looking for updated info on boston-area birthing options - Mothering Forums

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#1 of 24 Old 03-22-2009, 01:39 AM - Thread Starter
 
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hey all! i'm not pregnant, but working on it, and i'm planning ahead, thinking about what my birth options will be. i've read a ton of posts in the archives over the past 2 years, but i'd love some updated information since things have changed.

i am very interested in homebirth, but the issue is money. we'd pay $250 for a hospital or birth center birth rather than $3000+ for a homebirth. i have harvard pilgrim HMO, and it says clearly that planned HB is not covered. is there a way to get around that or get partial reimbursement? i don't see how we can afford an extra few grand - even if we had that kicking around, there are a million other places we'd NEED to put it. i'm not ruling it out, though, because if we could swing it, this would be my most preferred option. i would love to hear from anyone about how to make it affordable, especially if you had a payment plan or barter arrangement with your boston-area HB midwife.

last time around i used the MWs at women's health in wellesley and birthed at NWH. i had a great experience and an active, natural birth. i would love to go back to them for my care, but i do NOT want to stay in the hospital afterwards, even for just one night. does anyone have any info on leaving the hospital before they "let" you? my ideal situation would be to give birth there and then come home whenever ready, but i know nothing about leaving against medical advice with a newborn. i loved the MWs and i had a great birth experience, but i hated staying in the hospital overnight, and that was before i had a toddler at home.

i felt like the north shore birth center would be a great alternative, but then i read the info on them nearly closing and now requiring EFM. what exactly is this policy saying? it doesn't mean continuous EFM, does it? has anyone given birth there since things have changed? i'd also consider the cambridge birth center, which is closer to me, even though i'd read some not-so-great things about it when i was pregnant with my DD. the main reason i would consider going to a birth center rather than NWH is so that i can get discharged earlier. what i do not like about the birth centers is that there are so many midwives, and it seems so easy to "risk out" - and i'm not interested in giving birth at the cambridge or beverly hospitals. but i would still like to hear any info about them that anyone wants to share. i saw on the NSBC website that you can leave in 4-12 hours... how about at CBC?

i think those are pretty much the options around here, aside from mt auburn, but i'd prefer NWH to them unless MA has an early discharge program. i'm not interested in traveling to NH even though the birth cottage sounds amazing... but i am VERY prone to severe anxiety while in a car, and labor only served to make this worse last time.

any other ideas? TIA!

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#2 of 24 Old 03-22-2009, 10:55 AM
 
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Hi MmeMuffin~
Here's my story, I hope it's not too long & that you find some of it useful.

For DS1 I was with the Cambridge Midwives @ the Camb Birth Center. I really like the midwives, although they're much more medical model than I want now, I found that reassuring the first time around. They do work in shifts, however I foundit really easy to get to know most of them & felt very comfortable with them. It's a beautiful space with great big birthing tubs & paid for by insurance. HOWEVER - do in part to their association with Camb Hospital, you have to be a pretty much perfect canditate to not be risked out before labor. They have something like a 30% - 40% transfer rate that isn't talked about much. With DS1 my water broke early & with merconium, so I was immediately admitted to the hospital, where they tried to insist on continuous fetal monitoring, etc. We fought every intervention & ended up with most of them ("for the good of your baby" card was played over & over - even by the midwives. I wish I knew then what I know now! I would have fought harder ) 48 hours later (we refused to let them do the c-section the hospital wanted to do after 24 hours - the usual window allowed by the hospital between water breaking & delivary), Skyler was born. Here's the one cool thing - the midwives posted a notice on our door saying "Do Not Disturb - Birth Center Mama". So Skyler slept in my arms that very first night, with no interruptions by anyone. He was born at 10:00pm, we left the next morning at 8:00am - almost ama. They rushed to get the ped in to look him over when I told them we were leaving in 10 minutes no matter what.

DS2 - Homebirth, yay! We have very little money, but saved like crazy to be able to afford this. We have Harvard Pilgrim too, no coverage for homebirth. We bartered part of the fee, & almost every midwife we talked to was willing to barter some portion or work out a payment plan. I just didn't want to be in the hospital unless it was a true emergency. And boy, was this the right decision for us. My labor progressed almost exactly the same as with DS1. DS2 was almost 2 weeks late. My water broke early in labor, with merconium - but his heartrate was fine. I labored for 2 days, long slowly progressing contrations. I know that in any birth center affiliated with a hospital I would have been 'risked out'. I know that any hospital, even under excellent midwife care, would have pushed for induction, cfm, suctioning the baby, etc. We avoided all that & , after a lot of hard work, I birthed Gryffin in my own bed, surrounded by loving family & a wonderful midwife. Skyler cut the beautifully spiraled cord. We changed the sheets, & I went back to bed with my baby, while my mom made chicken soup in the kitchen.:

So...If you really want to be home, then I say do your best to make it happen. It was soooo worth the money, for us. Not just for the birth itself, but for prenatal appointments full of encouragement & faith in my body & my baby, rather than testing & fear-based practices. Save $$$, ask for bartering or paymnet plans, shop around, instead of a baby shower - ask all your friends & family for contributions.

If you do want to go back to NWH, then ask them what their policy is re: how soon you can leave (our midwife has a policy that she stays until the baby nurses, mama pees & eats). Find out if it's a time frame (24 hours) or what. Ask why. If you don't feel the policy is reasonable, ask what they would do if you insisted on leaving early.

But my opinion? Please don't let money stop you from trying to create the prenatal & birth experience that will be best for you, your baby, your family.

Loving mama to magical boys Skyler (11/21/03) and Gryffin Emrys (9/30/08). 

 

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#3 of 24 Old 03-22-2009, 12:24 PM
 
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Hey!
One option I'm considering for next time (and I haven't worked all the details out yet but...) is getting prenatal care at the Birth Cottage which would be covered by insurance. The midwives there are allowed to attend MA homebirths so the only thing you'd end up paying out of pocket for is the birth itself. But the drive there for prenatal care with a toddler is partly my hesitation so I'm planning to save up enough in the next year for a 2010 HB.

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#4 of 24 Old 03-22-2009, 06:30 PM - Thread Starter
 
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SkyMomma, thanks for your input. i'm glad you got to have such an awesome experience with you DS2 though it sucks that you had to go through that the first time around.

i think when i get pregnant i'll get names of HB midwives who are willing to barter part of the fee or work out a payment plan. i don't want to rule anything out, especially since i know it would be AMAZING if it could work out.

would there be a chance that, since i had no complications with my last birth, the birth centers would lay off at all?

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But the drive there for prenatal care with a toddler is partly my hesitation so I'm planning to save up enough in the next year for a 2010 HB.
if you get pregnant at the same time as me, we can carpool/watch each other's kids while getting prenatals. just saying.

great idea, though. i should look into that. (the birth cottage thing, not the saving up thing. though it is wise. i figure if it takes me a while to get pregnant, all the more time to save up!)

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#5 of 24 Old 03-23-2009, 08:25 AM
 
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Leaving nwh "early" is pretty easy. If you give birth between say 11 PM and 6am and want to leave at 11 am or noon just be sure to get done whatever you want to do before you leave (ie hearing test, birth cert, etc) If you give birth at 8pm and want to leave before midnight I doubt you'd get it all done. You can come back with babe to do it later but that is a pita, imo.

I had 4 kids there and only stayed with my first. I stayed until they kicked me out that time! I couldn't believe they just let us walk out with a baby.

nak w/ 2 kicking toddlers

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#6 of 24 Old 03-24-2009, 01:14 PM
 
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the EFM at the NSBC is continuous. This is my 3rd pg with them and they are becoming more and more medical by the visit

We don't have extra $$ and we are planning a homebirth. We're using our tax return and we have paid something every visit. Our mw was flexible with the payments as long as she had enough to cover the other mw she would wait for her payment. Thankfully we were able to pay her in full.

I see the nsbc because I need someone to be able to fill out paperwork for my job, get labs and incase I need to transfer

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#7 of 24 Old 03-24-2009, 09:49 PM - Thread Starter
 
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Leaving nwh "early" is pretty easy. If you give birth between say 11 PM and 6am and want to leave at 11 am or noon just be sure to get done whatever you want to do before you leave (ie hearing test, birth cert, etc) If you give birth at 8pm and want to leave before midnight I doubt you'd get it all done. You can come back with babe to do it later but that is a pita, imo.

I had 4 kids there and only stayed with my first. I stayed until they kicked me out that time! I couldn't believe they just let us walk out with a baby.

nak w/ 2 kicking toddlers
okay, cool. once i'm pregnant (, i'll talk to the MWs about it and say that i definitely will leave early unless there are complications, and see if it will be an issue to get all the test stuff done ASAP. that would definitely be an awesome option. does anyone have any info on whether or not the WHA midwives back up HB? that's another question i should ask.

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the EFM at the NSBC is continuous. This is my 3rd pg with them and they are becoming more and more medical by the visit

We don't have extra $$ and we are planning a homebirth. We're using our tax return and we have paid something every visit. Our mw was flexible with the payments as long as she had enough to cover the other mw she would wait for her payment. Thankfully we were able to pay her in full.

I see the nsbc because I need someone to be able to fill out paperwork for my job, get labs and incase I need to transfer
that's too bad that it's continuous. i think i will probably tour the NSBC and the CBC just to see what's out there, as well as interview some midwives, when the time comes. we are considering using our tax refund money towards HB, but we'll crunch the numbers once we need to. i think the one thing i need to do for sure is check out all the options so that i know i'm doing the right thing & feel good about it.

god i wish insurance covered homebirth! : then it'd be an absolute no-brainer.

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#8 of 24 Old 03-25-2009, 09:26 AM
 
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I'm pretty sure the WHA midwives will back up a homebirth.

We just put a bunch of our tax refund straight into the homebirth account since I don't want to TTC until we know we can pay for it, then again I had an awful hospital birth, which you did not.

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#9 of 24 Old 03-26-2009, 12:57 PM
 
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I had my DD at Mt. Auburn. I labored at home, and basically got to the hospital in time to deliver. I gave birth at 6pm, cuddled, nursed, and then DD got checked out by the ped. I ate dinner, used the restroom, and said, ok, so how much longer before we can go? They looked at me like I had 3 heads, and wanted to know why I didn't just want to settle down and go to sleep. This was 8 pm.

It took 4 hours and a lot of pushing, but we left shortly after midnight. After DD got a clean bill of health from the pedi, and it was clear I was having no issues, I really didn't think we needed to be there, and wanted to be in my own bed. It probably would have been easier if I were trying to leave during the dayshift, because the night nurses were really cranky having to do all the discharge paperwork. I had to sign papers that I was discharging myself, and technically left AMA. But, when asked what medical reasons there were for me to stay, all they could really come up with was "just in case"

So, if you want to be at a hospital, it can be done, you just have to be persistent and ignore the scare tactics (even if they are from nice, well meaning people!) But, if you feel comfortable doing a homebirth, and can save up your resources for it, I would go that route, rather than fighting with hospital regulations, etc.

Loving being a stay at home mamma to DD 10/07, and newly arrived DS 7/26/10
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#10 of 24 Old 03-29-2009, 10:15 AM - Thread Starter
 
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I'm pretty sure the WHA midwives will back up a homebirth.

We just put a bunch of our tax refund straight into the homebirth account since I don't want to TTC until we know we can pay for it, then again I had an awful hospital birth, which you did not.
yes, true. and even with my pretty-good birth experience, a homebirth is just so much more appealing. i hate the thought of staying in the hospital overnight and having the nurses keep coming in and bugging me. plus i'll have a toddler to worry about next time and i doubt they'll be impressed with me trying to squash into a crap hospital bed with m and a newborn.

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So, if you want to be at a hospital, it can be done, you just have to be persistent and ignore the scare tactics (even if they are from nice, well meaning people!) But, if you feel comfortable doing a homebirth, and can save up your resources for it, I would go that route, rather than fighting with hospital regulations, etc.
thanks for sharing your experience! it's awesome that you stuck to your guns like that and were able to leave. i can't imagine the process would be too different at NWH - i bet the midwives will have stories about women who wanted to leave early.

i had some ideas about low-cost homebirth, so if anyone knows if these are feasible, please let me know!

-i'm wondering if anyone knows about HB midwives in the area who charge UNDER $3K? i'm hearing figures of $2000-$5000 as the "range" but when i look into specifics i'm seeing $3000-3600 for the MWs i've heard about a lot. i'm not seeing anything in the $2-3K range. so i'm wondering if the figure is wrong, or if there are in fact MWs in that price range.

-finding a student midwife or midwife in training. i wanted a doula last time around, and during that pregnancy my DH was a grad student so we were strapped for cash. i found a doula-in-training who was working towards certification and she was amazing - so i had the amazing doula experience without worrying about the money, which was awesome. thus i'm wondering if it's possible to get lower fees from student midwives or recent grads who are just starting out.

-doing a UC. i'm very nervous about this, but i have seen that some HB midwives also attend births as doulas. i think i might be more comfortable UCing with a midwife-trained doula than having it be just me and DH. i know that if she was there in a doula capacity it would be different than a midwife-attended birth, but i think it would probably set my mind at ease to know that even if i didn't have a MW *attending* there would still be one *there* in some form or another, so i would feel comfortable knowing that she'd definitely be able to gauge if i needed to transfer to a hospital or something. and i could always have my prenatal care through the MWs who would provide hospital backup and thus covered by insurance. does this make sense?

if anyone has any other ideas - or names of MWs who'd fit the bill (as a lower-fee MW, student MW, OR doula) - i'd love to hear your input, whether it's info you want to share in the thread or PM me. once i'm actually pregnant, i will definitely be calling around, but i want to have some ideas kicking around until then.

(just as a disclaimer, i do not mean to imply AT ALL that MWs who charge more than $3K are overcharging. i firmly believe that HB MWs are doing fantastic work and should be well-paid for their services. personally i just wish that insurance coverage wasn't such a big deal. we'd all be happy! i would get the care i needed at a great price, the midwife would get her payment in full, and the insurance company would pay far less than they would for a hospital birth. but sadly this isn't the case. while DH and i would consider paying $3600 out of pocket for a homebirth, a more affordable option would certainly be nice to know about, especially since i think the decision may have to come down to what's financially feasible for our family.)

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#11 of 24 Old 03-30-2009, 11:28 AM
 
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We interviewed around 6 midwives and they were in the $2,500-$3,500 range. Most were $3K. Our midwife is $2,700. Maybe its cheaper on the northshore?

mum to Christopher (6/98) Elizabeth (2/05) twins Aaron and Dominic (7/10/06) and new baby Eden (4-18-09)
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#12 of 24 Old 04-01-2009, 11:03 AM - Thread Starter
 
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We interviewed around 6 midwives and they were in the $2,500-$3,500 range. Most were $3K. Our midwife is $2,700. Maybe its cheaper on the northshore?
PMed you.

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#13 of 24 Old 04-01-2009, 09:23 PM
 
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this site has a list of the Midwives that belong, I did notice a couple students listed..some place to start looking maybe?

http://www.massmidwives.org/?page_id=9

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#14 of 24 Old 01-12-2011, 09:51 AM
 
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I am on the same hunt. It is my first and while I am somewhat afraid that I will need more medical attention, I want it on my terms. I tried the Cambridge Birth Center and got mixed feelings-they offer low intervention births but I got the impression that they were nurses before midwives and would quickly suggest a transfer to a hospital.

 

Boston has many midwives and dulas. Can you homebirth with just a dula? I haven't looked into homebirth as much as a low intervention natural option.

 

I have heard horror stories about how by the book/protocol only Brigham and Women's, as well as Beth Israel is. That they will push for a C-section as quickly as possible.

 

I'm not ready for a home birth but I don't like the "state mandated" and "better for the baby" scare tactics they all use to do it their way.

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#15 of 24 Old 01-12-2011, 09:57 AM
 
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I had DD at Cambridge Birth Center. I did like it a lot.

 

They didn't try anything medical on me or push for a transfer or anything. I found them to be very understanding of everything.

 

I did however have a history of being raped and they made me do a psych exam...which I thought was ridiculous, but supposedly birthing can bring back trauma from that or some BS...not for me my birth was beautiful!

 

I do want my next birth at home, but with my first I was a little scared and I felt "safer" being in a birth center. I drove 2hrs to get there...it was big deal for me. I would never ever birth in a hospital, that is literally one of my biggest fears.

 

I had some "training" at Brigham and Woman's for my CNA course and I hated it there, in 2007 they were circing infants with sugar and we were "informed" how "important" it is to circ...I don't trust them period. I vote stay away from BIG hospitals at least b/c I get the feeling they don't really push for un-medicated births...


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#16 of 24 Old 01-12-2011, 10:09 AM
 
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also while I was in transition I was freaking out and kept saying I wanted to transfer to get meds for pain and the MW were great! They kept talking me down and telling me I did not need it, they empowered me. I would birth there again, I don't regret it.

 

Also I was only 21 when I had her and everyone laughed in my face about me wanting to birth un-medicated and breastfeed and all of that good stuff, the birth center were the only people who told me I COULD do it, and that meant a lot to me b/c I have almost 0 family and my mom passed away when I was a kid so I really had no support besides DP who was less than helpful during that time...we had some issues then, but it's all worked out now and we are doing amazingly...anyways just wanted to share my experience there.

 

They will abide by whatever you feel comfortable with, and really listen to you. They don't have drugs there at all, which was a plus for us.


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#17 of 24 Old 01-12-2011, 01:31 PM
 
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SOSURREAL09 : Whoa!  I CAN NOT BELIEVE that they made you do a psych exam!  That is crazy!  Who made up their protocols?!   I am so sorry, I hope you just chalked it up to ignorance.  Wow!  What do they think we womyn are?    I am so glad you had an empowering expereince with your birth!

 

 

YUMMYYUMYUMMAMA:  I think getting a student midwife for homebirth is a great idea btw...  You just want to make sure that she is being fully supervised by another midwife.  In other words your care is being used for her certification. 

 

Also, I would be careful about just looking for something inexpensive and make sure your midwife is either a CPM or is a student supervised by a CPM.  There are other options out there that as a mother and a midwife I would recommend you avoid for safety reasons, sad to say. 

 

Also here is an article about creative ways to pay for a homebirth:

 

http://centralfloridagreenguide.com/2010/03/11/creatively-financing-your-home-birth/

 

Best of luck!

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#18 of 24 Old 01-13-2011, 02:53 PM
 
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Just to chime in :)

 

WHA do NOT back up homebirth.  If you tell them you are having a homebirth they will ask you to terminate care.  They are lovely, caring midwives and I refer to them often for care. 

 

Smiles,

Alexis

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#19 of 24 Old 01-13-2011, 06:13 PM
 
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What's WHA?

 

\\\


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#20 of 24 Old 01-13-2011, 06:18 PM
 
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I am so sorry.  The Women's Health Assoc midwives at Newton Wellesley Hospital.

 

:) Alexis

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#21 of 24 Old 01-18-2011, 11:52 AM
 
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Just chiming in on what I've encountered so far. 

 

I too had my first baby at NWH with the midwives of WHA. With #2 I knew I wanted a home birth (I'm 31 weeks now) - my hospital birth was fantastic too but I have zero desire to make a trip there and stay!

 

I saw Valaree at WHA through 19 weeks while I researched home birth midwives. She knew from the beginning I was planning a home birth and was incredibly supportive. I elected to use them for prenatal until that point to make it a little easier on myself -- that office is very convenient for me in terms of work and that bought me some time to navigate the home birth midwife world without worrying about insurance (although I understand it's usually fairly easy to get insurance to cover a CPM / DEM for prenatal). WHA definitely does not backup homebirths.

 

My homebirth midwife uses a billing service that has been really helpful to me in terms of navigating billing insurance. I've also put some money into a flexible spending account to cover some expenses like the tub rental fee. My midwife charges approx. $3200 and all signs seem to indicate my insurance company will cover this as out of network, leaving me to pay a $450 deductible. I have Cigna PPO which is apparently one of the better plans to have in MA in terms of getting a home birth covered - there are a lot of women who have succeeded with them. That said, it's still pretty sketchy - they claim to only cover homebirth with a CNM with OB backup (impossible in our state). At this point I'm just hoping for the best that it will be covered and have accepted that it may not be. 

 

I interviewed five midwives - all charged around 3-3500 and all were in the greater boston area.

 

I was kind of surprised and disappointed by the process of finding a midwife to attend my homebirth - it's nothing like choosing a CNM from my experience where my focus was more on the birthing facilities, size of practice and just a personal impression. I got a fair amount of unsolicited personal anecdotes thrown at me while interviewing homebirth midwives and advice that in the end felt more about politics. It can be very confusing! Having a few people I knew I could trust to bounce information off of was really reassuring for me. 

 

 

 

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#22 of 24 Old 01-18-2011, 12:18 PM
 
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Just wanted to hop in and highly recommend The Birth Cottage. I've birthed twice with them and had a fantastic experience all around.

I'll bet you could have the prenatal covered by going to the center in Milford, NH, and then make a payment plan to work out the birthing fee for a home birth.

The whole office up there has been approachable, fair, flexible and unbelievably supportive.


Gwen , partner to D ; Mamma to T (6) , J (4) , and baby P
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#23 of 24 Old 03-03-2011, 11:04 AM
 
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I've had two at home with Deborah Allen and can't recommend her enough. Most HB midwives will work with you on price/payment schedule.

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#24 of 24 Old 03-21-2011, 01:47 PM - Thread Starter
 
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to update from my original post! we ended up moving to westford, so in hindsight, had i gone to a nashua-area NH CNM in network who would travel to MA for homebirth, i might have gotten it covered. but, no regrets!

 

i chose brookline-based CPM nechama wildanah (in-home prenatals at no extra cost = awesome), who i can't recommend enough. her backup was kim bradley (sp?) and they were both just amazing during the birth. nechama was exactly what i was looking for in terms of prenatal care, and she was willing to work with us in terms of a lowered fee based on income and a payment plan that ended up being a great compromise. anyway, major thumbs up to nechama; she seriously was *everything* i could have hoped for in a midwife, and my prenatal/birth/postpartum care were phenomenal.

 

i did use sorta/kinda co-care in the first trimester, but i told them (WHA midwives) i was considering homebirth. they asked me to let them know by a certain time. when i told them that i was transferring out of their care for a homebirth, valaree left me the sweetest voicemail wishing me the best. they would have been a bit far for backup care anyway.

 

i had one consult appt with AFA ob/gyn at emerson, and i think emerson's birth center is moving in the right direction. the midwife, sherri, is awesome & now my well-woman care provider. if i had been planning a natural hospital birth rather than a homebirth, i would have considered using sherri as my care provider. i know emerson's gotten some bad reviews in the past, but it looks like things are moving in the right direction.


fuzmalesling.giffemalesling2.GIF mama to my spunky little girl, m, born 12/10/07 blahblah.gif, and my sweet little guy, k, born 10/27/10 babyf.gif
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