Mountain Midwifery Center vs home birth?

[wildflower06]

hi all, i'm newly pregnant and starting my research into my prenatal care and birthing options. i'm pretty sure my ideal would be to do a home birth and work with one midwife throughout my pregnancy. unfortunately, i called my insurance company (BCBS) and they offer no coverage of home births with a midwife. :/

luckily, the mountain midwifery center is in-network and (i think) would be mostly covered. while i still don't know my exact out-of-pocket expense with them yet, it is comforting knowing that much of the cost would be covered by insurance. i think it might be hard to convince my husband to pay full price for a home birth when this birth center option is available and would be covered.

anyone have to make this tough decision between what you really want and what works best financially? any recommendations from folks who have gone one way or the other (or even better, have had both a birth center and a home birth experience?)

thanks for your insight! feeling very excited, freaked, and overwhelmed with options. :) 

 

[mamamiz]

I LOVE Mountain Midwifery!! They were not open when my oldest was born, but I had my second child there and it was simply wonderful. It's an excellent option. I can't recommend them enough.

I do believe that home birth is less expensive than a hospital birth, so while there may be out of pocket expense, it's not as significant as out of pocket for a hospital.

[maydaymom10]

I had my son about 2 years ago at MMC. It was a great experience and I really liked all of the midwives there. And believe me -- they will have you labor at home until you are ready. At the time our insurance covered the prenatal appointments, but not the delivery. 

I'm pregnant again and due in March. This time around our insurance isn't as hot, and I actually wanted to experience a homebirth. It has nothing to do with anything at MMC, but I figure that if I'm going to basically pay out of pocket anyway (I won't consider a hospital birth unless medically necessary), then why not try a home birth. I have a wonderful midwife and I'm really looking forward to the experience. I will say that there is one plus for staying home -- I won't have to make that drive to MMC while I'm in active labor and I won't have to pack up and come back home hours after the birth. I can stay in one place :)

I don't know when you're due, but I can compare the experiences for you in a few month.   As for the prenatal care, so far there hasn't been any difference between the two. Good luck & congrats.

[nia82]

I had my DD there nearly 2 years ago. It was awesome. My insurance doesn't cover homebirth, but covered MMC 100%. It was basically a homebirth at somebody else's house. No monitoring straps (they do intermittent monitoring with a Doppler), you have the tub and so on. They work with a doula group and they have students, I hired a student and it was $100 I believe, very worth it. Their backup is Dr. Hall who is excellent. We opted for a 20 week scan and he gave us 20 pics. He does attend breech deliveries at the Swedish hospital, cause if you're breech, you risk out of the birthing center. I also loved that they didn't give me a hard time for not wanting Doppler checks at each visit (fetoscope only and Doppler only in labor - I was fired in FoCo for not wanting Doppler checks), it was easy to decline eye goop and the vitamin K shot, no internal exams in pregnancy, you can do the strep B swab in the bathroom yourself, they were great in labor. My personal favorite is Aubre but they are all nice.

[cynthiamoon]

Wildflower, if I remember correctly from our orientation, out of pocket costs for MMC with NO insurance are around 5k for the whole thing. That's insanely affordable if you ask me! Luckily, we're covered too, so we don't expect to pay for more than a few classes and co-pays. Assuming we don't risk out, this is definitely who we're going with. Maybe we'll see you around! When are you due? 

My first appointment there isn't for another week, so I have nothing to say about their practice... yet! But I got really good vibes from the orientation at least. 

Another thing I like about them, especially as a FTM with family into traditional hospital care, is that they have a healthy relationship to the nearby hospital and Dr. Micheal Hall, who does the MMC's ultrasounds and risk-outs (if you choose him). He is LOVELY, and I like knowing that should something go wrong, I'll be treated as a known patient with certain preferences and concerns, and not as just another 911 mom they have to rush through. 

I have gotten to know Dr. Hall. I went to his office for an early u/s and blood test because I've had miscarriages before and mild thrombocytopenia, and he was really sweet. When I asked for vitamin recommendations, he launched into an overview of his extensive research into vitamin manufacturing practices and how he'd picked the best of the best to take for himself and to recommend for his patients. That made me feel really good about him as someone who is thoughtful and cares about things like responsible fish-farming practices and such. 

I wouldn't feel like MMC is a second-rate choice at all if I were you! But I will say that depending on how this goes, I'll probably be tempted to homebirth #2 and #3. 

[dayiscoming2006]

With all these rave reviews about the birth center, if it is covered by insurance for the most part, I would definitely choose the birth center in your situation. You can use the money you save for other things your growing family will need or for paying other bills if you have any. 

[colomomma]

We chose MM because it was in-network, only to find out that our deductible was greater that the cost of the birth center.  I am still happy with the care and education that I have received thus far. I also developed hypothyroidism, and I was amazed at how well they have been managing it.  I love the extensive network of physicians they have to manage minor complications during pregnancy. Swedish is also a wonderful hospital, should you need to transfer. About 11% of first time moms transfer in labor or postpartum from MM.

Would it be realistic at all to get the majority of your prenatal care covered by insurance, then transfer late to a homebirth MW late in the pregnancy?  I have no idea if that is feasible, or would save money, just throwing ideas out.

[askins]

I had both of my babies at MMC and had two incredible birth experiences.  I just made a post to the homebirth forum, because I can't get the homebirth idea out of my head.  But after really thinking about it, the ONLY disadvantage of MMC over HB is that you have to drive to the birth center.  That's it.  Otherwise you truly do have all the benefits of HB.  Plus you have the security of having Swedish right around the corner, which for me is a significant improvement over my proximity to a hospital.

Totally, totally recommended, 100%.  PM me if you want to talk more - I LOVE talking about MMC, and I LOVE talking about my births!

Here's DS's birth story: http://onpinehill.blogspot.com/2011/05/birth-story-of-andrew-lee.html

and Here's DD's birth story: http://onpinehill.blogspot.com/2012/06/birth-story-of-clara-joy.html

[cynthiamoon]

askins-- did the doula or midwife take your photos?

[sunshineincolor]

Just a heads up...I had Blue Cross and they said they did not cover a homebirth but did after the fact send us partial reimbursement for the prenatal visits.

[askins]

Originally Posted by cynthiamoon 

askins-- did the doula or midwife take your photos?

Some combination of my doula and my husband took the photos. 

My first doula was Jessica Potter.

My second doula was Jessica Bejot (because Jessica P was on maternity leave for my 2nd birth).

I recommend them both!  They are both affiliated with Cocoon Birth, another fantastic organization!

We had an issue with our camera flash the second time so the pics aren't the greatest - through no fault of the photographers!

[wildflower06]

THANK YOU everyone for your responses. so helpful! we went to our orientation at MMC and i felt quite comfortable there. first appointment is february 5th. :)

askins, i really appreciate you sharing your birth stories. i read every word! thank you for writing those and for sharing!

[maydaymom10]

Originally Posted by wildflower06 

THANK YOU everyone for your responses. so helpful! we went to our orientation at MMC and i felt quite comfortable there. first appointment is february 5th. :)

askins, i really appreciate you sharing your birth stories. i read every word! thank you for writing those and for sharing!

Congrats! I know you're going to love it there. When you start looking for a doula Cocoon is awesome and everyone on their "list" is trained to work in a birth center setting. Jessica B is also great -- I know her and have attended  births with her (where she was a doula & I was a midwife asst). Also, I don't know when you're due, but I might be getting back into doula work by that time (I'm on "leave" until after my next baby is born in March). I'd love to talk to you if you're interested. We're doing a homebirth this time, but we did MMC for my DS. I know a lot of the midwives & office staff/doulas over there and hope to be joining the Coccon Birth list this summer. Good luck & happy pregnancy!! :)

[LauraBran]

I would agree with everything positive said about MMC, but not about Dr. Hall. I had to meet with him for a post-partum procedure and he really made me feel horrible. "They let you push too long" and "these are the worst tears I've ever seen" were top on the list. My daughter is 18 months and it still gets my blood pressure up thinking about the negative things he said to me, both the night of our birth and at my six week check-up. I'm hoping by the time we have our second, MMC will have another doctor that they can refer us out to if needed. Otherwise, I will look very seriously at home birth options and choosing my own back-up doctor.

[cynthiamoon]

Laura, thanks for sharing your experience. I have noticed that Dr.Hall is very frank, but I like that in a doc. I've also since met a couple of doulas who've attended births with him and they gave rave reviews, saying he was very caring and welcoming of their presence at purpose, and never pressured unneeded intervention.

Is it possible you really did have bad tearing worth noting? I can't tell if it's that you didn't like his tone or that you didn't like that something wasn't 100% healthy.

As for me, I ended up risking out of MMC, but I am happier at Hall's practice in many ways.

I had what seem like an atypical experience at MMC, but it wasn't good. I didn't get any of the personal, warm, attentive care that is supposed to be their whole niche. I still like the classes though, and will keep going to my childbirth class there.

I also didn't like how no one had ever familiarized themselves with my chart before that appointment. Every time I met a new midwife, I had to repeat my whole history to her while she scrambled to find the papers in my folder. They were really disorganized.

Also, I didn't like that I was recommended a homeopathic remedy. That stuff is total junk, and anyone who believes in that scam loses my respect pretty quickly.

ETA: By "homeopathic" I mean strictly things that follow the "dilute till it's useless then sell it" pattern. I am perfectly happy to learn about herbs and other holistic perspectives on healthcare.
Edited by cynthiamoon - 5/8/13 at 10:11am

[LauraBran]

Hi Cynthia,

I'm glad you are happy with Dr. Hall. It was definitely his tone and attitude. It wasn't about being frank, he seemed very uncaring to me. I actually heard from another mama that he had said the exact same thing to her (re: tearing) the month before. In my opinion, no matter what the truth is, that's not a very nice thing to say to a mama who has recently given birth and I hope no one else has to experience that. And being told that you pushed too long after 24 hours of labor? Again, not something I was very open to hearing. A caring doctor would have chosen better words and honored my birth experience, in my opinion.

I know MMC has gone through a lot of staffing changes in the last year and I wonder if that's part of the reason you didn't have the same experience most of us did. 

Laura

[askins]

Laura - I have to say, that I didn't get the greatest vibe from Dr. Hall either.  I saw him for two ultrasounds during my 2nd pregnancy (dating&viability and the 20week) he was over an hour late both times, mumbled to his assistant rather than speaking to me, wanted to make small talk throughout the u/s instead of talk about what we were seeing, gave very few pictures to take home and those we got were terrible views. And when we were determining the gender he made what I took to be a sort of crude remark about girl parts.  It wasn't horrible, it was just... unprofessional.

We were sent to South Federal Family Practice for ultrasounds the first time around and our experience couldn't have been more different - prompt, on time, good technical detail, spoke to us like we had the intelligence to understand, spent sometime looking at interesting baby shots even though it was a medical ultrasounds, gave several great take-home pictures.

I know it's not as big a deal as your experience, but it did rub me the wrong way, and I was glad I didn't have to spend anymore time with him than necessary.  I hope to ask for SFFP ultrasounds if I am blessed with another pregnancy.

[cynthiamoon]

It really is amazing how different women's experiences with a care provider can be!

I have to conclude that when talking about two overall good and well-liked providers, it has a lot to do with personality compatibility and dumb luck.

I've never waited longer than 10 mins or so at Halls's office, and he's been perfectly kind and informative during my US's, answering all our questions and narrating his measurements, etc. He did make some kind of sex joke when we couldn't find boy or girl parts, but that sort of thing doesn't bother me.

Once, they scheduled me in the very next day when I had an early bleeding scare (maybe that's what makes appointments run late?).

One time he even requested to be the one to answer my question when I called the nurse's line to discuss some test results. That really shocked me! We ended up talking for about 10 mins about that visit and my next one.

Also, when he first diagnosed my (then) placenta previa, and saw the look on my face when he said "c-section," I could see his eyes softening, and he lifted my chin up and reassured me that things could get better (they did!) and that no matter what we'd be in good hands. It was moving and made me feel well cared for.

I will add that of the midwives I met, I had really good rapport with Molly, who seems also very matter-of-fact and knowledgeable. Too bad it's not a private practice.

[LauraBran]

Hi Askins, Thanks for sharing your story. I had a similar vibe at our 20 week ultrasound and had my fingers crossed we wouldn't need to see him again. :-) I even addressed it with the midwives to try to get a different perspective on my interaction and got the feedback that he can be off-putting, but that he's very talented to handle complications. And I was very impressed he was coming off a late night helping a women birth twins naturally. 

[maydaymom10]

Originally Posted by LauraBran 

I would agree with everything positive said about MMC, but not about Dr. Hall. I had to meet with him for a post-partum procedure and he really made me feel horrible. "They let you push too long" and "these are the worst tears I've ever seen" were top on the list. My daughter is 18 months and it still gets my blood pressure up thinking about the negative things he said to me, both the night of our birth and at my six week check-up. I'm hoping by the time we have our second, MMC will have another doctor that they can refer us out to if needed. Otherwise, I will look very seriously at home birth options and choosing my own back-up doctor.

I had a very similar experience with Dr. Hall. I was transferred postpartum from MMC for a grade 3 tear, including an arterial tear. My husband & I were exhausted at that point after being up for about 30 hours. First, he told me that he would have to sedate me if I didn't calm down after the pain of the shots that he was injecting directly into my femoral nerve. I'm sorry, but my pain tolerance was shot after a 27 hour labor, 2 hours of pushing, and sitting through an attempt to stitch me up. Then my husband heard her comment to his nurse about "those women who insist on pushing these babies out naturally". It left a really bad taste in both our mouths. 

That being said, I've heard from several people in the birth community that he's wonderful during pregnancy & birth, but not so good bedside with postpartum issues. If I was looking for a VBAC, twin or breech birth, I would definitely go to him. He's very good at those specialities.