Birth options in Providence area?

[Lauren710]

Hi ladies, I'm apologizing in advance for rambling, pregnancy brain has not been so good to me this week

I wanted to get some opinions from anyone who's given birth at Women and Infants' in Providence or Memorial in Pawtucket, or anyone who's homebirthed, for that matter. I'm due December 20 and although I would love a homebirth, money is really an issue and insurance will pay for a hospital birth, so it's looking like that's what I'll have to deal with.

I've been using the Center for OB/GYN for my prenatal care, but after talking with the CNM I've been seeing at my appointment yesterday I'm having second thoughts about sticking with them for the rest of my pregnancy.

There are only two CNMs at the practice and there is no guarantee that either of them will be on call when I go into labor, thereby preventing me from delivering in the ABC at W&I. There is at least one OB at the practice with whom I do NOT feel comfortable, I haven't met anyone else yet. I really don't want anyone messing with me while I'm in labor, no interventions etc., and the OB I saw didn't exactly reassure me that they'd respect what I want. I'm 22 and healthy, taking my prenatal vitamins, RRL tea, and have been doing some yoga as well. My baby girl has looked/sounded great at every visit so far, so barring any unusual unforeseen circumstances, I'm on track to have a pretty straightforward labor. Since I'll be delivering around the holidays, I'm pretty concerned about the possibility of being induced or told I need a C-section with no real medical necessity (ie, because the doctor just wants to get home to their family).

I'm debating whether it would be worth it at this point to try to switch providers, or if I'll encounter the same scenario anywhere I go. Mary Mumford-Haley and Deb Erickson-Owens are both listed as preferred providers for my new health insurance plan and I believe I've read good things about both of them on this board, as well as Memorial Hospital over Women and Infants'.

Too bad DH is going to be a nervous wreck, otherwise I'd seriously consider UC. I'm planning to read up on it anyway, maybe I'll be able to talk to him about the possibility of just staying home if everything's going well.

Anyway, sorry for the long post, I really just needed to talk out my situation and I'd love to hear the good, the bad, and the ugly about birth options in Providence/RI.

[Sage Green]

Oh, me too! I am very interested to other's experiences and recommendations. I am not pregnant, but my baby is one year old now. I also went to the Center for OB/Gyn and was mislead that I could deliver at the ABC until I actually saw a midwife for one of my appointments at 26 weeks or so. She said that they did not attend births at the ABC b/c there were too few of them to guarantee coverage and that they might provide labor support if I was in labor durning the day she was at the hospital.
I didn't switch practices even though my heart told me I should. I ended up at W&I about 6 hours after my water broke. I labored for 5 long hours in Triage behind a curtain (with no support from nurse, other than to be told that many women labor everyday and I am no different) and was finally sent up to L&D (room shortage that day), put on pitocin, begged for an epidural, pushed for 2 hours w/every contraction one ontop of the next. Her head crowned and with no further progress Dr. said he had to do C-section. Dr. wasn't in my group practice - apparently Center for OB/Gyn shares call hours with another group.
So, I have learned to hire a doula and find a practice that can guarantee a midwife on call for your delivery. I also had to wait 4 long days to see a LC at W&I, totally unacceptable and unimpressed. However, I am terrified that if I am not at W&I and something goes wrong with my next baby that I won't be at the state of the art maternity hospital in RI. I SO want to let that go and see Mary & Deb at Memorial for my next. I really need to be taken care of, especially for a Vbac. I need to let go of the trauma of my first birth/BF failure and be guided for the next.
GL in December. I think having a doula would make the difference for you at W&I.

[Paige, CPM]

I would second Mary at Pawtucket...she had a homebirth, she really gets it and wants you to get that kind of experience...I personally would go to no other if I were in your area, it is just too chancey...which is the intuition you are experiencing now.

But, to address the homebirth issue...some think their birth as like getting married...psychologically it is one of the most important days of your life...and in our society we pay a lot of money for weddings sometimes, so perhaps the birth is worth it too? Although I truly think it is wrong, as well as stupid from an economical standpoint, for the insurance company not to cover it (are you sure your's does not?).

As to OP, I would contact ICAN for support, there is a support group in Providence. MiNa is the leader, her user name here is "seoul mama", you can contact her for info (but I know she is out of town this week so she may not reply right away. Below is some info on VBAC. We (midwives) feel comfortable doing VBAC at home because of the statistically small chance of rupture, in fact, it is similar to the risk of a primip (first time mom) rupturing during labor.

________________

http://www.ican-online.org/

Henci Goer, is a researcher on childbirth, including VBAC, there is some info here http://www.hencigoer.com/articles/ and you can ask her any questions on this blog http://www.lamaze.org/NormalBirthFor...9/Default.aspx .

Here is one of my favorite sites on VBAC ... http://caesarean.org.uk/ and another one http://www.vbac.com/ .
________________________________

Many blessings to you both!

[fancyoats]

women's care is another group of midwives that works with the abc at w&i. i had a good experience with linda nanni as my midwife. i arrived at the hospital @9cm and gave birth in the abc an hour and a half later. she encouraged me to stay home to manage my labor as long as possible, which i think is the best advice if you want a minimum of hospital interventions.

good luck. you still have time. i switched to linda after i was 29 weeks i think. you can switch any time you want.

[laneysprout]

I simply adore Mary and Deb. I gush about them, in fact. Mary is the least intervening midwife in the state. I wouldn't consider delivering in a RI hospital with anyone but her. She is profoundly respectful of birthing women.

[greenebeene]

Linda Nanni at Women's Care was my midwife, too. I liked her and the other WC midwives I met. WC has 6 midwives, and I think someone from the practice is always on-call at W&I.

[Jojo F.]

Right now I am with Dr.Claireborn from WC. We had a good talk about birth and how I want to do it naturally but I am starting to lean towards Mary. Not that Claireborn isn't good, he's AWSOME in fact, very crunchy, but I feel that a MW would be better for me and as you can see here everyone loves her(Mary).

Are you sure your insurance won't cover a HB? I contacted mine and they said they would not cover a "planned" HB but when I contacted a HB MW here in RI she said my insurance would cover part of it it's worth a shot.

Paige, I'm going to PM you, is that OK?

[bastaya]

I gave birth 10 weeks ago at the ABC. Used midwives at Women Care. LOVED IT! Had a completely unmedicated, un messed-with birth (no monitors, IVs, med) and was really surprised how much the folks at W&I left us alone. It was just what I had hoped for.

By the way, I changed midwives (from OB/GYN Associates) at 25 weeks. You can change whenever you want. Good luck!

[Lauren710]

Thanks everyone

Sage, that's exactly what I'm afraid will happen to me I'm sorry that your birth experience wasn't so great, lots of luck for a wonderful birth next time!

Paige, the wedding-birth analogy is great, I hadn't thought of it quite like that.. I'll mention that to DH when I discuss HB with him, it might help him see where I'm coming from. He's not anti-HB per se, but he and his sister were both c-sections and there were other less-than-optimal experiences in his extended family, so he's taking a while to see birth as a natural process instead of a medical condition. If we had the money it wouldn't even be a question for me to just budget for the HB and deal with convincing DH and taking care of the insurance later, but we're both grad students and we're already taking out loans to pay off credit card debt, pay for health insurance for the baby, etc.

I think I'm going to go with my gut and give Mary a call next week. I may try to see if I can get insurance to cover a HB, I'm switching from an HMO to a PPO, so maybe I'll get lucky and get out-of-network coverage for a midwife without a problem. Either way, I'd rather go with a practice and hospital that I won't have to fight with if I can't give birth at home, instead of hoping for the ABC and taking a big risk that I won't get in.

[Paige, CPM]

You all should watch the Business of Being Born together, this will help so much explain the homebirth thing... You can rent it from Netflix.

PPO's many times do reimburse for homebirth.

And if you see the post about reimbursement for hb in MA here you will also see that some people are taking their providers to court to get their reimbursement. A totally worthwhile and seemingly not difficult endeavor.

Take care and good luck!

[eema-v]

so, here's how i see it: now that you're looking to switch practices (and its definately not too late) the main decision to make is where to switch to;
1. memorial, with mary or deb
2. women & infants with a practice like womens care
i can tell you that women's care has a midwife on call all of the time... you would be assured of getting a midwife- and unless you risk out of the abc, or the rooms are full (very minor chance of this happening), you would get into the abc as well....
so, unless you really want memorial with mary or deb, it seems like the women & infants option, with plan to use the abc, will give you a birth experience that is closer to a home birth.
(both my kids were born with women's care midwives at w&i; first birth upstairs, second in abc. both were fantastic experiences and both unmedicated. the abc is amazing!)

[Jojo F.]

Just an FYI- The ABC is not downstairs anymore. They closed that and "moved" it to a regular labor room. There is talk about whether to rebuild it or not. Let's just say the MW's are not pleased. Please write W&I and tell them of your experience and how important the ABC is to pregnant/laboring women. I just talked to my OB about this Wednesday so this is not hearsay.

Anywho- We have seen TBOBB and I can't say enought about that movie. DS even watched part of it and was quite entranced by it- the labors. DH changed his tune half way through the movie and really wants a HB as well. BUT, the $$ stands in our way. I understand the whole HB-wedding analogy and it makes sense to me but we spent $45 on our "wedding" and paying for a HB out of pocket is not not in the chips for us, we've discussed it and it's just not possible. My one thing is that I REALLY want a water birth and the only way I am going to get that is with a HB.

From what you described about the practice you are with now MY only option would be to switch but that's just me. Don't worry about how far along you are, if you really want to switch, do it.

[Paige, CPM]

BTW, you can have a waterbirth at Newport hospital with the midwife there.

Two things you want to know, does your personality fit with the midwife that does them, as some people have said they clash with her style. Second, is she on call for you 34/7 so that you will get a waterbirth, or does she have vacation or go off call on a regular basis...because then you most likely wouldn't have a waterbirth.

And to the pp re W & I, I am so glad you had a good experience but I would really consider taking a chance in birthing in a place with as high of a c/s rate as they have there. From what I understand the midwives' protocols are pretty conservative...more toward liability practice then medical evidence practice. But who knows, now that they are not so far away downstairs maybe they have more flexibility?

[laneysprout]

And I would just add that Mary takes call for all her clients. So you KNOW exactly who is going to be at your birth. She is fine with any tests you want to decline during pregnancy, encourages you to labor at home as long as possible, will be totally hands-off during labor, and encourages you to leave the hospital as soon as you're ready to. For me, that meant that four hours after DD was born we were heading home to our family bed .