only interviews two MW last time because I didn't look for care until 20 weeks. The first one just didn't feel right, plus DH did not like her. The second one was PERFECT, our search was over.

I am hoping this time I am able to find one that feels right.

ETA: I have had two hospital births and both times I was stuck in the overflow room to labor and deliver :/ With the second babe, all of the birthing rooms had pools, except the one I was in. I think it is luck of the draw.

[blue butterfly]

Jazzmin - I just noticed you are in Norhtern Indiana as well


My first birth was with an OB at the hospital and my second was with a CNMW in the hospital. With my last pregnancy that ended in a m/c we were already planning a homebirth with a midwife that is about a half hour from my home. We had one appt with her before the m/c and i really liked her so the plan is to stick with her! we will have to pay out of pocket but i feel it will be worth it.

[calihannah]

I am up to my ears in care providers:

* I am seeing my OB from last time around because she'll do an early u/s at 6 and a half weeks and help relieve my early m/c fears (which are all-consuming and overwhelming). She's a private practice/solo practitioner and is reallllllly good at being present with her patients. We got along great until about halfway through my pregnancy with DD, when I realized that she was very interventionist for the actual birth part. My water broke before I went into labor spontaneously, and she was all about her timelines, and she got very angry with me when I didn't go to the hospital for several hours. My birth experience was still good, but I don't want to go through that again. Arguing during labor is SO not fun. Still, I'll get care from her for the first trimester or so, and then I have to gently "break up" with her

* I've also established a relationship with a group of 3 midwives who deliver at a different hospital. I like the midwives very much, but I don't like their practice (very large) or the hospital (not very mama-friendly). They don't see pregnant women until 8 or 9 weeks, but they do know about my BFP because I was having ongoing discussions with them about whether I needed assistance to get pregnant due to a luteal phase issue. This is my default right now once I switch to them later this trimester or early next tri.

* AND I'm starting to research homebirth midwives. I have three real options. DH and I will be interviewing them starting after I see the heartbeat on u/s in a couple of weeks (fingers crossed), since they are a limited resource here and I don't want to have them book up.

If we do choose a homebirth midwife, we will do dual care (likely with the hospital midwives rather than my OB, but we'll see). Did anyone else do dual care or is considering it?

[ladyelms]

haven't decided whether i'll up/uc again. i may have a good doula friend attend me because i missed the "woman" support last time.

i do know i want at least one visit w/ an OB (and then just never show up again) to do the nuchal fold testing via ultrasound to check for downs, w/ my being "advanced maternal age" and all. (i know, rolls eyes)

[xekomaya]

I had a good midwife for my last, who is now across the country from us so I'm looking again for someone else. Homebirth is the only option -- I am NOT getting in a car in late labor, let me tell you.

My birth pool is in storage across the country as well, hopefully i can get it here in one piece before it is lost or stolen or whatever else. That is actually causing me a lot of stress but i just keep trying to tell myself I can always buy another one just in case....

Reading birth stories on all the various types of birth can be a good way to decide what you do and don't want. I would read everything from planned c-sections to UC's and see what starts to click.

[Jazzmin]

Originally Posted by blue butterfly

Jazzmin - I just noticed you are in Norhtern Indiana as well


My first birth was with an OB at the hospital and my second was with a CNMW in the hospital. With my last pregnancy that ended in a m/c we were already planning a homebirth with a midwife that is about a half hour from my home. We had one appt with her before the m/c and i really liked her so the plan is to stick with her! we will have to pay out of pocket but i feel it will be worth it.

Hey neighbor! What MW did you use? I am looking for one, they all seem to be to the north and west of where I live.

[tanyab]

We are currently interviewing midwives as I would prefer a hb this time round for a number of reasons. I am a tiny but sad that I won't get a 6-week confirmatory ultrasound this way! I still don't feel like it is real and that may have helped. I have my annual exam due so maybe she will do one anyway.

[blue butterfly]

Originally Posted by Jazzmin

Hey neighbor! What MW did you use? I am looking for one, they all seem to be to the north and west of where I live.

Laura Gilbert, she's out of Goshen which is about 30 minutes from me.

[Jazzmin]

I e-mailed her earlier today! I know her assistant Janis, the only downside is that prenatals are in Janis' home, which is not near me.

[Eresh]

I had a homebirth last time with a practice of CNMs. They were fine but I think this time I want to really know who is going to attend my birth. I think that will really help my comfort level. I also want a more naturalistic HCP this time around.

Fortunately Virginia is one of the best states for midwife care (in regards to laws) and I have several good CPMs to choose from in this area. I interviewed one last time and really like her, but a friend of mine heavily recommended a couple of the first MW's apprentices that recently started their own practice. I think around 8 weeks I'll schedule interviews and decide.

Lyndzies: Yeah, I would encourage you to make your first appointment as soon as possible. It sounds like the kind of practice that would book up very fast. The MW practice I used for my first birth was like that (20 clients per month limit) though they magically had an opening for a Feb due date when I called at 28 weeks (then DS came early .. )

[sunwillshine]

Originally Posted by Eresh

Lyndzies: Yeah, I would encourage you to make your first appointment as soon as possible. It sounds like the kind of practice that would book up very fast. The MW practice I used for my first birth was like that (20 clients per month limit) though they magically had an opening for a Feb due date when I called at 28 weeks (then DS came early .. )

Thanks for the suggestion! I actually already made the appointment, for 6w2d (2/9). I'm super psyched. I've still got my first "official" prenatal appointment w/ me OB scheduled for 2/25, which I MIGHT keep... but depending on how the MW appointment goes earlier in the month, I may dump them altogether. Lol.