How do prenatal visits work for homebirth?

[eayeary]

We’re planning to get pregnant sometime this year and have discussed our options.  After a horrific hospital birthing experience I vowed my next will be a homebirth.  We have some unanswered questions we do not seem to find the answers for so perhaps someone here can help us out.

I have a regular OB/Gyn that I see for my yearly pap and who delivered my first son.  Do I go to him for my prenatal visits and then just not go to the hospital for my labor?  How does this situation work?  When you opt for a homebirth are you opting out of an ultrasound?  I know the midwife I plan to use for the birth does not have that type of technology because she is a certified midwife that does not have or work for a private organization.  If someone could just explain to me where and how you do your prenatal visits, check-ups etc but still deliver at home, I would be greatly appreciative.    

[HippyMomOf4]

I saw my midwife for a consult at 6 weeks, then I had my first appt at 10 weeks. I saw her every 4 weeks until 30 weeks then I started going every 2 until 36 then I went every week. She did labs if I wanted them done and pap(I didn't need one). It pretty much the same prenatal visit schedule that an OB would have but with long appts and more bonding time. Each one of my appts were 45 min- 1 hour. 

[mommabones]

The midwife I'm seeing just writes referrals for ultrasounds and lab work when it is needed, and they send her the results. For me, it's covered by insurance (the homebirth and prenatal visits aren't, just the ultrasounds and lab work and, if it becomes necessary in an emergency, hospital transfer). But a lot of her clients have to pay out of pocket for these services because their insurance just won't cover it at all. 

The appointment schedule with my midwife seems to follow the schedule of most care providers. Every 4 weeks til 30-32 weeks, can't remember exactly. Then every two weeks til 36 weeks, then every week, etc. Our visits with our midwife are usually 40-45 minutes but she sets aside an hour for each client, and if it takes longer she doesn't just cut you off and leave. 

[Youngfrankenstein]

Hi!  Welcome to MDC.  I am in Cuyahoga Falls.  I chose to do parallel care with an OB/CNM practice and then joined up with my midwife and did pre-natal care in her home with her.  We didn't decide to homebirth until about 28 weeks or so.

Because homebirth isn't really legal in Ohio, I decided to do the parallel care so that if I had to transfer during the birth, I would be seen as a "regular" patient.  I hired a mw with the full knowledge that she would be by my side all the way in case of transfer but it made it less of a hassle having paperwork with my GBS status and the like.

I did not have to transfer and was facing an induction but luckily it wasn't necessary.  In doing the parallel care I got the basic bloodwork and an ultrasound as anyone else would. 

My pre-natal care at the practice was paid for somewhat through insurance although I still had a lot of out-of-pocket just because of my insurance but I paid a flat fee for my mw in addition that included post-natal care as well.

[gmaemaymama84]

My midwife has someone to refer you to if you want an ultrasound.  They have it worked out so the results are sent to her.  She draws labs if you want them, and she has the results sent to her as well.  She has an office in her home that she works out of.  Her patients go to her house and get their blood pressure checked, temperature, urine tested, she listens to baby with a doppler, she palpates the baby to check positioning.  The appointment is pretty much the same as when I saw an OB with my first baby, but I spend almost a full hour with my midwife every appointment, chatting, talking about how I feel and how to make it better, my emotions, etc.  By the end of this last baby, I felt so loved by my midwife.  I couldn't have asked for a better experience. 

[eayeary]

Thanks for everyone's advice and help. 

Youngfrank I delivered at Robinson Memorial for the first time around and that was the most horrific nightmare in the world!!!  I lived in Kent since 2006 and moved here to South Akron in June.  I found a waterbirth clinic in Westlake but that's quite a drive for appointments once a month or more.  However, they have an all midwife staff and allow in water birthing...very exciting that Ohio is starting to expand a bit in the natural delivery area!

I have a midwife who was my doula before so I just want to make sure I get all the checkups and required care that she can't provide...urine testing, ultrasound, etc.

[Youngfrankenstein]

I lived in Kent for 7 years!  I drove an hour to my appointments so I know what you mean.  The mw who delivered my first child in a hospital was great.  Her name is Sue Hudson and I think she practices in the Wadsworth area.  I think she delivers at General and a hospital in Wadsworth. 

My water broke at 38 weeks and she let me wait around all day to see if I'd go into labor before inducing me.  She went very slowly with the pit and she knew I didn't want an epidural.  When my labor kicked in I told her it felt like I was having double contractions and she backed the pit way off.  She offered me Nubain once and when I said no she didn't bring it up again. 

She just talked me through the whole thing.  I had 2 stitches.  I would have used her again but she was no longer with that practice and was farther away.  Honestly, if I'd could have had her, I may have considered a hospital birth with her rather than a homebirth but I loved my homebirth too. 

[eayeary]

That sounds wonderful and very helpful but I'm pretty stuck on a water birth.  That opens my options to 1. Homebirth or 2. Westlake.  I'm leaning toward Westlake at this point in time because I don't want to go through the out of pocket expenses to pay for or rent a birthing tub and supplies.  We have fantastic insurance so I would probably pay less through the Westlake Birthing Center. 

Did you ever attend LLL in Kent in 2007?  If you did, we may have met! :)

[eayeary]

Youngfrank,

I tried to PM you but it won't let me.  Who was the homebirth midwife you used in the Falls area?  We got our first BFP today and I contacted the doula I used with my son but want to look into other people as well before we decide.  You mentioned the OBCNM practice you used was  okay with you combining them?  They knew and accepted that you wanted a homebirth?  I don't have a local OB out here since we moved so I'm looking for ideas local.  I work near the Falls so that might be okay for us.