How to choose?

[SumnerRain]

I have interviewed two midwives, both do homebirth. One is in network (100% paid) the other is out of network (70% paid). One is in a group with another midwife, in an office, with a birth center, one works out of her home. Both give me warm fuzzies, but I think I connected with the other more, just because she was more straight forward about how hands off she is.

The problem is, I think I could be happy with either midwife, and I don't want it to come down with "who is cheaper". I slept on it, when I woke up, I was sort of mulling over "office" vs. "home" for appointments, honestly I think that is the only thing bothering me about the 1st midwife.

If you have used more than one homebirth midwife, and one worked out of a practice/office and one worked on her own.... which did you prefer? WWYD??

[fairydoula]

I would go with the one that is more straightforward about being hands off. But that's such a personal thing... Personally after two UC's, one unintentional and one intentional, I do not want anyone else's hands on me unless I ASK for it... so that is a big consideration for me. Maybe for someone else, not so much....

[SumnerRain]

It's so funny, I want a doula so I can have someone pushing on my back (horrid back labor each time) and comforting me, but I don't want that person to be my midwife....?

[mbhf]

From the information given, I personally would choose the midwife who works on her own and does prenatals at home. I have only had midwives who worked on their own, so I can't really comment on a midwife working with a group though I don't think that is for me, it's hard enough to find one midwife that you love! I love home visits, especially with lots of small kids. I am more comfortable in my home and it is so nice to just lay on my own couch for my prenatals while my kids run around, no worrying about them making a mess in the midwife's office or finding someone to watch them.

[SumnerRain]

I think I typed that wrong. The group is made up of two midwives who both do homebirths, they work out of a standalone office which is a 1909 Victorian home converted into an office & birth center. It still looks and feels like a home, but at the same time they don't live there.

The "home" midwife I mentioned is a midwife that works out of her own home, she will come to my home once at 37 weeks, the birth, and twice after the delivery. Same as the 1st group.

As far as the home office vs MW office goes, they office is much roomier with more toys for my kiddos, closer to my home.

I guess the advantages would be that the single midwife takes on less clients, and my care would probably feel more intimate. Where in the office I would be a part of a larger group, meaning more people to get to know since they have two midwives that attend births, or a midwife and assistant. There is an office manager and I don't feel like I am invading someone's space.... however the trade-off for the office is it may make it feel more "clinical", I am not sure. When we were there, I didn't see anything at either space that made me feel uncomfortable.

Honestly it may just come down to money. I felt comfortable with both of them, I think I could get good care with both, but for #1 I would pay $300 + $20 a visit, where #2 would be $300 + $20 a visit plus $1,200 my insurance would not pick up.

[ckumelos]

I have been in both situations. My first HB midwife worked from an office, and the one I am using now works out of her home.

There is a marked difference in the "clinical" aspect you speak of. That is just those midwives, it could have nothing to do with the office. The first midwife I used was much more hands on, but I think that may have had mroe to do with her experience and training. My 1st midwife has worked mostly in hospitals and clinics, whereas the second has worked in third world countries and in lay midwifery care.

If I were you I would get a little more into detailed questions about the specific handling of different situations to get a better feel for who will handle your care the way you want it handled.

possible examples
1. how to handle breech at 25 weeks
2. how to manage diabetes diagnosis
3. What prenatal screening tests are done, why, what do you do with the results

....

[peaceful_mama]

I want someone who will listen to me first and foremost.

All things equal like-ability wise, I would go with the first one. Office appointments don't bother me I've never had one come to me.

[russsk]

I saw a CNM (hospital birth) for DS. The office was in an apartment building and it was not very office-y. The CPM I am seeing now works out of her finished basement. I so much prefer the CPM, in part because it just feels like a more private space. I like seeing the CPM for many reasons, but it all comes down to it feeling more personal. I also interviewed a homebirth CNM who works out of an office in a professional office park. Insurance would have covered almost everything for her, but the atmosphere felt kind of clinical and I would have likely seen assistants at many prenatals, rather than the MW. I don't think that her care is clinical, but the setting was. So I chose to pay the CPM out of pocket. I think a lot depends on how big an impact your setting during appointments will be. For some people it's no big deal, but for me it's important.