problems getting a midwife.

[PunkElmo]

Sorry if this is long and venty/whiny, but I'm worried and frustrated and... practically in tears (again).

I'm 28 weeks today, and have received little-to-no formal prenatal care - I'm not into western medicine except when all else has failed (glad to have the option of a c-section, but no chance in hell will I take it unless it's going to save a life), and I'm very in tune with my body and what's going on - I know if there's a problem and act accordingly.  I have no insurance (that whole system is VERY broken, don't get me started), just a wad of cash saved up for the baby delivery.

I am taking my pre-natals, I eat VERY healthfully (although I may have been overdoing the chocolate lately ), tons of veggies (esp dark leafy greens and cruciforms!), fruits, well-sourced meats, half glass of red wine a few times a week, teas, coconut water, plenty of hydration, etc.

I did more reading and research before TTC than (it seems) most people do through multiple pregnancies - I'm a curious little monkey - I always knew I wanted a natural birth if possible, and I asked around for midwife suggestions - I was told I should contact a midwife between 12 and 24 weeks... 

I've been doing a TON of travelling (both for work and pleasure), and finally got settled back at home at about 23.5 weeks, and started e-mailing and calling homebirth midwives... almost all of them were booked for May or out of the country, so I FINALLY (after a week+ of communicating with her) got in to see one last night.

I was basically made to feel horrible about not having had all kinds of blood tests, and I was told that I was probably too late in the process to really find a homebirth midwife, and that I was probably anemic and hypertensive (I'm not either).  Also, the midwife was going on vacation for a total of 6 weeks between now and my due date, so... she ended up saying she wasn't comfortable working with us with so little time to get to know us.  

She DID give us some other recommendations, but I was off-put by several things that didn't meet my expectations - full fee for pre-natal (despite the fact that I wouldn't be getting FULL pre-natal services), doula REQUIRED, not included in her fee, and none that she works with regularly or could recommend (I'm a pretty private/introverted person and I want as few people at the birth as possible) and now I'm kind of freaking out and worried that I won't be able to find a midwife and I'm going to have to have the baby either in a hospital or on my own...

The whole experience last night just kind of - EEK.  I don't want lots of invasive tests - I'm firmly of the belief that women have been doing this for thousands of years just fine, so I'll be just fine too... even 30 years ago when I was born, by the time my mom was 28 weeks, she'd barely had ANY visits or testing.... and let's not forget about those women who don't know they're pregnant until they're 8 or 9 months along - and usually have healthy babies with little-to-no judginess. *sigh*

guess I'm just looking for support and help figuring out what to do next...

Edited by PunkElmo - 6/3/11 at 8:54am

[Ola_]

Sounds like that midwife is definitely not the right match for you - keep looking!  They can really differ in their philosophies IMO.  That said when you contact midwives seems to depend on how busy they are in your area.  We contacted ours the morning I got a positive pee stick even though I passed on most of the early testing etc., just because I know the demand here is high.  However our midwife said that they do have some openings for women due within a few months also because some moms risk out of their care and need to transfer - so there's definitely a chance of finding someone, I'd just start contacting them all asap till you find someone who is available and works well with your approach to things.

Good luck mama!

[PunkElmo]

yeah, definitely not a good fit - guess I'm just discouraged  and feeling slightly hopeless after that meeting, thanks for the encouragement! 

[crunchymama214]

Oh good gracious!! Definitely not the MW for you!!! My midwives allowed me to waive any and all tests and procedures I wanted to, which fit in nicely with how I viewed my care being during pregnancy. Definitely keep looking!!! Have you looked for the homebirth community in your area?? There are ALWAYS mw's that are willing to accept you even this 'late' in the game. Heck, I didn't switch care with my 3rd baby til 33 weeks to a midwife! That was a birth center though, not a homebirth, but still...there are always midwives out there willing to help any mama achieve the birth she wants, even if you haven't had all the tests. Keep looking and best wishes!!!

[PunkElmo]

See, this is what I thought!

maybe it's because there are not THAT many midwives in NYC... The one we met with last night said most of her clients contact her between 12 and 24 weeks... and I was only 26 weeks when I contacted her, so... just seems silly to be chastised THAT much for a difference of 2 weeks. 

 

I'm looking into the other midwives she recommended - and anyone else I can find - and birth centers.  Maybe I'll just say "F-all of this" and hide out on the Farm in TN with Ina May Gaskin 

 

Originally Posted by crunchymama214 
there are always midwives out there willing to help any mama achieve the birth she wants, even if you haven't had all the tests. 

[nashvillemidwife]

What makes you think the midwives at the Farm are still living in the 1970s and not practicing according to the same professional standards as every other modern midwife? Seriously, they are not the Mecca for all pregnant women who can't otherwise find a midwife.

[PunkElmo]

I never said that they were still living in the 1970's.... or that they were Mecca... 

I was more joking about skipping town than anything else... (joking being the operative word - seriously, how practical would it be to pick up and move to TN, or ANYwhere for that matter unless I HAD to?)

Originally Posted by nashvillemidwife 

What makes you think the midwives at the Farm are still living in the 1970s and not practicing according to the same professional standards as every other modern midwife? Seriously, they are not the Mecca for all pregnant women who can't otherwise find a midwife.

[Peony]

It certainly sounds like she was not a fit for you BUT some things she did bring up do happen in the MW world. It is standard practice to charge a flat fee regardless of when you transfer or start seeing a MW. Some will "pro-rate" a pg/birth, many will not. I started seeing one MW at 32 weeks and still had to pay the full fee, it is just how it is. Prenatals are just a small portion of their time. And some MWs, the farther along you get, if you have received no "formal" prenatal care, will not accept you. For varied reasons. I'm not saying that is the way it should be, they all have their reasons. I interviewed a couple MWs last pg actually at 25 weeks or so and it was already too late for me to see one since I had not received care yet. 

Anyway, keep looking, if you find one that you really like but is booked up, stay in touch with her, she may have a spot open up. HB MWs can fill up quickly, I emailed my old MW this pg at 11 weeks and got her last spot for the month I am due, and I'm due early in month so the others must of contacted her right away.  Very lucky since I have literally gone through every single other HB MW in my area during the course of 4 pgs, let's just say I am very particular as well.  Expand your search as well, mine is from 1.5+ hours away, I bypass all the closer ones for good reasons mentioned above! 

[PunkElmo]

Thanks for the encouragement - I have no doubt I will find SOMEone to help me birth this baby... it just might not be at home like I wanted... even if it's in a hospital without a midwife, it's going to happen the way the universe deems it necessary (how's THAT for hippy-dippy?!) - and it will be as natural as possible if I (or DP) have anything to say about it! ;)

I get not wanting to pick up patients too late in the game... I understand not everyone wants to take on someone like me.

I also understand that the pre-natal isn't the biggest part of the package, I was actually way more irked about REQUIRING a doula and specific classes than her charging the whole fee (she was going to schedule extra meetings as well, so paying her whole fee wasn't THAT big of an issue, really).

Thanks again - I'm getting perked up by the positive responses :)
 

Originally Posted by Peony 
It is standard practice to charge a flat fee regardless of when you transfer or start seeing a MW.

And some MWs, the farther along you get, if you have received no "formal" prenatal care, will not accept you. 

[Super~Single~Mama]

Originally Posted by PunkElmo 

See, this is what I thought!

maybe it's because there are not THAT many midwives in NYC... The one we met with last night said most of her clients contact her between 12 and 24 weeks... and I was only 26 weeks when I contacted her, so... just seems silly to be chastised THAT much for a difference of 2 weeks. 

 

I'm looking into the other midwives she recommended - and anyone else I can find - and birth centers.  Maybe I'll just say "F-all of this" and hide out on the Farm in TN with Ina May Gaskin 

 

I gave birth at the Brooklyn Birthing Center, and loved it.  PM me if you want - I know some people have bad experiences (but people have bad experiences with all different types of birth too), but I loved it there.

[Neuromancer]

Originally Posted by PunkElmo 

See, this is what I thought!

maybe it's because there are not THAT many midwives in NYC... The one we met with last night said most of her clients contact her between 12 and 24 weeks... and I was only 26 weeks when I contacted her, so... just seems silly to be chastised THAT much for a difference of 2 weeks. 

That could be it.  I'm in NYC, too, and I starting contacting midwives in mid-July, as soon as I found out I was pregnant (which was right away), and met with the one I chose before the end of the month.  I think they "fill up" their calendars fast here.
 

I didn't know any better (it's my first pregnancy), so I'm not saying you "should" have contacted midwives earlier. I'm just remembering that when I was contacting them super-early I felt a sort of aura of urgency like my choices were already dwindling, even that early in the pregnancy!

Sorry you're having trouble finding someone! I hope there have been some "drop outs" that you'll benefit from.

[MeepyCat]

Where I live, if you want a homebirth, you kind of have to start making calls as soon as you test positive.  It's not that midwives won't take people who are late to care, it's that they fill up way in advance.  Some keep waiting lists, some don't.  Spaces do sometimes open up later, because of pregnancy loss or transfer of care, so it's worth calling again.

Some midwives are happy to take on clients with minimal or no testing, others are adamant that they want to know in advance if there are detectable issues that might risk you out of homebirth.  A lot of the midwives I spoke to insist on at least one ultrasound.  It's better to do that soon, for you, because as the baby gets bigger, it gets harder to visualize specific parts on u/s.  In terms of paying - have you looked into Medicare?  Most pregnant women should qualify.

[Meganlove]

With DD I transfered to a home birth MW at 36 weeks. She didn't charge me full price. I am with the same MW this time around and and I don't do any of the testing. My body my choice. What that is only true now days if you are having an abortion? 

As for The Farm being a Mecca for pregnant women. Of course they are! Have you been there? My sister just went this summer for a midwifery conference and was blow away by them. I would give my left foot to give birth on The Farm. We even looked into at one point with my last pg but live 2000 miles away so it really wasn't  in the cards for us. 

[PunkElmo]

Ladies - thank you SO MUCH for your support - I was feeling really discouraged and panicked yesterday, today I'm feeling SO much better!  I was saying to DP and MIL how much better I felt after the responses on here 

I did some more poking around, e-mailed about 15 additional midwives yesterday (e-mail is a huge plus for me because I can fire off an e-mail at ANY hour, not just business hours), and found two that have availability in May and are SO MUCH closer to my apartment.

I spoke with one today - her fee is more reasonable, she even talked about discounting it because I hadn't had the pre-natal stuff up to 28 weeks (and she TOTALLY didn't trip out about that either!) - she said it's totally my choice on ALL of the lab tests, but she does have recommendations.  She said she doesn't require a doula or a class, but will happily help and support me if I want those things, and she's happy to take bloodwork from another source and/or to give me my lab results to take to another midwife if I decide not to work with her...  *BIG SIGH OF RELIEF* 

[crunchymama214]

Do NOT give into the "it's too late to transfer care"  thought. It's NEVER too late! I've heard of women transfering at 38-39 weeks pregnant, and I, myself, transfered from an OB to a midwife (ran out of my OB's office crying at 30 weeks after discussing my desires for my birth because she would not 'allow' me to birth any way other than on the monitors, on my back with an IV) at 33 weeks pregnant. So, do NOT believe that! You CAN transfer at any time! Some MW's may not accept you, but there is ALWAYS one who will!! Keep up the search and hope you find the right one soon!!

[Tumble Bumbles]

You could always pop over to the Unassisted Childbirth forum here in Birth and Beyond to see if birthing without a "professional" attendant would be a right fit for you. Many first-time mamas on here have had a freebirth with their first (I don't want to give specific usernames in case that's against the user agreement).

Keep in mind (in fact, make this a mantra lol) this is your body and your baby and you do not have to consent to any testing. There is no "allow" when it comes to doctors/midwives. You are a grown woman. Yes, a doctor or midwife can exercise their right not to accept you as a client, but consider it a blessing because I would not want to work with someone who was so bent on usurping my position as adult, mother, uterus-haver, baby-carrier/birther and paying consumer.  Educate yourself, become informed, in tune, take care of yourself, and in the vast majority of cases baby will have no problems and neither will you. Part of life is accepting that there are risks to crossing the street, going out in public, driving a car, eating in a restaurant, going on an airplane, walking up or down a flight of steps, and yes, giving birth. People and babies have died in all the aforementioned situations. Like most things though -- with education, information, careful consideration, and appropriate risk/benefit assessment, there is a very high rate of success and a relatively low rate of catastrophe.

I had a midwife-attended birth with my first and switched from an OB in my 3rd trimester (it is not too late until the baby is actually here). She was fairly hands-off but I'm freebirthing this time. I let my current home birth midwife go at approximately 25 weeks. Even though I had regular prenatal care until 25 weeks, I have not had a hand on or in my vagina and have had no tests except for urinating on a protein/glucose test strip of which I did myself (and interpreted the results myself) in her ladies' room at each appointment. The test strips are available at home. BP can be done at home. Glucose monitoring can be done at home. Cervical checks and internal exams are mostly useless (in my personal opinion) unless there's a problem which would indicate one be performed. Nothing should be a pressure, a guilt trip, a "dead baby" scare, or a threat to drop you. Midwives are meant to have opt-out paperwork to cover themselves professionally when a woman exercises her legal right of informed consent and informed refusal. I happily sign the "I was offered and opted to decline _____ test" paperwork.

If you choose a midwife and feel that's the best path for you, I wish you much blessings. Midwives are a valuable part of the natural pregnancy/birthing community and I value their place with women who believe they are best-suited for midwifery care. However, like every other profession, you have midwives who are good at what they do and one's who aren't. Ones who are a good fit, ones who aren't. Having the title of 'midwife' doesn't automatically make someone a person you'd feel comfortable with or someone who respects your wishes in labor/birth.

[BirthTender]

I, stubbornly, remain here in my home area (after having trained and lived away from age 18-32) and after 28 yrs. I have never had to turn away pregnant women because of filling up with too many clients in a particular month. Wow, to much busier than 2-3 births/month has always been a Huge goal of mine. Why don't some of you NYC ladies move down to western NC?

[PunkElmo]

I'm (hopefully, if everything works out right) meeting with 4 different midwives this week - I've been upfront with them all that I'm at 28 weeks and haven't had any prenatal care, and that has not really bothered them (though some of them were more insistent than others that I needed to get in for testing ASAP) - YAY!

I don't think UC is for me for the first birth (who knows, maybe for the second or third - we'll see how #1 goes ). I AM firmly of the opinion that my body knows what to do, but it comforts me to have someone there who's attended births other than their own and knows a thing or three about childbirth - especially the postpartum support!  I'll definitely be asking questions about salves and poultices in the case of tearing - already asked about placenta encapsulation over the phone!

I've also read on the UC forum that getting a birth certificate can be difficult, esp. in NYC, and seeing as how I may need to travel internationally with this child during the first month of their life, I'd rather not deal with that AND all the "typical" new mama stuff ;)

I'd assume in ANY big city the midwives are more likely to have to turn away clients/patients more than in a less urban area - I think hospitals are the "norm" but that more and more women are wanting to go the natural route - it almost seems trendy :eyesroll (I mean, okay, at least it's a GOOD trend, but for those of us who've ALWAYS been "crunchy" and been ridiculed for it, it's kind of a double edged sword)

[PunkElmo]

Just an update...

Feeling down again, because one midwife I spoke to pretty much insisted that I go get Medicaid, even though I told her I'd saved cash for prenatal/delivery/postpartum care. Other than that, I really liked her, so I still scheduled a consult.

But then I looked into Medicaid - I'd have to provide SO much personal/private information (not particularly interested in sharing my income, utility bills, bank statements, etc - besides, if they saw my savings, I probably wouldn't qualify... I'm a REALLY good budgeter/saver) AND it looks like they'd REQUIRE all kinds of "necessary" medical tests I'm just not interested in... ick on several levels!

So I'm tempted to just cancel the consult appointment with this woman - her fees are some of the most expensive of anyone I've talked to - no discount for cash up front (nor do I expect/require there to be, but many people DO discount cash in hand), an almost insistence that I sign up for Medicaid TODAY, and even WITH Medicaid, I'd still be responsible for $3k+ of her fees... her fees without Medicaid are at the WAY upper limit of my budget, with medicaid, they're WAY within my budget, but I can't help but wonder why she charges so much...

I guess it's just another :-/ in the road to finding the perfect midwife - like I said, I'm still debating whether to even MEET with her.

I have an appt. on Thursday that I'm SUPER-excited about - she just seemed like a GREAT fit over the phone (talked for about 15min with her), but I am very afraid to put all my eggs in one basket (one ovary? lmao) in the event that I meet her in person and it's not a good fit.

[Banana731]

Medicaid in my state requires almost no documentation, just information. I don't think they even asked about savings, just current income. And being pregnant makes it even easier to qualify, I know that I will not qualify for it after the pp period, but I do now. They've never required any tests (though I do know it says there may be certain requirements in the fine print),  I've never even seen my PCM(whom I chose), other than when I brought my kids in for a check up just so we could meet her. I know that it varies from state to state, but this has been my experience.

If she takes medicaid and charges you less because the state pays her for part of your care, then she is probably just trying to save you some money. Another thing that might be on her mind is what happens to you in case of a transfer. I got to see the hospital bill after my c/s birth. It was $30,000. Even a regular vaginal hospital birth is something like $10,000!

Don't get me wrong, I am a homebirther. It would have to be a pretty dire situation for me to set foot into a hospital during labor, but if I had to go, I couldn't afford the out of pocket costs without insurance. Even if you have those kinds savings, do you want to spend it on that?

Maybe that is where she is coming from. It's certainly worth asking, if that's the only reason you are writing her off.