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Is it normal to have a Midwife AND OB/GYN?

773 Views 12 Replies 11 Participants Last post by  mother_sunshine
Aloha everyone!

I'm Michelle and we just found out I'm pregnant!
Before I go looking for the right midwife, I was wondering if it is "normal" to have a midwife and an ob/gyn? If so, when do you go to the midwife and what for (besides birth planning)?

I have a great ob/gyn but I'm planning a homebirth so I'll want a midwife. Our insurance supposedly covers both but not sure if I have to choose or what (will need to call).

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Not unless there is some medical reason.

I was confused by this when I was pg with my first baby and didn't understand that midwives provide complete prenatal care and even some complex management of pregnancy and birth.

I now understand that we don't need OB/GYN's when we're pregnant unless there is a health problem or pregnancy complication that makes the pregnancy or birth high-risk. And a midwife is a better person to tell you if you're high risk, as doctors want to medically manage all pregnancies in some way.

You're not sick, so you see a midwife, that's my understanding and philosophy. If you become sick, then you see a doctor.
I'd just see the mw unless you have problems that arise during the pg.

This time, my hb mw's wanted me to have local backup so I started seeing a CNM/OB group here in town. While I like the CNM here, the office and the atmosphere there almost induces worry and fear for some reason. My hb mw's on the other hand, are fabulous and I feel wonderful after our visits.

Of course, this is just my experience
but if I didn't need to see the CNM/OB, I wouldn't.
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I have been seeing a CNM in an OB office since I conceived. I just started seeing my homebirth midwife last week @ 23 weeks (it took awhile to interview and select the one I wanted).

I will continue to see both, but this is a unique situation:
1 - they know each other and are both part of Birth Year Network out here (that was how I found the CNM to begin with)
2 - neither is threated or upset that I am seeing them both
3 - in that rare 2-5% case that I have to transport during labor I will know who will be meeting me at the hospital and that was important to me and the parental units who are a bit nervous about this whole "home birthing" thing!

The CNM is far from a medwife and had no problems with me declining tests etc., but we are doing the ones that the hospital will want to see *if* I end up there for medical reasons.

For my peace of mind this has worked out best and I now have the support of my mother who believes I am in good hands (and after I clocked how long it took to drive from my home to the hospital she is content with my decision.)
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I've heard of people seeing both all along if they are paying directly for a homebirth MW (ie their insurance doesn't cover that), but otherwise I'd say go with the MW for the visits if that's who you want to give birth with. It is great that you have a OBGYN that you like, especially if you DO end up having to go to the hospital - you could even talk to him/her about the situation and discuss birth options so that they have the heads up and you know what to expect if you get transferred. I would NOT expect that insurance would cover both, though, unless you transfer to the OB for medical reasons and stop going to the MW. No harm in asking the insurance company, though!
The only reason I am getting care from both my homebirth midwife and my primary care physician is that the PCM is covered by insurance 100%, my midwife is out of pocket. I saw my PCM for the initial bloodwork, my 20 week ultrasound and will go one more time at 36 weeks to have the GBS test done. I'm not receiving full maternity care from my PCM (no need to double up) but just wanted insurance to pay for those items, I then have the test results sent to my midwife.
The midwife provides full prenatal care, unless there is a problem found that would indicate some intervention from an OB.
I'm sort of seeing both, but I have only seen the OB 3 times as sort of a CYA because of my risk factors. Most likely, I will see her breifley after the baby is born and that is it. The Midwife will handle everything else.
No. Here it is considered duplication of care and your health insurance won't pay for it.
If your ob is really good then it might be worth it to have some kind of arrangement with him/her in the case of a hospital transfer or even premature labor situation so you are sure you'll get good care there and not be stuck with some other ob who will not know you and may not be open to your wishes. Especially because transfers are unplanned and in that stressful time it's good to have a doc who you click with.
Thanks Mamas!!

I will look into just a midwife, but maybe I'll arrange some sort of one-time appointment with my OB too just to cover all bases. I am hoping my m/w will be covered in insurance (I think I'd have to pay 30%....any ballpark figure of how much that would be?) but both aren't covered simultaneously unfortunately. After reading the responses here, I don't need both anyway unless necessary. I'm 37 so hopefully I'll be fine with just m/w.

Looking forward to this experience!!

Thanks again!
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The midwife's fee can vary from $1500-$3600... just depends on your area mostly. We had a thread going here in I'm Pregnant and I tried to search for it to post a link for you but the search isn't working right now (Happy April Fool's Day I guess!).

Last time I saw the midwife's unofficial backup OB once and it turned out to be a good thing when I had a sudden kidney stone attack and went in to the ER on a Sunday morning... but I haven't bothered this time. It feels great to just see my midwife, plan my birth and not mess with waiting in waiting rooms or anything.
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Thanks Michelle.

Good to know that we won't pay more than around $1000 (hopefully way less than that though, or dh is going to
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