UC with midwife "back up"

[zoebird]

heya!

my husband and i are TTCing and think we might be pregnant (it's only day 12 after O! but i 'feel' different). so, we're thinking about stuff practically now.

for years, i've been researching birth and my husband and i are both "on board" for UC and excited about it. but, we also starting thinking practically about what we would want for "back up," and we really wouldn't want to go to the hospital if we could avoid it.

and we thought about hiring a midwife. we think that this is what we would want from this person:

A. minimal prenatal care with 3-4 visits tops--with no vag exams, dopplers, etc. no 'tests' and what not, maybe weight and measuring fundus and talking about how cool pregnancy is;

B. to be 'on call' when we are due, with knowledge that we may not call if we want to UC, and thta we will call i for consultation/advice over the phone, and if we feel we need it, then we'll ask the midwife to assist us;

C. if the midwife assists us and determines that we need to go for emergency care, then we'll go together for emergency care and she can help us with decision making and so on;

D. a post natal visit to do all the baby stuff, perhaps help with BC paperwork and what not.

So, now the big questions--

1. how do i find a UC supportive midwife who would be willing to offer us the most minimal of care?

2. what sort of questions should i ask to make sure that we're a 'good fit?'

3. how do i discover how 'hands off' a midwife is? are there 'buzzwords or language that she might use? is it appropriate to ask for a couple of clients to talk to as references?

4. do midwives charge the same amount to everybody, even those who want minimal care, or can we expect to pay just for the services that we use and the privilege of being on 'the list'? (i'm willing to pay for the privilege of being on her list at that time, as i know that midwives are busy professionals who may have to reject clients in favor of others who really want a midwife at their birth)

5. does anyone know of a midwife in my area (eastern PA, phoenixville area) who is UC supportive and would be game for this?

Thank you so very much for taking the time to answer these questions for me! We're just thinking about our options and what we want. We definitely want to UC, but we want to have a viable 'back up' as well.

thank you!

[alegna]

I would say that if you can find such a midwife (they ARE out there ) then the cost will probably be similar. Especially if you really want them on-call for birth.

-Angela

[mommyminer]

Originally Posted by alegna

I would say that if you can find such a midwife (they ARE out there ) then the cost will probably be similar. Especially if you really want them on-call for birth.

-Angela

:

You aren't just paying for the midwife to be there - you are paying for her knowledge and expertise - which it sounds like that's what you want her for.

Some midwives will discount, others wouldn't. I would try and find some hbing moms in your area for a perspective on how the midwife is at a birth. Or you could ask the midwife for referrals.

[zoebird]

but if i don't use her knowledge and expertise, then i'm really paying for her time only--time that could have been used working with someone else who wanted her expertise. so i am concerned about the midwife's interest in her livelihood as well as the health of other women who would use this midwife.

and i'm willing to "pay" for that. if i need her expertise, then i'm happy to pay for that also; but i assume that i will not need her expertise and that we'll UC with no problems.

i'm checking to see if insurance covers care now. hopefully, it does. then, the financial situation won't be as much of a question.

[alegna]

But if you want her on-call for the birth then she is going to NOT take someone else at the same time.

-Angela

[zoebird]

right.

which is why i'm willing to pay full price if i have to. but i was wondering if people who do this sort of thing have a more 'a la carte' situation or if it would be paid in full.

the other wrinkle is this. . .

if i have to pay full price out of pocket, i may not be able to afford that. if my insurance pays for it, then it's no problem to pay in full.

[MidwifeErika]

I am guessing that if you want her on call, it will be a full price situation. I would just start calling midwives in your area and talking to them about what it is that you are looking for and see if anyone can meet that need. There are some midwives who are fine backing up a UC.

[zoebird]

i can't find a listing of midwives in my area. i've tried google, my phone book, and the health care provider hotline through the government, though not through our insurance company. i plan on making that call once i get the number from my husband's HR dept.

so far, i've found one homebirth midwife group in our area--and i will call and interview them. i've known about them for a long while--before i knew about UC--but i've never contacted them or utilized their services. though, they're definitely on the list.

but before i contact them, i need to know:

what should i ask?

what sorts of answers should i get that would indicate that the practice is in line with my values/needs?

[pamamidwife]

I think you should ask specifics: that you're wanting to plan an unassisted birth, but you'd like some prenatal visits that you decide what is done. you'd like her to be available for the birth, but you may not call her. you may want her to come postpartum.

YOu should be able to tell right away if a midwife is cool with this.

CHeck in the "Finding Your Tribe" forums for PA and see what others say about mws in your area.

I do unassisted support for local families. My contract is as follows:

Unassisted Childbirth Contract

Recognizing that parents have the right to choose the type of birth they desire and feel most safe with, I wholeheartedly support unassisted (or unattended) birth. I am familiar with the politics, criticisms and benefits of an unattended homebirth.

This contract is between the undersigned and myself, Pamela Hines-Powell, CPM, LM (midwife) for families that are planning and desire an unattended birth at home.

Deposit: A deposit of $500 up front ensures that not only will I reserve space for you in my practice, but I will also be on call for any questions, issues or problems that may arise in your pregnancy.

Appointments: If a woman desires a prenatal and/or postpartum appointment, the per-appointment charge is $75. For postpartum appointments that occur outside of a 30 mile radius from Salem, an additional $25 is charged. All prenatal appointments will take place in my Salem office. I let the woman decide what she'd like done clinically at the visit. Labwork is an additional cost that may be discussed at the time of request.

Birth: I request an additional $300 at 36 weeks for on-call services for the birth. This is not a fee to attend the birth, but a fee to make sure that I'm available around your due date for questions in labor, birth and postpartum.

Should you ask me to come to your birth, there will be an $800 fee that is required to be paid by two weeks postpartum. If the family lives outside a 30 mile radius from Salem, a $300 distance fee will apply.

If a family calls me in labor with a situation I feel is dire and an emergency, I reserve the right not to go to their home in labor if asked, but to recommend emergency medical services instead.

If the couple desires my attendance at the hospital during transport, the $800 fee still applies. This fee covers the cost of any other midwife being brought in should another of my clients go into labor while I'm with this family.

The undersigned agree to this contract and its contents within:

[zoebird]

thanks, pam!

i did 'cross post' and i did find a few more listings than the one i already knew of. it looks like i'm looking for CPMs as much as i can find them. the CNMs are very medical it seems.

your contract is a *huge* help. it's nice to see how "a la carte" it is. that's very helpful, and hopefully a local midwife would be willing to do this.

my husband says "i do wish our midwife was a freak like Pam."

[pamamidwife]

ha! I'm a freak in many ways beyond midwifery. Actually, I'm not even a freak as a midwife. Just in every other way.

[Synchro246]

That's an awesome contract pam, thanks for sharing :

[Rowankc]

Whereabouts in PA are you?? There are midwives in the Harrisburg/Carlise area, I know as I assist one of them!!

[SublimeBirthGirl]

I know some midwives locally who were willing to come if I needed them. They weren't exactly on call, because they didn't charge me. I knew I was technically on my own, but they'd have come if they could. I was pretty relaxed though. Asking around is probably best. See if you can find some local UCers.

[Maggi315]

I don't think you are near me, I would assist you and I do more of an 'a la carte' thing. I like pam's contract, i think i might snag parts of that if she doesn't mind:

How far away from harrisburg are you?

[zoebird]

i'm near phoenixville/pottstown area.

[Maggi315]

I think that's pretty far from me, have you found anyone to help you out yet? maybe i could ask around...good luck to you...

[PapayaVagina]

We had a midwife sort of (I was kinda really flaky about it and refused to call her our midwife because I really didn't want a midwife) on backup for us. I wanted someone who could come and help if I feel like I needed it at some point in labor. My worry was that I'd panic and end up at the hospital and give birth 5 minutes after walking in the door. I also was really drawn to having postpartum care because I just really wanted some good support and nurturing.

We did get a big discount because I mainly only saw her to chat and have her feel my belly towards the end because I was curious about positioning (but we did have at least 1 visit before as well because I was freakishly huge). Usually our visits were just us lying on my bed laughing, talking about midwifery or playing with her kids. She did do a lot of postpartum care for us as well which was awesome because I ended up with a cesarean and a gajillion interventions that caused all sorts of problems. I would have loved to have not had her come at all but she ended up being a resource that I really enjoyed. Hopefully, for future births I won't need her at all

I talked to quite a few midwives before we decided what we wanted to do. I just flat out asked for exactly what I wanted if I had a UC (for someone to be on call and come if I felt that I needed them) or if I asked them to be there (hands off, heart tones only if requested, no perineal support, no suctioning, etc.) and most told me that they weren't comfortable with it. I had an advantage though because I knew several of them personally so I had at least a fairly good idea of how they practiced.

[zoebird]

maggi:

i have found two 'leads' in this area. i am going to interview them in the coming months. i'm not pregnant yet, and we decided to put TTC on hold until Nov at least. so, we're going to go when i start TTC again.

it's a start, at least.

[Charmie981]