Co-care???

[slavila]

So I was wondering if anyone continued care with their doctor after deciding to have a homebirth with a midwife. Here's my situation: we decided at 34 weeks to have a homebirth with a midwife, so up until then we have been seeing an OB. Our insurance covers the OB and hospital delivery, but not the midwife and homebirth. Our first official appointment is tomorrow with the midwife and today was our last appointment with the OB. All tests are covered by our insurance throught the OB and my husband has said he would like to continue seeing the doctor as well in case any kind of complications happen. Today at the OB appointment the doctor said he's not sure if the baby is breech, so now I'm freaking out about that. Our midwife knows we saw the doctor today but doesn't now our feelings about seeing her and the OB; we plan on discussing this with her tomorrow, but I'm worried about what she will say. And we haven't even told my OB that we are planning a homebirth!!

Anyways, I hope that wasn't too confusing and was wondering if anyone has ever been in a similar situation and how they handled it. Thanks!!

Sarah

[Xiao]

We were seeing an OB only up until 30 weeks. At that point we switched to a new OB who is homebirth friendly, and signed on with a lay MW. Insurance covers the OB and hospital (if we go there); and we are paying the MW, either out of pocket or out of a flex account at work if they approve it. The MW gave us a discount because we signed up kind of late in the game.

The OB knows about our homebirth plans, and is very supportive. But she was really hard to get in with, and is the ONLY OB in town who seems to feel this way. I think it might be rare that things work out so well. If we had not gotten in with the new OB we still planned go with both the OB and MW, but not mention home birth plans to the OB. (Oops! We did it at home! Who knew they came so fast???) We talked to the MW about this deliberate misrepresentation of our intentions (to the doctor), and she was willing to go along with this plan, but obviously it was not ideal. It had the potential to be rather awkward if we were to end up transferring later in labor with some kind of a problem. Some OB's are really, really hostile toward homebirth...if you are completely honest about this, things may become so unpleasant that you will have to switch OB's anyway.....

We are both really happy with the current arrangement. We hope to stay home for the birth; but have the added security of being established with the OB just in case. This is a first baby/first homebirth and we had read that the transfer rate for first time mothers is higher, even leaving aside major issues like breech presentation. We didn't want to run the risk of showing up at the ER and not having an established relationship with an OB. My husband especially was insistent upon this; but I have to say that I am now really glad that he insisted.

Regarding the baby's position, I hope that turns out well for you. Definitely check with the MW, OB, and on the internet for information on helping the baby turn. My sister's second baby was breech. They tried positioning and an external version, these did not work. Then her CNM taught her some pressure points on the feet and hands, and gave her some herbal tea. The baby ended up flipping on her own and she had a really good birth in a freestanding birth center.

Things are never guaranteed to work out the way we hope they will....but sometimes it pays to be persistent and consider alternative methods. Best wishes to you and your husband and baby.

[Nicole77]

I do not see an OB but my midwives encourage their clients to choose one of their back up providers for a bit of concurrent care. So, I see a hospital based midwifery group once per trimester just so that I have a relationship with them and they know who I am in case we ever need to transfer to a hospital. The group knows that I am a homebirth patient and they have a good working relationship with my hb midwives. I also use them for any bloodwork or testing that I decide to have done (which is basically none!) so that my insurance picks up the tab.

[Slingin'Momto4]

No, I just see my midwife. No OB's will see me because we are having a homebirth. I tried to see one in the beginning and did but then they told me they couldn't see me anymore cause of our homebirth plans...

[erinkrum]

I had ptl with my DD, so I see an OB as well--and will until I'm 36 weeks, and can birth with my MW at home. The MW knows we see the OB, but the OB doesn't know we don't intend to birth at the hospital as long as there are no problems. I doubt your MW would have a problem with you seeing an OB as well; mine had no issues with it whatsoever, and totally understood why. Depending on where you are and the legality of midwifery/homebirth, there may or may not be an OB willing to see you knowing that you're planning a hb. Where I am, any mention of homebirth in an OB office will get you dismissed from care.

Also keep in mind, in a true emergency transfer, you'll most likely get whoever's on call at the hospital anyway, as there won't be time to get your actual doc.

Good luck whatever you decide!