Tell me to make an appointment already.. (small update)

[boingo82]

I cannot decide what to do.

I have not been to the doc yet. Here is my problem:
My insurance will not pay for a straight-up midwife. If we want a homebirth, we will have to pay for it OOP and that will mean a VERY tight budget for the next while..and that's assuming no unexpected expenses like the car breaking down or something.

My insurance WILL pay for a CNM - but the nearest one is an hour away. Last time, I was at the hospital for less than an hour and a half before my baby was born, and he was the first! Don't they usually get faster when it's your 2nd? I really do not want to be in transition, or even worse, birthing a baby on the interstate.

My insurance will also pay for local OBs. I did not like my hospital delivery last time though, like I said I was only there an hour and a half before Blake was born and I though that was too long. I showed up at 9cm and they made me nervous and I basically stalled in transition. They are always sticking you full of IVs and whatnot and without my consent, invited 10 or so students in to watch the birth. Did not even tell me they were there.
Plus, I have a REAL PROBLEM with the hospital in the circ department - my last OB, while I was in transition, asked what we were having, I said a boy, and she said, "You know what that means! A lot of circumcisions tomorrow!!!"
So needless to say, I could not go back to her. I simply cannot trust somebody who gets excited about baby genital mutilation, around my genitals.
The ped also asked us 6 different times if we would circ (stopped seeing him too.....) and the hospital tried to give us circ-care literature when we went home.
So my option here is to call around and find an OB that doesn't perform circumcisions. I will be surprised if I find one, the rates are very high here. And then I am still stuck with a lousy hosp birth. But it will be paid for.

Then to add to it, I'm starting to think that there's a chance it's twins. I have had a lot of symptoms early on this time that would indicate increased hormone levels, my fundus is about 3-4" over my bellybutton at 22 weeks, I feel movement simultaneously at the very bottom right and very top left which are very far apart, my mom had twins (don't know if they're identical or fraternal, they were never tested), and my coworkers have all decided on their own that I'm having twins.

:sigh: So there you have it. I do not know what to do, and am paralyzed in indecision. I really just need to go make an appointment SOMEWHERE but I don't want to pay for a midwife and don't want to go anywhere near an OB. :nut

[provocativa]

My homebirth midwife is very easy about payments, and did the first couple prenatals with no money down. I think she is used to getting big chunks at tax return time. I procrastinated and finally got a medical card 2 weeks ago, which would pay for the cnm who was there for dd's hospital birth last time, but won't pay for homebirth. You might find out from a hb midwife how late in a pregancy she takes a new client, then you could have prenatals at the inconvenient cnm and birth with the other mw, maybe for less money? The HB makes things very tight here and I think it's worth it. Unassisted would not e an option for my husband, lol.

[Guinevere]

your situation isn't unusual -- most insurance plans don't pay out for hb. i'm in the same boat with regards to my insurance only covering cnm or ob, so i'm paying out of pocket for a hb.

if i were you, here's what i'd do: make two appointments -- one with the cnm (or ob, if you'd prefer for appt convenience's sake) and one with a hb mw. talk to the hb mw about your situation, start saving up $ (which, if you wanted a hb, you really should have started doing when you found out you were pg, just in case) and work out a payment plan with her -- i've yet to encounter a hb mw not willing to work with you on that front.

while working on payment arrangements with the hb mw, go see the cnm or ob and RULE OUT TWINS and make sure all is well. if you're having twins, a hb might not be an option, anyway, and it would be go to know that ahead of time, wouldn't it? then, either continue with joint prenatal care, all the while knowing you intend to have a hb, or just stick with the hb mw from there on out. i will say, though, having a relationship with the cnm or ob would be helpful if you need to transport for any reason.

if you decide that you just can't swing the cost of a hb mw, then the sooner you start seeing the cnm or ob, the better the chance you will find someone to suit your needs AND someone who will be invested in your care. frankly, how interested is a cnm or an ob going to be in you if they only meet you for the first time a couple of months before you give birth? recipe for disaster!

get your ducks in a row, it's high time you made a decision!

guin

[Slabobbin]

I would make appointment with everyone and weigh my options from there.

[afishwithabike]

I would do the OB and "oops" I stayed home too long and had unassisnted birth route. Unless of course there were signs in prenatal that shows you that the Hosp is really a better option. Good luck. I know it can be a really tough decision. I would personally like to go to a stand alone BC, but ins doesn't cover and DH refuses homebirth. I'm stuck with hosp BC and CNM. I happen to really like my CNM though.

[Happypants]

i'm having my 1st and paying for the hb midwife oop is putting a serious cramp in our budget, since my dh is underemployed. BUT i wouldn't have it any other way. i went to the er 2 weeks ago and that just made me feel even better about my decision. i say if you really want a hb, don't let money be an obstacle. you can always get more later.

[boingo82]

Provocativa - good point about the tax return. We made very little last year and we do have that coming, still.

your situation isn't unusual -- most insurance plans don't pay out for hb. i'm in the same boat with regards to my insurance only covering cnm or ob, so i'm paying out of pocket for a hb.

if i were you, here's what i'd do: make two appointments -- one with the cnm (or ob, if you'd prefer for appt convenience's sake) and one with a hb mw. talk to the hb mw about your situation, start saving up $ (which, if you wanted a hb, you really should have started doing when you found out you were pg, just in case) and work out a payment plan with her -- i've yet to encounter a hb mw not willing to work with you on that front.

I like the two appts idea, I will call around tomorrow and see where that gets me. Good point that I can see both for a while. My insurance basically pays 100% for prenatal so it would not hurt to do both. And good point about having a relationship with an OB if I need transport for any reason.
When Blake was born, it was as natural as a hosp birth can be, and he was 9.5 lbs, but I know that things do not always go that smoothly.


if you decide that you just can't swing the cost of a hb mw, then the sooner you start seeing the cnm or ob, the better the chance you will find someone to suit your needs AND someone who will be invested in your care. frankly, how interested is a cnm or an ob going to be in you if they only meet you for the first time a couple of months before you give birth? recipe for disaster! ..

Last time I saw her starting at 12 weeks and it still sucked!
She was one of those make-you-wait-naked-for-45-minutes only to have a 5 minute appt type of OBs.

[boingo82]

I would do the OB and "oops" I stayed home too long and had unassisnted birth route. Unless of course there were signs in prenatal that shows you that the Hosp is really a better option. Good luck. I know it can be a really tough decision. I would personally like to go to a stand alone BC, but ins doesn't cover and DH refuses homebirth. I'm stuck with hosp BC and CNM. I happen to really like my CNM though.

I am lucky DH is ok with whatever I want to do. I just wish the CNM was closer!

[L'lee]

Remember, you can always talk to different OBs than the one you used before!

Good luck!

[Guinevere]

emily, i sympathize with your previous icky ob experience, having had a few of my own! :( you're right, knowing someone from the beginning isn't necessarily an indicator of commitment, either (although if your appts. were like that, i'm sure you already knew your ob wouldn't be stellar during birth, either, huh?), but at least building a longer-term relationship with someone increases the likelihood that you'll have a connection with them (or, if you don't, that you'll know in enough time to switch to someone better!)

good luck with your phone calls! :)

guin

[Mom2Adam]

If you find a midwife you like and her services/birth are not covered by ins. talk to her about options - she will have some because other families are in the same boat!

I think it might be difficult to find an ob that does not perform circ's, they are still performed in high numbers, but finding one that respects your decision to not circ might be easier.

Talk to other mothers in your area (maybe try AP groups or FNL groups or LLL groups) or on finding your tribe to get some ideas of birth friendly OB's etc.

In many states, insurance has an upfront request policy. You may be able to request some payment for hb or midwife if you provide them with good data (about safety, keeping their costs down etc). Check your Coverage book or call your insurance ombudsman to find out more.

Good luck!

[busybusymomma]

I can understand your hesitation... I wouldn't want to see an OB either, I've BDTD. What we did last time and will do this time is pay the midwife with our tax return, otherwise it would be nearly impossible. Would the mw take a partial payment and then monthly installments until you pay the fee? Does she have a sliding scale?

Good luck deciding! :Hug

[Ksenia]

Hi Emily,

For me home birth is the only option because I am pretty phobic about doctors and hospitals. In your boat I would do as afishwithabike suggests and plan for unassisted childbirth but take advantage of prenatal care that you are covered for (enough to get any information that you want). If you've already had a precipitous birth then you should be especially prepared for an unassisted birth - you may not have any choice! Two local mamas planning MW-assisted homebirths recently ended up with unassisted births because their midwives didn't get there on time. Unassisted birth seems pretty radical to most, yet when you see unassisted birth videos you realize that it's really no big deal - just bodies doing what they are designed to do. There's actually an incredible video out there of a woman birthing twins unassisted - very cool.

A good place to do research on unassisted childbirth is to join the c-birth yahoogroup (http://groups.yahoo.com/group/c-birth/) - but do it soon because there's a two week enforced lurk period. The sister group c-birthstories (http://health.groups.yahoo.com/group/CBirthStories/) has lots of unassisted birth stories archived that give you an idea of what these births are like (including ones that end up with hospital transport).

FWIW, I would prefer to go unassisted, but instead we'll be paying a midwife to sit in the other room for backup due to dh's fears.

[waterbaby9503]

I am now 25 wks and only interviewed a hb mw for the first time last week. I was nervous about what she would say about that- but very happy how the interview went! Judging from my phys appearance and attitude alone, she said it looks like I'm doing fine and would hope I start prenatal care by my 8th month in case of early delivery. I'm glad she recognized that despite not seeing a professional for "prenatal care appts", I have definitely been taking care of myself differently thoughout this pg(diet, exercise, reading books, avoiding hot tubs, ect).
I also called an OB office at around 15 wks. I asked basic questions, and when the nurse found out how far I was she freaked! "Oh, you should practically go to the ER by now! There are so many tests you should have had already and you're way behind the schedule!" :blah :lol
Um yeah, didn't call back. And I still have not started seeing a mw, though I absolutely intend to by the end of next month.
Sometimes, working with the diff professionals' personalities is the hardest part! You may find an OB with a better attitude than a medwife in your area, or anything in between!

[boingo82]

Thanks everyone for the suggestions. :) I have been thinking on this and I've realized that really the only reason I was considering an OB/hosp birth is because I think I *should* use the insurance that I already paid for. Which is a silly reason, really, because that is not the kind of care I want. Plus my insurance coverage rolls over to the next year if I don't use it this year. (*long story, it is a health care spending account type of thing)
I'm going to call around midwives today, I have a few people I can hit up for recommendations also. :)



//
I also called an OB office at around 15 wks. I asked basic questions, and when the nurse found out how far I was she freaked! "Oh, you should practically go to the ER by now! There are so many tests you should have had already and you're way behind the schedule!" :blah :lol //

That was another reason I did not like about OB/hospital care. Every little thing was "OMG!!!! YOU FAILED THIS TEST!! YOUR BABY WILL PROBABLY BE BORN WITH ALL SORTS OF PROBLEMS!!!" - then you spend 2 weeks worrying, then they do the follow-up test and reveal that, oh, just kidding, everything's fine! And then you read on the internet about the first test you failed, and find out that 98% of people who "fail" it get a false failure and everything's fine.
They were so alarmist about everything.

[boingo82]

I have an appointment tomorrow, with a traditional midwife, who seems very nice on the phone. She says I sound like a great candidate for hb so far. I am actually excited to go to an appointment!

[busybusymomma]

Keep us posted! :thumb

[L'lee]

Great! Hope it goes well!!

[SlingWearin'Mama]

Hi there I just wanted to add a different perspective. One thing to think of is, if you are carrying twins do you want them to be detected? How will things change? If you confirm twins things will be a lot different, if you are seeing an OB your care will greatly change and the hospital birth that wasn't fun the first time around may be less fun. Routinely they want to deliver in the operating room, have a GAGGLE of people and they will monitor you very closely a lot more. If you are going the HB route it doesn't make much of a difference, and it would be nice so she can call in other MWs, I know the one I talked to really wanted two other MWs to help her although she had delivered twins solo before. Just some food for thought! Also CNMs usually want take twins, at least they won't around me! Good luck!

[boingo82]

Hi there I just wanted to add a different perspective. One thing to think of is, if you are carrying twins do you want them to be detected? How will things change? If you confirm twins things will be a lot different, if you are seeing an OB your care will greatly change and the hospital birth that wasn't fun the first time around may be less fun. Routinely they want to deliver in the operating room, have a GAGGLE of people and they will monitor you very closely a lot more. If you are going the HB route it doesn't make much of a difference, and it would be nice so she can call in other MWs, I know the one I talked to really wanted two other MWs to help her although she had delivered twins solo before. Just some food for thought! Also CNMs usually want take twins, at least they won't around me! Good luck!

That is part of things too - being afraid to find out one way or the other. I think at this point I'd rather know.
I know that a twin birth would be a lot more managed. My twin brothers were the only ones of us NOT born in a birth center or home. Even though my mom had both of them naturally, it was her least favorite birth for sure.

[boingo82]

Update:

Saw a midwife today, she was very nice and spent a full hour talking with us and feeling around. My husband did not get the "no" he wanted.
By my dates I am about 24 weeks. Lisa said the strength of the movement indicates 24 weeks also.
However, I am measuring full-on 32 weeks. My uterus is very nearly in my ribcage. She would have thought that I just had my dates REALLY wrong, except that the baby(ies) were not big enough to have definitely identifiable parts. If my dates were just wrong, and it was a 32 or even 28 week single baby she would be able to feel the head out. As it was she could not really tell.
Lisa said that things looked "suspicious" for twins, and gave an ultrasound referral. We should be doing that later this week.

[JennInSeattle]

I can't wait to hear! I happened upon this month by accident but I hope the u/s goes really well and you get what you want.. singleton or twins! :)

[boingo82]

Thanks Jenn!
I'm not sure what I want, but poor DH is the SAHD and he wants a maximum of 1 infant at a time.

[busybusymomma]

LOL! My dh would freak if we were having twins. ;) I'm measuring 24cm at 25 weeks so my twin phobia can officially go away now I think. LOL

Let us know what you find out! :D

[mamacatsbaby]

I'm glad you were able to see a nice MW boingo. :thumb Can't wait to see what's afoot! :wink

[boingo82]

PHEW!!

Ultrasound this morning...there is only one in there,
healthy boy, who is for some reason taking up more
space than he ought to!
My dates are about on too, by my guess I am 25 weeks
today, ultrasound said 26w 2 days, so very close. The
different measurements were all pretty consistent.
This is a big load off because 2 infants at once would
be very hard to manage, plus our 800 sq. ft. house
would not cut it for 5 people. (And there is no WAY we
could afford a bigger one..)

So, there is my update. Not very exciting, but that's
a good thing!

[HollysMom]

Glad everything went well! Congrats on your baby boy!!

[Xiaguan]

So glad to hear all is well~ Congrads on your healthy baby boy!

Warmly,
Melissa

[busybusymomma]

Well congrats on one healthy boy! :wink :balloons

Where does that leave your birth plans then? Inquiring minds want to know! :lol

[boingo82]

Well congrats on one healthy boy! :wink :balloons

Where does that leave your birth plans then? Inquiring minds want to know! :lol

We'll still be seeing the midwife. I'd rather avoid the hospital this time around. :)

[busybusymomma]

:thumb I totally understand. I always say one hospital birth was enough for me!