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Discussion Starter · #1 ·
I am feeling frustated.

Here's my background. DD #1 was born here in Germany and my OB care was provided by my Reproductive Endocrinologist (a continuation from the infertility treatment we did with him.) We delivered in a local hospital attended by another doc. I've returned to my RE for prenatal care for this pregnancy, but won't be delivering this next Babe in Europe. We will be in the states by that point.

Anyway, I haven't pushed the issue with trying to get midwife prenatal care while I am here in Germany for a number of reasons. Mainly having to do with the fact that I do (did?) like my RE and have gotten nothing but the run around with my insurance on what they will and won't cover regarding German Midwives.

Pretty much I am just bidding my time until I can get stateside.

I still haven't picked the midwife I want when I get stateside. May not make the decision until I can interview the midwives face to face. However, since I am wanting my insurance to pick up the tab, it looks like I will be restricting my choices to CNMs who offer Homebirths. BUT to do that I need a referral from my OB saying that I am a good candidate for homebirthing. (Otherwise it affects insurance coverage... blah blah blah.)

My plan was to ask my current doc to write the referral, fly back to the states when I was 34/35 weeks along, and locate my midwife the next week. Sooo... today I had an appt with my doc and I brought it up. The first thing out of his mouth is that he doesn't support the decision for me to fly back to the states so late in my pregnancy. He's afraid I may be dialated, or there may be complications, and I'll end up having the baby preterm on the plane. He doesn't recommend that I fly any time after 30 weeks.

Which means I'll have to stay with my parents for a month longer than planned. Which means my husband & I may be separated for as long as 6-7 weeks (Dh returns stateside AFTER the time I had orignally planned on heading back anyways.)

I called Delta airlines and they don't have any flight restrictions on pregnancy and flying. They'll even take you past term, according to the woman on the phone, as long as I don't look ready to "pop." Apparently the note from the doctor is just precautionary and just helps the pilot and attendants feel more relaxed about allowing me to fly.
:

Then, I asked about my RE writing the referral for us. He first said that he thinks I'll have to get an American OB referral (which he may be right about.) BUT then he went on to say that he wouldn't be comfortable writing a referral that far in advance of the birth anyways. Because, apparently, how can he be sure that I am a good candidate for homebirthing unless he monitors me up to the week before my due date?

In otherwords, even if he COULD write the referral. He wouldn't. To cover his butt.

So now, on top of everything else, I have to find a homebirth friendly OB in the states who can fit me in for ONE appt in order to refer me out for homebirthing! The very thought that I have to obtain some sort of 'blessing' in order to pursue homebirthing bothers me in a way I cannot even begin to articulate. Plus, how does a person go about finding a homebirth friendly OB who is willing to see a patient once, and refer them out?

*sigh*

I am feeling very frustrated and overwhelmed by all of this. I really wish dh and I had the financial freedom to just toss the insurance crap out the window and pay out of pocket. Unfortunately, that's not an option. Instead I have all these hoops I need to jump through. And I swear each week there are MORE hoops than the week before.

Will there never be a time when I can happily smile and say I have it all worked out?
 

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I'm afraid that i don't have any advice for you, i do understant how it is having to jump through hoops so far along in your pregnancy...don't you just wish that you could go unnasisted?

your situation sounds so much more complicated thatn mine, i was just trying to have a VBAC homebirth to no avail, and then i had more hoops to be able to leave the hospital immediately after.

My thoughts are with you

Blessings
~K~
 

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I feel your pain on the flying. My best friend is getting married when I will be 36w pregnant in CA (I'm in GA) and no one will sign the paperwork letting me fly. Not the back up OB or the HB MW. Frustrating, since I too researched and it was surprised at how lenient the airlines themselves seem to be. Yet everyone on the ground seems to think as soon as I am in an airline, I will go into labor. (Was induced at 39w w/DS so no history of early labor).

I would definitely ask your MW for a referral to an HB friendly OB. She should know of someone who will do the paperwork for you. I had to drive 2 hours to see the HB friendly OB for backup, but at least there was one in the state.


PS: What does "look like you are ready to pop" mean to the airline employee? I was told I looked like i was ready to pop when I was 7m pregnant with DS. :LOL
 

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Discussion Starter · #5 ·
Quote:

Originally Posted by BensMom
PS: What does "look like you are ready to pop" mean to the airline employee? I was told I looked like i was ready to pop when I was 7m pregnant with DS. :LOL
Oh boy. I was LARGE by that point in my pregnancy with DD. That's part of the reason I approached my Doc about writing the letter and brought up flying. I'm afraid someone will take a look at me and think I am carrying multiples past term! Man, I wish I carried small. Then I wouldn't even worry about it.

I do think I need to contact one of the midwives I am considering regarding finding a HB friendly OB who will do my referral. Best as I can figure I am going to need to line up the OB appt so that I can have it as soon as I get stateside. That way the rest of my pregnancy is with the midwife I want.
 

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You're Tricare right? If so, then you don't need a referral or permission from your OB for a HB. Maybe they're telling you that because the OB is your current doctor? However when you come stateside, that OB is NOT your doctor anymore. Or else fire him. What Tricare says is you need a referral from your PCM (which could be an OB but is usually your PCM). How about come stateside, walk into your nearest MTF, and get a referral from your primary care doctor (aka who ever is on duty when you make an appt with your general health care doctor).

Make sure you check around with the midwives regarding their availability ASAP. Some might be booked up by that time and you could miss out.

When I went to my PCM to get my referral for a HB, I was very worried about the same thing. My PCM did try to refer me to the OB clinic but I refused - I would have needed her to refer me to the OB clinic, wait 1-2 weeks to go through their silly orientation half day before I could even get an appt to see an OB practitioner. Plus I didn't want to go there.

My PCM didn't give me any hassles about the HB, was more concerned about the procedural aspects and how to enter it into the computer. My PCM was a nurse practitioner but I'd never even met her before.

As for the airline issue, what about lying to the OB - tell him/her you'll fly at x weeks or whatever makes him happy. Or else you leave a few weeks earlier? I can't believe a doctor can prevent you from flying because he's not comfortable. Maybe if you have a history of preterm labor I'd understand it. It should be your decision. Or can't he write something like "I'm not comfortable with her flying but there is no medical reason why she can't". Or doesn't he have some disclaimer you can sign about it, saying you were warned but made your own decision? Are you sure he's not just trying to keep you there to get paid for this birth? Contact his medical board and check he's allowed to prevent you leaving the country with your husband? Maybe if you make enough fuss, he'll be glad to be rid of you


It's so hard dealing with all the runaround when you're overseas.
 

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Just wanted to add that when Tricare does a referral outside a MTF, it is because the MTF DOESN'T OFFER that service, and that service is medically necessary. So MTF doesn't offer HB, you're giving birth at home and therefore you need medical assistance from the CNM. That's how to frame your request. OBs opinions shouldn't come into it.

Also if that OB is refusing you something that is your right, take it up his chain of command if he's military or to his boss/management.
 
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