I planned a CPM homebirth but wound up using the CNM recommended by my CPM for a hospital birth when I developed PIH/pre-e. I planned a homebirth even though I was on medicaid. Medicaid covered a hopsital birth, but not a homebirth. We wound up paying about $2500 out-of-pocket for the homebirth portion (somehow, out CPM's biller was able to squeeze something out of the company contracted to provide my MA benefits).
I had a great experience with my CNM. We really clicked. I did go in (at 37 wks) with a long list of dos and don'ts as a birth plan. She knew I wanted a natural birth and helped me achieve that even though I was forced into a hospital setting (and by the way things went, it was good that I was in a hospital. I would have had to transfer if I had attempted the HB).
I really had a great birth. Even though it was in the hospital.
One caveat, I stayed at home for as long as I could and arrived at the hospital around 8 cm with my CPM in tow as my "doula." I was at the hospital for only about two hours before DS was born. I had the pre-e, so things went very fast and I was definitely in laborland for most of the hospital portion.
I love the CNM that attended DS's birth so much that I still use her as my primary care. Until I met her, I was never greeted at my yearly pap smear appointment with a hug.
If I were to get pg again, I would plan a hospital birth again simply because I click with this CNM so well.
With regard to advice to the OP, I am in MN, which, from what I've heard, is vastly different from TX. From the little I've heard about TX, if I could avoid a hospital birth, I would. Including scraping up the $$$ to pay for a homebirth (which I did anyway, despite the hospital birth).
I did see an OB through most of my pregnancy for the sake of getting an US and other tests that I felt necessary given my family history. MY CPM could have done some of these, but MA paid for them if I went to an OB, so I saw both the CPM and the OB for many months.
The moral of the story for me was to find someone that I really clicked with. Regardless of where she practices. Although, I will never know to what degree the fact that I was a homebirth transfer influenced my treatment from my CPM. I will always wonder if the fact that I was originally planning to do everything at home with no epidural. etc made it more likely that she didn't offer it in the first place (as in she knew I was serious because in my ideal birthing situation, pain meds would not even be available). But, on the other hand, I know that she is pro-natural birth (and was very excited by the way mine turned out), so she probably wouldn't have pushed meds on me anyway.
One last thing: When I went in for my yearly exam, she told me how proud she was of me that I was still nursing. Now I am proud of myself that I am still nursing, have no plans to stop any time soon, and know that it is the best thing that I can do for DS. But it was nice to get the support. It was nice to feel as if someone was on my side. It was nice to have a healthcare provider that understood thje importance of bfing, and had bfed her own children.
Bottom line, it doesn't matter so much the letters after their name as how you feel about them. Regardless of price. If you have to pay out-of-pocket, you'll find a way. Just find the person that you are the most at ease with. If she wasn't my main healthcare provider, I would totally go out for a drink with this woman.