Should I fire my midwives?

[ajsgirl]

I'm only 22 weeks, so I have some time to think about this, but it's something that plagues me everyday, so I thought I'd get some opinions from you ladies....

Currently I'm seeing a group of 5-6 midwives (www.nymidwives.com) and they seem competent and I've heard nothing but great things about the hospital where they deliver, but... so far, I'm just not that impressed. When I was pg with ds, I had a great group of midwives who were so personable and natural and delivered at a baby-friendly hospital down the street. That was in Massachusetts. Now we live on Long Island where "natural" is hard to find. The hospital this time is 45 minutes away in no traffic, and there's always bad traffic on Long Island. My last labor was 6 hours, so I'm thinking that this one could be much shorter (they usually are) and it's possible I may not make it on time. I have thought about a home birth, but I'm not completely comfortable with this idea. The midwives on LI that do homebirths are great, but they don't take my insurance, so it could be up to $5000 out of pocket for us. And if I were transferred to a hospital, I'd end up paying for the out of network midwife PLUS the overnight hospital fees ($1000 deductable with my insurance). The midwives I'm seeing now seem nice, but they don't seem very involved. My appointment is getting weighed, blood pressure checked and listening for a heartbeat. No education, nothing else. And once, when I had some spotting and cramping, I called the midwife on call TWICE and never got a call back. I feel like with the homebirth midwife, I'd get better care.

Sorry this was so long, it's just weighing on my mind so much lately. Any thoughts would be appreciated!

[because]

You could at least look into the HB mws. You might find some with lower fees or who will barter with you or who have a payment plan that works or whatever. And you might be surprised by your insurance if you ask for reimbursement!

How high is your transfer risk? Any health issues or complications last time? Find out what the m/w's transfer rate is. It might be worth the chance. Also, many hb mws prorate if you transfer before the actual birth. For example, my mw knocks of $1300 if you transfer before the start of your labor. However, if she's been with you for 24 hours during a difficult labor and then you transfer at the last minute, she's pretty much earned the $1300, YK?

I'm very homebirth biased and I would do some significant legwork to get one for myself...

Good luck! It's certainly not too late to figure this all out but I would do it before the nesting urge hits because I find it hard to make big changes then.

[Sweeney]

You gotta obey that Mama instinct!

After my very short experience in an OBs office where I spent more time getting weighed with the nurse, than with any doctor... then moving onto a midwives practice and then to my hb midwife. I came up with the following list of criteria for myself that I'll share because I'm an opinionated birth junkie ;)

1.) You should have a relationship that involves trust and compassion with your caregiver. Remember that you are a client, not a patient! The relationship should be equal. You have the right to take your business elsewhere.
2.) Imagine worst case scenario: If you became temporarily brain dead and an important decision needed to be made without you- do you trust your caregiver to make a decision in accordance with your beliefs/desires/needs regarding birth/your health/the baby?
3.) Do you look forward to each appointment? Do you leave feeling satisfied? Are your needs being met?
4.) Do you want this person/these people present at an extremely important event in your life? Do you trust them to be there?

Honestly, the whole 'not calling me back about spotting' thing would bother me immensely. Not only because you are paying them for that service and it could have been serious. But to me I would internalize that as they didn't think it was important enough to call me back and therefore I am not a trustworthy source of information about MY body. And of course the incredible amount of fear and anxiety you have during a situation like that means nothing, right? (Can you tell I had a similar experience once?)

Explore your other options. Are there any other midwives groups around? Can you travel? What about The Farm in Tennesee or something like it? You might want to interview a few homebirth midwives as well. You'd be surprised at how much the right midwife will ease the hesitation you might have about homebirth. Discuss your monetary issues with the people you interview. I've found that people who are really passionate about birth will try to find a way to make their services more affordable for the people that need them.
There's always the possibility of congruent care- where you continue going to the midwives you are now where everything is covered by insurance as a just in case of something bad or hospital transfer, and pursue an out of pocket birth with someone more to your liking.

It's a tough decision and very important one. I wish you luck and let us know what happens!!

[Dancer Mama]

Just wanted you to know that I share your insurance problem. I am going to have to pay about $3,000 for our homebirth with this second baby that we are expecting. It is so frustrating!! I will just put my two cents in about homebirth. I had our first at home with a different midwife who is no longer practicing. There is no way I would go to a hospital. I think once you have had a homebirth - you can't imagine anything different. I am traveling 45 min. to see a midwife and like I said, will be paying a lot out of pocket. I think we are going to have to use our tax return or something to pay for this. Ugh! but, it is soooooooooooooo worth it!
I feel your pain,

[because]

Just wanted you to know that I share your insurance problem. I am going to have to pay about $3,000 for our homebirth with this second baby that we are expecting. It is so frustrating!! I will just put my two cents in about homebirth. I had our first at home with a different midwife who is no longer practicing. There is no way I would go to a hospital. I think once you have had a homebirth - you can't imagine anything different. I am traveling 45 min. to see a midwife and like I said, will be paying a lot out of pocket. I think we are going to have to use our tax return or something to pay for this. Ugh! but, it is soooooooooooooo worth it!
I feel your pain,

I could've written this post. The cost, the probable lack of insurance, the drive, the different midwife.... etc etc etc. All me, too!

[Wugmama]

Sorry you are going through this!

With my first pg, I had a hospital birth with CNM midwives. It was ok, I felt good about the birth, but boy there were a lot of interventions.

Now I have a homebirth planned with this one and CANNOT believe the difference in care I am getting as well as the knowledge and beautiful attitude toward birth as natural - a process not to interfere with and only to support as needed. I also am paying $3,000, probably out of pocket - we will see if the insurance picks up any or not. We have been told "no" and also "70%". I think it will be money well spent though. We are blessed to be able to afford it - not everyone can. Nor does everyone feel comfy with a homebirth.

At any rate, wanted to suggest that before you fire them make sure you can find something that will actually be better. It would be terrible to let them go and then find out they are the best game in town!

Best wishes mama!
Tracy