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Questions on HomeBirths

post #1 of 10
Thread Starter 

Hello all. I'm newly pregnant with my 3rd child. Two older children are in their teens now, so this all feels so new to me!
I've grown a lot in my politics and preferences through the years, and know that I want to have a home birth. I have a home birth midwife picked out... she's mentioned that some moms want a "back-up" just in case. I have no intention of using a hospital midwife for the delivery, or for most of the check ups, but understand that my home birth midwife can't perform some of the blood work tests that I think would be a good idea to have, just to ensure that this baby is indeed healthy. 

How do I go about getting a hospital approved midwife, but not have to pay for her to be my full midwife? Can she release the medical data from said tests to me or my home birth midwife so that she is informed of my health, etc? My home birth midwife will be preforming my prenatal exams, and I trust her both personally and professionally to be quite adept at this.


Experiences? Guidance?
All is useful!!


With warmth,


post #2 of 10
I have not heard of a midwife being unable to order tests. Mine have ordered whatever blood work I wanted, ultrasound, etc. They also have a hospital backup that they work with regularly.

I would ask your midwife if she has a good relationship with a particular doctor. It is reassuring to know that your backup and your midwife are on good terms and respect each other. If that relationship is already established, and you don't have an OB you like, and have a history with, it would seem easiest to go with her recommendation.
post #3 of 10
I found a local hospital midwife who is homebirth friendly, and she has facilitated having my testing fine at her office on a per appointment basis.
post #4 of 10
Thread Starter 

Thank you for the info, ladies.
Looking at locking into a home birth friendly midwife. So much to plan for, eh!?

post #5 of 10

my homebirth midwife had relationships w/ certain centers and could order bloodwork and any tests she deemed necessary.


i have yet to have a single test done through her, but it was always an option.  she actually did the heelprick test on the baby after my last birth too (i had that done w/ the dr's office the first 2 births)


never got the back up OB either- always figured if we needed a hospital run, it would probably be an emergency section so was pretty much set for that too.


3 successful (and 2 very long) homebirths w/ her so far and looking forward to one more!

post #6 of 10

I would never recommend having no OB backup. Ever. 

This is foolish and a recipe for disaster.


I know many HB parents do this - and some HB midwives condone this. But this is not a wise way to go about having a safe OOH birth.


Also - you may need medical care over the course of your pregnancy and birth that is *not* an immediate c-section, or even emergent in nature. Having a provider whom you have a relationship will allow you to get this care much more readily - and hopefully - seamlessly.


There are a few ways you can establish care with a hospital-based provider:


First - which hospital would you transfer to in labor? Find a provider (CNM or OB or Family practice doc) who delivers there.


Schedule an appointment with one of these providers - maybe an OB consult - or pregnancy question/concern - some appointment that is *not* an "initial prenatal visit". (That will establish your care with that practice.)


Ask these questions: Can I come to you for lab/diagnostic testing during my pregnancy? If I needed to transfer to the hospital during labor, who would assume my care? If I have any postpartum complications, can I see you? Who do you recommend as a baby doctor or pediatrician? When should I bring in the baby for a routine visit?


Even one appointment will establish you as a patient in that practice.

Even if the provider is not excited or supportive of OOH birth (hopefully, you will find a supportive one!) - the practice will have a record on you as a patient -and you wouldn't be in the situation of rushing to the hospital looking for an emergency C-section.


Make sure your back-up hospital provider has - at the very least - your blood work on record. They will be able to take better care of you in the rare event that you need medical care if they have some information on you.


If you are paying out-of-pocket for your midwife and not intending to bill insurance, you may be able to get duplicate care with a hospital-based provider (whose services would be billed to insurance) and your midwife (whom you'd be paying out-of-pocket).


I saw CNMs and doctors during my pregnancies for lab work and consultation. I obtained a back up OB who knew that I planned to deliver OOH and who would order ultrasounds, tests, labs, and would take me as a transfer if needed during my labor. Each of the back up hospitals where I would have transferred knew about me - and had records on me - if I ever needed hospital-based care.


I ended up not needing those services - but I would not ever have given birth at home without those relationships in place.


Wishing you a happy and safe and satisfying birth!

post #7 of 10

wow!  i read all of the above and thought 'i need to get an OB' then promptly thought, but only if i have to meet them once and never see them again.... i think i only did 4 total vists w/ my midwife last pregnancy. so seeing anyone more than that seems so anxiety inducing for me.


i might consider looking around for an OB at a local hospital, but don't know where i'll be living in August.  and also really really would not want any oversight or interventions.


how does that work w/ OB practices?  b/c avoiding those extra tests, u/s, and visits is what pushed me to homebirth and midwives in the first place!

post #8 of 10
^^ this is what we are doing. Duplicate services- ob & billing insurance, paying cash for my HB midwife. MW cannot order tests here (at lest cpms cannot) so it made sense to see an ob. I also wanted some prenatal testing to assure that baby and I are a good match for HB. I will also plan on pre-registering at the local hospital if we should have a transfer.
post #9 of 10

my last midwife had a Dr she worked closely with and billed through. We've since moved so this time that is not the case. The midwife bills through a medical billing service. both times though I just get a referral to go to an imaging place or quest diagnostics for labs. easy enough. I work full time and don't have the time, energy, desire or need to have concurrent care (and therefore double appointments) through an OB.

post #10 of 10
Sweetsummer- I'm totally with you on the double appointment thing (and it being a total pain in the neck). However, in our case, where we live, OBs CANNOT know that you are seeing a HB MW (or if they get wind that you are planning on a HB) they will "fire" you. This is a huge challenge since CPMs cannot order tests here. AND CPM services are not covered by my insurance. So, it's what I'm stuck with :/ But I totally agree, it would be so nice to see one care provider and be done with it!!
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