hospital bith in Baltimore- Kathy and MD general not options :(

[HappyLamb]

I am roughly 8-9 weeks pg. My last child I had 4 years ago with Kathy's practice at Mercy and I have been going there since then for annual exams, check-ups, and a m/c and I've been very happy there.  My husband's employer just switched to Cigna, and Kathy's practice DOES NOT accept Cigna!  Apparently, Cigna doesn't "recognize" them because they are a practice of CNMs, vs. a practice of CNMs and docs....or something stupid like that.  Unfortunately, I don't have a choice in the insurance plan, and paying out of pocket is not an option. Kim (the office manager) told . me that I was the 3rd former patient she turned away in the past 2 weeks because of a recent switch to CIGNA, she is working with the accreditation person at Mercy to solve this problem, but it could take months, if at all. Bayla told me I should complain to Cigna-- actually, the broker who purchased the insurance for my husband's firm is planning on helping us, but who knows if and when this will yield results? And in the meantime, I need to work out a plan:

What are some other options for me? A hb is not an option for me at this time.

I called MD General, and the midwife practice does not accept CIGNA-- maybe is there another practice affiliated with the hospital that does?

Bayla suggested the midwife practice at St. Joseph's in Towson, as did Kim.  I couldn't find much info on this site about them, but what I read seemed okay (it was mostly about someone who transferred there during a HB, plus another one about a lady on methadone maintenance or something like that.....)

I made a mistake and thought MD General was the same as Univ. of MD, so I scheduled an appointment with the midwives there (at U. of MD)  but Bayla told me it's more "med-wife" there, so I will probably cancel it, unless someone has a different opinion.

Kim also likes an OB practice at Mercy: Drs. Hoffman and Nichelson.

I work outside the home, so commuting to Special Beginings or Upper Chesapeake would not be practical to me--- I can't miss so much work for appointments.  I live in the Mt. Washington area (near Sinai hospital) and work in Towson (right near GBMC), so anything roughly within a 20-25 minute drive would probably work, including downtown baltimore.

would def. appreciate any feedback!

[KatyLinda]

I couldn't find a whole lot on the St. Joe's midwives either, but I was told that Mary Knauer is heading up that practice and I've heard good things about her on here.  Kathy's practice doesn't take my insurance either.  My top two choices right now are St Joes & Md General.  

Good luck!  It seems it's a tough decision these days....

[lizsky]

I'm sorry about your insurance situation :(  That must be very frustrating.  Since you are still pretty early, you might be able to fight and get results within a month or two...I certainly hope so!

When I was pregnant with my DD, I started out with an OB, but learned pretty quickly that my OB was not what I was looking for.  I asked a doula in the area who has attended a few hundred births about MWs and hospitals and she said positive things about the MWs at U of Maryland (and Kathy's group at Mercy, and Maryland General).  

I interviewed with one of the U of Maryland MWs and did a hospital tour.  Honestly, I felt like the MW was very supportive of natural childbirth and interestingly so was the nurse who gave me a tour.  I also know a mama who had a med-free VBAC there a couple years ago and she said she felt supported.  However the practice is large, and I don't know if the MW I saw or the MW my friend birthed with are representative of the practice as a whole.  It might be worth keeping the appointment just to see for yourself.  I did feel like Mercy was more flexible with regard to hospital policies (delivering in the tub, heplocks, eating during labor etc...) and I ultimately chose Kathy's group.  

One other thought...some insurance companies pay 80% for an out-of-network provider...any chance yours does and you could manage the 20%?  

[bedheadmaestro]

What about Sinai itself?  They have CNMs there.  I never hear anyone talk about Sinai as an option?

I've attended births as a doula with Dr. Hoffman and Nichelson, with the midwives at U of MD and with Kathy's practice (each of the midwives there!), and my clients and I are pleased with the care we received from all of them.   They all treat meconium the same (cord clamping, separation and all the festivities that go along with mec), and they all "let" you go with ruptured membranes for the same length of time (12 hrs?), and all required an initial 30 minute stint on the monitor, all thanks to hospital policies, but other than that, it's the midwifery model of care.  Induction is done with cytotec at U of MD.  It's these little differences in regard to various complications that make the difference, because they are basically all the same with regard to normal, spontaneous birth.  and that's what you have to ask each provider about if these things are important to you. 

[juneboymum]

I also wanted to use Kathy's group - but again, insurance was the issue.  I chose to commute up to Upper Chesapeake (because they have a birthing tub - although you can't actually deliver in the water from what I understand) and so far have been happy there (currently 27 wks preg).  I always get the first AM appt and I'm usually home by 9 or 9:30 AM.  I know you don't want to miss much work, but just wanted to let you know that there is not a lot of sitting around in the office.  They are quite efficient! 

[MegBoz]

I've heard good things about St. Joes. I believe my former doula even added their MWs to her list of practices she recommends in the area & she is a very tough critic on hospitals!

I'm pretty sure MD General has the lowest CS rate in the hole Balt/Wash area! A friend of mine transferred there after problems with HB with Evelyn & was pleased with the care. I don't know a ton about it otherwise though.

Dr. Theresa Hoffman at Mercy has a decent reputation, but a friend of mine birthed with her last hear. First, she "HAD TO" be induced because her water had broken <roll eyes>, then she said Dr. Hoffman asked her permission to cut an episiotomy, "because you are going to tear anyway." I freely admit, I'm a bit psychotic on this issue, but I would never allow a health care provider who thinks a cut is better than a tear to get near my genitals. Period. A cut is WAY WORSE than a tear! Cutting "because you are going to tear anyway" is HORRIBLE! (But, again, I'm crazy about this one.)

To be fair, that is probably not a reason to rule a doc out of the running, and at least she did ask permission (which my friend granted. she said she only needed 2 stitches, so I guess it wasn't second-degree.) my friend was happy with her.

[HappyLamb]

Umm, you're not going to believe this, but in the 24 hours that this was posted, this has become no longer relevant.....

I've had an exhausting day and need to go back to the hospital first thing in the morning,  but later in the week, I will tell you all about my experience with St. Joseph's in Towson- so far, it's been good, we'll see what happens tommorrow.

thanks all for the replies anyway!

[lillymonster]

If anyone else is interested, I went to the UofMD midwives. I was trying for a VBAC, it didn't happen, but they were very supportive of VBAC and my age (advance maternal age) and very hands off. I switched to them at 36 weeks and met with about 4 midwives in that short amount of time and had a great experience with all of them. However, if you do need a c-section, the OB I had isn't that great at listening skills and addressing serious medical conditions outside the realm of normal.

[lillymonster]

Originally Posted by HappyLamb 

I made a mistake and thought MD General was the same as Univ. of MD, so I scheduled an appointment with the midwives there (at U. of MD)  but Bayla told me it's more "med-wife" there, so I will probably cancel it, unless someone has a different opinion.

NOOO. It is not med-wife there. A lot of doulas recommend them for VBAC. I went to 9cm before I asked for an epi on my vbac, they wanted to try other options first. I don't remember if I got an IV because my labor was so fast. One midwife was at Special Beginnings. Interview with them. They told me they would not monitor me until after I was 42 weeks, and for being a vbac and AMA (almost 40) with no mention of a c-section at 40 weeks is pretty great IMO. They are not med wife to me. I was in a medwife office and transferred to them at 36 weeks