Illinois - Midwives - Medicaid ???

[boomer78]

I'm not quite sure where to post this, whether here or the pregnancy forum(?).

I live in IL (west Chicago suburb) and this is my 2nd pregnancy. I'd like to do things differently this time around. I would like to avoid the typical ob/gyn practice and see a midwife instead. Someone that's [hopefully] open to refusing some tests, exams, etc. I'm not thrilled to give birth in a hospital (even with a midwife) despite a positive previous experience. I would like to be able to move freely and be in charge this time and would also like to avoid the typical pushing position if possible. Are there any birthing centers around the west suburbs of Chicago that accept Medicaid or is a hospital my only bet? Are any tests legally required in IL? I was trying to find the answers online but was not very successful. If I give birth in a hospital and refuse the HIV/GD during pregnancy - will there be consequences? Will they treat me and the baby like positive? I'm not opposed to the regular-breakfast-finger-prick-gd-test but would like to avoid the glucola test.

I always find very useful info here on mothering so if someone can offer an advice I would greatly appreciate it. Thank you!

[flg mama]

Unfortunately there are no free standing birth centers in IL right now, hopefully that will change!  West Suburban Hospital in Oak Park has an Alternative Birthing Center with waterbirth tubs, birthing stools, and a home-like environment (more so than any of the other hospitals in my opinion.)  West Suburban Midwife Associates are really wonderful, but they don't except medicaid anymore.  They offer a discount for self pay though.  There is another group that delivers at West Sub www.oakparkmidwife.com , not sure what they except but its worth a shot.  I am almost positive that there are midwives at Swedish Covenant Hospital in the city who accept Medicaid also.  Swedish is a great place to have a baby too, I've met many wonderful midwives and nurses there.  And they have tubs.

Not sure about the tests.  I think its always up to the mother, but they will pressure you if you fall into a risk category (like for GD or group b strep).

Good luck and congratulations!

[AmandaMamma]

Hi there!

I had my first baby in late 2007 with a midwife practice that no longer exists. They delivered with Alexian Brothers in Elk Grove Village. I had a horrible experience as well as a friend of mine. Bad experience as in I went to therapy for a while after. The one silver lining was a specific midwife who saved my ass from a section and stood up for me. Fast forward to this year and becoming pregnant I found her again. She works under an OB in his office in Arlington Heights.

She is not like a home birth midwif though. Her background was labor and delivery nurse first. She does believe in some testing. I did do the glucose testing which I was okay with becaus of my weight. I passed by a measly point and she has me monitoring but refuses to give me the official diagnosis because of the extra intervention it would bring.

The OB she works for sought her out and trusts and believes in her. For me that was a great sign.

She delivers at Northwest Community in Arlington Heights. When I went for the tour the nurse talked about how once you get in there they want you up and moving around, if everything is fine they do the baby checks while the baby is on your chest. And they defer to your doctor (or midwife) about what kind of monitoring you need. (at Alexian I was bullied by the nursing staff, my midwife says Northwest is a much nicer place.)

Anyway, I'm on the Mom and Baby insurance and they take that. I can PM you her specific info. She might be worth trying compared to alternatives, but again I'm not sure if she is quite as hands off as you would prefer.

Good Luck!
Amanda

[boomer78]

I have to say, I spent the past few days calling and asking questions... I'm getting all nervous and sweatty (out of frustration) after talking with a few providers/hospitals.

Flg mama and AmandaMamma, thank you both so much for your replies, I really know nobody that would question doctors/procedures/hospital rules when it comes to anything, pregnancy/labor/delivery including. All I have is mothering.  

Yes, it's a shame there is no FSBC anywhere around here. I did check out one of the practices in OP (it was the one you mentioned flg mama - oakparkmidwife.com!) that still accepts Medicaid but after realizing how far is it and cosidering the possibility of a typical Chicago traffic I feel like I might end up delivering in my car. My first labor was kind of fast and I was forced to not do anything and wait for the doctor who was not coiming for an hour or so. Um, how exactly do you not push for such a long time when you have to push? :) If it's true that second labor tends to be faster I'm not comfortable driving all the way to OP from our house, I'm way west of there and traffic towards east (Oak Park, downtown, etc.) can get really, really bad.

AmandaMamma - wow, you must have had some really bad experience delivering at Alexian Brothers. Sorry to hear that. That was kind of the last place I ended up with. Was the good midwife W. Allen by any chance? I have found this name/Arlington Heights practice searching all threads about midwifes/Chicago here on Mothering. Thanks for the info on Northwest Community Hospital. It does sound like a better fit for us at this time and I will definitely check it out.

I called Alexian Brothers - labor and delivery - to ask if our dd could be present in the room with us. I don't understand this. They have no official policy, but normally it's not allowed. Karen (who is responsible for decision) takes my info, promises to call me back (was just leaving) and tells me it should not be a problem. i'm guessing it probably doesn't happen very happen at all there and wouldn't want them to think we're all nuts as soon as we arrive. I would like to not be hooked up to any IVs, I want to be able to move around and change positions, I don't know but delivering outside of the norm of the usuall position is probably asking too much, right? The doctor that delivers at Alexian Brothers is Richard Mruz. Their web page says he or midwife Jill could be there for delivery, depends on who the mom choses. I'm all for just having women around at such time (besides husband of course) and was told over the phone that only the doctor does deliveries now. I feel like having a male ob would just get me a little more stressed out. I just want this to be a positive experience, that's all. I also don't want them to take dd out of the room for anything without me or dh present so NW Community Hospital sounds like a good match (not sure what the policies are at Alexian Brothers for this). It's not the closest either, but not super far and driving North should definitely be less of a problem than driving East.

[AmandaMamma]

I have a friend who delivered at Central Dupage with her 2 year old present. But that was because her labor was so fast they all had to go and the baby came out very quickly after arriving. If you are planning a natural birth I wouldn't recommend them. They have higher rates of Caesarian and interventions.

So far I'm really happy with what I've seen of Northwest Community. Nurse on the tour said they encourage mom moving around, using the shower, birth ball, etc. The encouragement of breast feeding, never giving a pacifier, never giving formula, not taking the baby from the room. She also said just tell us your stance on pain meds. If you don't want it just tell us so we won't offer. Hopefully it's not all talk!

I've learned though that no matter how much you want something to be flexible.. Can't control if labor goes a certain way, they have to suction from meconium, stuff like that. But I'm making sure I know what will happen either way.

[DoulaSam]

As a doula I have had some pretty horrible experiences at NCH in Arlington Heights(with midwives and OBs), but every provider is different. I will say they have(or at least still did in Dec 2011) a mandatory separation time for baby in the nursery after delivery. I believe its that they take the baby for an hr to be observed, so I would ask about that.

Dr. Murz is a really great MD, but at Alexian Brother you can't refuse Vit K shots and the eye ointment can also be a battle, so that may be a sticking point for you. Hospitals try to sell themselves and say what people want them to say. When interviewing with a practice don't only ask what they allow, but how often it actually happens. There is a huge difference between there being no policy against something and it actually happening. An example is Alexian Brothers has a room with a labor tub, but yet the room is usually used for people who are ruling out preterm labor or there for over night testing and not for laboring women. I was actually there with my one client who had been promised the room, but then when she got there was told it was full and when we went on a walk there was a sign on the door that said "24hr urine collection in progress" needless to say mom was pissed.  

I personally would make the drive to WestSub or Swedish and I live in Schaumburg, so I know it is a hike, but it is 100% worth it. The practices in our surburbs rarely see natural birth so while they are very skilled in routine delivery practices, they are not very specialized in low intervention birth like the midwives at WestSub and Swedish are. There is a labor tub in every room at Swedish and at Westsub they have two birthing tubs. Both midwife practices also practice delayed cord clamping. I just can't stress the difference between suburban provides and city(or near city) providers. At Swedish they will give you your placenta all boxed up nicely, don't bat an eye if you refuse vit k/eyes and so on vs the burbs where some hospitals have policies against handing over placentas and will call DCFS over refusing to give vit K. 

As for HIV testing if you refuse it while pregnant they will draw blood from the baby, it is a state law. Also the PKU test can't be opted out of either. 

Depending on where you live west Dr. Carroll at CDH is supposed to be good, Dr. Michael at Sherman as well as are the midwives in Aurora at Rush Copley(they do water birth). 

[AmandaMamma]

Wow, I'm hoping they don't have a manditory nursery stay! I have asked several staff specifically about that and told no. Also my midwife has told me they don't take the baby. I will ask again on Monday at my next appointment.

[DoulaSam]

Hopefully they've recently changed things, but my last birth their in early Dec required a 1hr stay after baby has had a good feed and everyone has had some cuddle time. While 1 hr is hard the real issue comes about on a busy day where the 1hr becomes 3 which happened to my one client, but that was a few years ago now. I will say the nurse I have met are all nice and compassionate which really helps. Also if someone is hoping for a natural birth really look into getting a doula. Many do the occasional lower cost birth if price is an issue. 

[AmandaMamma]

Wow. Thanks for the info. It just seems so crazy to me. Did they give a reason for this? It just seems so opposite of what the baby would need.

[DoulaSam]

Just that it was policy :/ hopefully that has changed. 

[Eyelet]

Boomer78 - I don't know if homebirth is an option for you, but I hear that Debbie Boucher (http://yourbirth.com) accepts medicaid. She's located in Liberyville, so your appointments would be quite a hike... BUT at birth she of course would come to you. If she doesn't cover your area, maybe she can recommend someone who does. Good luck.

[boomer78]

Thank you all who have posted, sadly I lost the baby not too long after I posted. :(  I swear when I started searching what options I had, different hospitals, doctors, procedures + Medicaid involved...my head was spinning. Then I found out I had a blighted ovum (probably from issues with progesterone from breastfeeding). I did go for an ultrasound (when I started bleeding) to Dr. Mruz and he - luckily - didn't give me any hard time about breastfeeding and ttc. He was pretty reasonable about it. 

While it seems like getting pregnant while breastfeeding will be difficult for us (I'm not going to wean dd) it's still great to know what options I may have if I ever get pregnant again. 

DoulaSam - Wow, those are some great things to know and information to have!!! I did read about how refusing some things at Alexian Brothers may turn out very difficult, if not impossible.  

Eyelet - to be honest I haven't decided for a home birth at the time but kept considering it. I had no luck finding a midwife/doula back then that would accept Medicaid. Thanks! :)

AmandaMamma - I exchanged a few messages with you and you have helped a lot, too! Have you had your baby yet? 

[emmagrace]

I am currently on the hunt for a home birth midwife, and hopefully one that can see me in Chicago (no car) and accepts Medicaid.  I have a consultation with Sarah Simmons this week (I know she does not take Medicaid, but I'm prepared to pay out of pocket if ultimately necessary), but I was wondering if anyone knew if Gentle Birth Care (Hillary Kieser) takes Medicaid?  They are located in Oak Park, but I've read they also see patients in the city at Mother Me.  I'm planning to call again tomorrow (apparently I called on a very busy day last week, and didn't have a chance to really ask anything), but I was hoping someone might know.  Thanks!

[DoulaSam]

I believe only Debbie takes medicaid and she is in the northern burbs 

[cupcait]

emmagrace - Hillary was my midwife and she doesn't take medicaid, but I think she gives a slight discount if you pay in full by 36 weeks. If you can afford to pay out of pocket, they are awesome! I saw them in both the Oak Park and Chicago office.

[boomer78]

I'm revisiting this thread again, it seems like I'm pregnant again. :)  So far I've been going to Dr. Mruz (last mc, this time for a blood test) and was wondering if it's still a fact that you can't refuse certain stuff at Alexian Brothers. I would call and ask but am a little afraid I'll get a 'nice' answer and than not such a nice surprise later on. What are your thoughts?

DoulaSam, your info is not very comforting as Arlington Heights was my other choice when I was pregnant the last time.

It's exactly what you're saying. The hospitals are trying to sell themselves so I'd much rather hear from a mom/doula/midwife.

I don't think I woud be comfortable with West Suburban, it's a good 50 min drive if there is no traffic. Sweedish is even more further out. But it's a good point that they're more likely to not have a problem with some requests. Oh boy.

I had no idea they would draw blood from the baby for the HIV test.

Thank you for all information, I'll check out the providers mentioned that might be a little bit closer. Is Sherman the hospital in Elgin? Does anyone have any experience with it?

I really like the nurse at Dr. Mruz's office. But sadly Alexian Brothers is out since I can't opt out of vitK injection, eye ointmemnt or the hepB shot. I don't want to deal with DCFS. :(

Originally Posted by DoulaSam 

As a doula I have had some pretty horrible experiences at NCH in Arlington Heights(with midwives and OBs), but every provider is different. I will say they have(or at least still did in Dec 2011) a mandatory separation time for baby in the nursery after delivery. I believe its that they take the baby for an hr to be observed, so I would ask about that.

Dr. Murz is a really great MD, but at Alexian Brother you can't refuse Vit K shots and the eye ointment can also be a battle, so that may be a sticking point for you. Hospitals try to sell themselves and say what people want them to say. When interviewing with a practice don't only ask what they allow, but how often it actually happens. There is a huge difference between there being no policy against something and it actually happening. An example is Alexian Brothers has a room with a labor tub, but yet the room is usually used for people who are ruling out preterm labor or there for over night testing and not for laboring women. I was actually there with my one client who had been promised the room, but then when she got there was told it was full and when we went on a walk there was a sign on the door that said "24hr urine collection in progress" needless to say mom was pissed.  

I personally would make the drive to WestSub or Swedish and I live in Schaumburg, so I know it is a hike, but it is 100% worth it. The practices in our surburbs rarely see natural birth so while they are very skilled in routine delivery practices, they are not very specialized in low intervention birth like the midwives at WestSub and Swedish are. There is a labor tub in every room at Swedish and at Westsub they have two birthing tubs. Both midwife practices also practice delayed cord clamping. I just can't stress the difference between suburban provides and city(or near city) providers. At Swedish they will give you your placenta all boxed up nicely, don't bat an eye if you refuse vit k/eyes and so on vs the burbs where some hospitals have policies against handing over placentas and will call DCFS over refusing to give vit K. 

As for HIV testing if you refuse it while pregnant they will draw blood from the baby, it is a state law. Also the PKU test can't be opted out of either. 

Depending on where you live west Dr. Carroll at CDH is supposed to be good, Dr. Michael at Sherman as well as are the midwives in Aurora at Rush Copley(they do water birth). 

[DoulaSam]

I just recently did a natural birth at NCH in June and they didn't do the 1 hr separation which was great, so I believe that policy was finally lifted. The parents opted for all the newborn procedures so I can't comment on that, but mom was left alone for the most part to labor as she saw fit which was nice to see and we were allowed the wireless monitors. They did give us a hard time about the placenta being release however, but all in all it was a pretty good experience with the nursing staff.

Sherman is in Elgin at Randall and 90, and has been instituting some good skin to skin policies which is great to see. Another option could be Hinsdale, they are at 294 and Ogden and just put in labor tubs in three of their birthing rooms and have wireless monitors. My clients in the past have gotten all the routine newborn procedures done, but they seem pretty flexible as a whole. Most people see Dr. Daube (OMGWH), but that is also a little far. I live at 90 and Roselle and during non-rush hour Hinsdale and Sherman are both 30 minutes, Swedish 35 and West Sub is 40 or so. 

If you're open to home birth try Debbie http://yourbirth.com/ as she takes medicaid and then you don't have to worry about the hospital being too far or newborn procedure issues. 

[boomer78]

DoulaSam - thank you so much for all your advice! I really, really appreciate it. I remember calling to Alexian Brothers (Elk Grove) and Sherman (Elgin) to inquire whether dd could be present for the birth. At Sherman I was told no problem, at Alexian I had to give out info and wait for someone to call me back. When they called back they said it's on case by case basis, ask who my doctor is and said it would most likely be possible.

I'm considering a home birth. I'm not convinced I can do it because there is so much fear around (from what can go wrong, etc.), yet I want to refuse most of what the hospital would offer and maybe even fight with them about it so a home birth would actually be a more peaceful birth anyway. I should probably trust myself more?  I would like to to this one without epidural but really I'm thinking, while looking brave, can I really do it? And all these...what ifs... :) 

If I decide not to go with home birth (but you really do have me thinking!!!, it's about 50/50 now) which one of the hospitals you mentioned would you feel most comfotable sending your clients to? I actually don't live too far from you, just slightly SW of I90/Roselle Rd. I would have to start a whole new search about an ob/gyn who accepts Medicaid (most seem not to) even if I do find a good hospital, I mean a new one, that I haven't considered yet. What happens if I don't want the monitor on me at the hospital? Could they force it? I don't even know if I would be comfortable with the wireless one. I don't really like anything wireless. Oh boy, I'm just making this even more difficult... Perhaps another reason for a home birth?

I will definitely check Debbie out. Thank you so much for the link. 

I'm getting a little panicky like the last time eventhough this time I'm a few steps ahead thanks to MDC.:)

Originally Posted by DoulaSam 

I just recently did a natural birth at NCH in June and they didn't do the 1 hr separation which was great, so I believe that policy was finally lifted. The parents opted for all the newborn procedures so I can't comment on that, but mom was left alone for the most part to labor as she saw fit which was nice to see and we were allowed the wireless monitors. They did give us a hard time about the placenta being release however, but all in all it was a pretty good experience with the nursing staff.

Sherman is in Elgin at Randall and 90, and has been instituting some good skin to skin policies which is great to see. Another option could be Hinsdale, they are at 294 and Ogden and just put in labor tubs in three of their birthing rooms and have wireless monitors. My clients in the past have gotten all the routine newborn procedures done, but they seem pretty flexible as a whole. Most people see Dr. Daube (OMGWH), but that is also a little far. I live at 90 and Roselle and during non-rush hour Hinsdale and Sherman are both 30 minutes, Swedish 35 and West Sub is 40 or so. 

If you're open to home birth try Debbie http://yourbirth.com/ as she takes medicaid and then you don't have to worry about the hospital being too far or newborn procedure issues. 

[boomer78]

So home birth is ruled out, we can't afford to pay as much at the moment, unfortunately. Sigh. Back to square one and back to a hospital.

[DoulaSam]

If I was personally having a baby in a hospital I would go with one of these three choices below and use the midwives. They will be more open to your requests and won't look at you like you have two heads like many OBs will. As for monitoring many are open to intermittent monitoring(which is usually 15min on, 45 off or something similar) after they get a good 20min read on baby. That being said if you are planning medication you have to wear the monitor for 20-30minutes before they give you the medication and for the rest of your labor. Natural birth is a pretty amazing thing, it is very hard work, but also very doable with the right support and education. I work with lots of mamas trying for natural births and many have had previous epidurals and when they finish their natural birth they say it is like night and day with how they feel after, so it is something to considered since it sounds like you don't want the baby exposed to unnatural substances(the epidural medication does go to baby). 

UIC-allows 42w pregnancy, lots of natural birth patients, very low c/s rate, wireless monitors that can be used in water, two deep tubs for labor, big showers every rooms, hopefully getting waterbirth soon, open to gentle slow inductions. Negatives are lots of students(though you can refuse them) and it is a large group so it is hard to get to know everyone. I haven't had a sibling birth there yet, but they may be open to it. I have had clients refuse eye medication, but not vit K there. Even though it is miles wise farther than West Sub it is right off 290 so it takes the same amount of time, sometimes faster.

[phone]

Swedish-Sometimes allows for 42 week pg, labor tubs/shower in every room, birthing stools, few students, lots of natural births, and nurses are used to low intervention. Negatives no wireless monitors so if induced you are stuck on a short leash. It is a small group and all the midwives are very nice and supportive. They will box your placenta up no issue and most of my clients don't do eye medication and some have refused vit K without issue.

http://swedishcovenant.org/medical-services/midwifery/team-clinicians

West sub-Allows 42w pregnancy, they have two rooms specifically designed for natural birth that offers water birth, have queen size beds and so on, wireless monitors, lots of natural births, showers in every room, used to people taking a placenta and refusing different medical treatments, siblings at births is allowed as long as their is one adult for that child. Negatives, if ABC is full no water birth, hospital a little older looking. If you are planning a natural birth and the ABC is open you are given priority, once in the room they don't offer pain medication. If you change your mind and decide medication is needed they will move you to the regular labor floor. There are two midwife groups and I can't remember which takes medicaid. 

http://www.westsubmidwives.com/index.php

http://www.oakparkmidwife.com/home/Midwives.html