Birth Options - Low-Income - Louisville

[thatgirliknew]

Since midwives cannot legally practice in KY and therefore cannot accept Medicaid (and I am guessing would be too much for a very low-income client to afford?) and Clark Memorial seems to be the best place to birth in Metro area (which also doesn't accept KY Medicaid), what sort of options are there for "natural" births in Louisville. As in no continuous fetal monitoring, no inductions, change in positions, etc. Are they any OBs in the area that will actually "let" you do these things in the hopsital? Are there any hospitals in the area that actually "allow" it? What is the average cost for a midwife attended homebirth? Have you found midwives in the area to be flexible with people of lower-incomes? I know some doulas in the area discount prices but unsure about midwives since they're more physically involved (that may not be the best way to say it)

Also, I am not on Medicaid yet because I just realized I was pregnant (not planned). And if there were a way for me to homebirth, would it raise flags to accept Medicaid in case of an emergency and then never attend any OB appointments?

I am really hoping that someone has some idea that may help me or knows someone who went through a similar experience.

Thanks for reading

[mkat83]

We had always planned a homebirth, but my water broke just shy of 36 weeks, and after discussing things with our midwife, we decided to go to the hospital to be on the safe side.  We went to UofL hospital, which I think a lot of people don't consider.  We went there because the midwives all said that homebirth transports usually have the best experiences there as far as not being judged, etc.  We weren't a true transport case with our scenario, but we were still an unknown to the staff.  Here's my experience, for what its worth, which was in July 2011.

I was in active labor when we went to the hospital (I knew I didn't want to go to any hospital if labor hadn't started).  My water had actually been broken for over 24 hours, but I had been carefully monitoring myself for signs of fever, etc, so I told the staff my water had only broken a few hours prior.  Over all, I was VERY pleased with how we were treated.  We had a birth plan prepared in case we went to the hospital, and the resident on call went over it with us line by line.  I know with residents, it was the luck of the draw, but we obviously got a great doc.  We got everything we requested except intermittent monitoring.  Had I not been a homebirth "transport," I might not have had to be on continually monitoring, not sure.  No one ever offered me any drugs.  My labor went fast, so there was never a need to talk about interventions such as pitocin, so I don't know how it would have been if they thought things we going "slow."  The lights were kept low in the room while I was in labor.  The attending physician allowed me to labor in the position of my choice, requested a squat bar for me, and also requested a mirror (which they didn't have).  My main concern was getting the baby immediately after it was born.  One nurse said that as a matter of routine, the NICU team would have to examine the baby first and I could not hold it immediately.  The resident said we could talk to the NICU team and see.  I did get to hold the baby immediately, almost for 10 minutes, and they respected our wishes to delay cord clamping about 10 minutes.  NICU team was in the room, and DH carried the baby to them, and baby was back to me in minutes.  They did wipe the baby down, which I wish they hadn't done.  The same nurse hooked something to my IV line, and DH asked what it was... it was pitocin.  We both snapped at her that we didn't want it, and she unhooked it, but she wasn't happy with us.  After 20 minutes, the doc informed me of the medicines I could receive to help deliver the placenta because they "like it out within 30 minutes," and I asked if I could initiate breastfeeding instead.... she said sure.  Placenta was delivered w/out drugs.  I had some other issues with that same nurse... like when it was time to push, she automatically put me on my back in stirrups until the attending asked me what position I would prefer. The same nurse also was directing the pushing, which pissed me off.  I later spoke to another mom who had a planned birth at UofL and had that same nurse, and had issues with her too.  (I'll share her name with anyone who might be going to UofL so you can request NOT to have her!)

The baby was NEVER taken from our sight.  No mandatory nursery time at all.  No one even asked to take the baby.  Formula was never offered.  They are very pro kangaroo care, and baby was on my chest nearly 100% of the time unless DH or a family member was holding him.  The lactation consultant was very helpful.  We declined vitamin K with no issues, but the pediatrician on call pressed us into the eye goo since I was GBS unknown, although DS didn't get the goo until the next day.  We also declined Hep B shot with mostly no issue.  Ped tried to press it, but I finally said, "I know I don't have Hep B, so its okay."  We requested to keep the placenta, and we were able to have it released to us.  I also slept with the baby, and one nurse gave a small speech about "best for baby to sleep in crib," but that was the only comment.

No one ever said anything about us being a homebirth transport.  A few people even said they were sorry we didn't get what we had planned.  Now, that was a totally different situation that what you would have, since presumably you would be in the care of a specific OB.  But, if your OB is on board with your wishes, then you should have no trouble at all at UofL.

All that being said, I definitely think you should talk to some of the local midwives first.  I will send you a message as well with some additional info.

[jennyf917]

I was looking online and apparently U of L has the best c-section rate in the city. My first was born at Norton and it was an ok experience but my doctor was an ass. That was ten years ago, though. I also am curious about medicaid +OBs in Louisville. 

[provocativa]

medicaid does cover certified nurse-midwives, and there is a great one named katie  ican'trememberherlastname who practices in frankfort, if you can get that far.  otherwise, look for a CNM in louisville.

[mkat83]

Originally Posted by provocativa 

otherwise, look for a CNM in louisville.

There are not any CNMs currently practicing in Louisville.
 

[crunchywannabe3]

I'll offer my 2 cents...for whatever it's worth...lol (and I live in Bowling Green)

I have medicaid and I did go to my first prenatal appointment (I was 24 weeks at the time and still was trying to find a midwife) and just acted like I "wanted" a hospital birth...blah, blah, blah(I only acted like I wanted to birth in the hospital to hopefully get attention off of the fact I had 2 kids at home w/ a midwife in another state)...and no one really batted an eye.  I wanted to get checked out and what not, but I didn't go back after that.  They did call when I didn't go to my next appointment, but they can't make you go and no one has hunted me down, yet, lol I'm 34 weeks now.  And no one has called since.  I also found out if you miss so many appointments on medicaid you can't come back in, lol...I thought about just missing as many as possible if they did become too nosy and act like I thought I "couldn't" come in...but nothing came of me missing appointments, so I didn't have to go that far.   

I don't know about Louisville, but I did go to the ER down here( I was having contractions at 19 weeks, but it was from horrible, hot, physically demanding working conditions)I HAD to have a cathiter and moniters galore, I was not happy about that...then I found out it was for nothing because they wont stop contractions that early in pregnancy anyway, but the contractions stopped on their own, once my job fired me, because they found out I was pregnant...)  Then I had to go in again, because I got a bladder infection from the cathiter that I didn't want...and they kept me for hours.  It was so silly I couldn't go to normal dr. because I didn't have medicaid yet..so then I HAD to apply for medicaid to pay the bills... They go so over the top and cause more problems...that just made me want to birth at home even more.

There is a midwife in Lexington(she is too far for me) that I can find the name of if you want, pm me.  Sometimes midwives will let you keep making payments.  (I can't believe that most charge thousands down here...in WI I paid a thousand for everything...I think I got spoiled...

Hope I helped in some way...

[crunchywannabe3]

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