Tag Archives: midwife

Seeing a midwife does not mean I’m giving birth in a hut in the woods

One of the funniest things I’ve noticed throughout my pregnancy is how little people know about midwives — especially young people who haven’t yet considered having children and older people who gave birth during a time when hospital births and obstetricians were pretty much the only option in the United States.

Midwives are still much less common than obstetricians in the United States — in 2003 only 8% of births were attended by midwives. That’s likely gone up in the past 7 years as natural birth has become increasingly popular, but the majority of births are still attended by obstetricians. This leads to a lot of misconceptions about midwives.

I don’t know if it’s because the word sounds New Agey or what, but when I tell people I’m seeing a midwife, they often make the following assumptions:

  • I am planning a homebirth.
  • I am somehow opposed to modern medicine.
  • I’m taking a great risk with my health and the health of a baby by refusing the care of a doctor.
  • I’m a crazy hippie lady who wants to give birth in a hut in the woods.

None of the above assumptions is true.

I’m sure most of you reading this are quite familiar with midwives and what they do, because I have smart readers. But I just want to clarify for my own sanity.

Midwives are modern care providers. They are highly educated nurse practitioners who happen to specialize in child birth and female reproductive health. Instead of medical school, they attend a graduate program in midwifery — a form of medical school condensed to include specialized education in caring for pregnant women and female reproductive health. Because they’re not learning a variety of specialties, their education is shorter, but still comprehensive.

Midwives typically have a different style than obstetricians. Because they are nurses and birth attendants, they often stay with patients throughout the labor rather than showing up to catch the baby at the end. (I’m sure there are obstetricians that also do this, but it’s less common.)

Midwives are also more likely to encourage natural birth practices such as unmedicated birth, but that doesn’t mean they’re not qualified or capable of administering pain medication during birth if you choose to have it. Choosing a midwife does not limit you to a natural birth, but if you want a natural birth, choosing a midwife can make it easier for you to achieve it.

Choosing a midwife also doesn’t mean you’ll be giving birth outside of the hospital. Most midwives have hospital privileges.

Midwives also deliver at freestanding birth centers and some do home births. Freestanding birth centers are sterile, modern medical facilities that are often dressed up to provide a more homey atmosphere than a hospital. They are not huts in the woods. Women who choose freestanding birth centers always have an emergency back-up plan in place to transfer them to a hospital in a hurry in the event of complications. However, complications are rare, because midwives generally only care for women with low-risk pregnancies.

Midwives cannot perform surgery, so if an emergency c-section is required, a surgeon will need to perform it. The good news is, all midwives are affiliated with obstetricians, which means there is likely a doctor on call within their practice who can take over if you become high risk or a c-section becomes necessary. Because they’re unable to perform the surgery themselves, midwives are less likely to push for unnecessary c-sections.

I don’t think home birth is for me, but I would have liked to use the birth center affiliated with my midwives’ practice. Unfortunately, it wasn’t covered by my insurance, so I’ll be giving birth in the hospital.

So you see, midwives aren’t just for crazy hippie ladies who want to birth in a hut. It’s just another option for prenatal care and delivery.

If you’re considering getting pregnant in the near future, and you’re not familiar with midwifery, definitely look into it as an option for you! I have been so happy with the care I’ve received from my midwives. It’s possible that you’ll decide to stick with an obstetrician for your prenatal care, but you should be aware of all of your options in case it turns out that a midwife would better suit your needs.

If you suffered complications during your birth and you’re facing a medical negligence claim, be sure to contact a lawyer as soon as possible.

Photo by jonlarge

Health insurance hijinks

Remember a few days ago when I said I’d like to have a midwife, but they’re not covered by my insurance? It turns out I was wrong. Well, EYE wasn’t wrong so much as my insurance company was wrong. Amazing, right?

Yesterday, I set about the task of finding a new doctor in Fort Wayne so I could make my next appointment with them. When I first started looking for a doctor (or midwife), I started my search with my insurance company’s directory of in-network physicians. For an in-network physician, my out-of-pocket costs will be $2,000. For someone outside the network, it would be $4,500. Big difference.

To be honest, I didn’t try very hard to find a midwife. I ran a search for certified nurse midwives (a specialty that was included in the drop-down menu for my insurance company’s directory search). When it said there were zero in-network midwives in the entire state of Indiana, I was skeptical. But I chose an OB, and moved on. I decided I’d give the OB a shot, and if I was unhappy with her, I’d explore switching to a midwife once we were settled.

When I started my search for midwives in Fort Wayne, I found a practice that interested me. Their website listed my insurance provider as one of the plans they accept, so I called to confirm. They verified that yes, they accept my insurance. I asked if it was possible that the midwives would accept different insurance plans from the obstetricians, and she said no. All physicians, midwives, and nurse practitioners in their practice accept the same insurance plans. Great!

I assumed that there was a glitch in the providers directory on the website, so I called to verify that the midwife I wanted was in-network.

As a brief aside, can I just say how much I hate talking to a recording? It’s bad enough when I have to choose my options by hitting a number on the keypad, but at least I don’t have to repeat myself a million times. My insurance company’s recorded message is the WORST. Every time I call them, the menu takes me in so many circles that I’m dizzy and frustrated by the time I talk to an actual person. I’ve actually started repeating, “Representative” over and over again just to avoid the mess.

When I finally got to talk to a real live human, I explained my situation. He responded flatly, “We don’t cover home births.”

Me: “Um. That’s fine. I don’t want a home birth. The midwife I want delivers at an in-network hospital.”

Him: “We don’t cover midwives, because they’re not licensed to deliver babies legally in Indiana.”

Um. WHAT. At that point, it became clear to me that the guy had absolutely no idea what a midwife is. So I asked as politely as I could if I could speak with someone who does, in fact, know what a midwife is. He was pretty annoyed by the request, but he transferred me.

I didn’t have much luck with the next representative. He ran a search in the database, probably using the same search tool I had used, and told me flatly that the provider I want isn’t in network, because there are no midwives in network. I told him what the insurance specialist at the midwife practice had told me about all of their physicians accepting my insurance, and he told me she was wrong. Okay.

Frustrated, I hung up and called the midwife practice again. I told the woman what happened, and she was confused. Apparently, they bill my insurance company frequently. It’s a major one, and a lot of their patients are on it. She even asked about my specific plan, and said that yep, a ton of their patients are on my very same plan. WTF?!

At this point, I was irritated and determined to straighten it out. I called the insurance company again, dealt with the insufferable menu options, and finally got to a person again. Thankfully, this representative was not a total idiot.

He explained the problem, which actually makes complete sense. Midwives don’t come up in the physician search, because they’re not physicians. They practice and bill under a physician. In that case, I don’t understand why “Certified Nurse Midwife” is a search option on their website, but whatever. He explained that I needed to find out my midwife’s attending physician, and search for him or her. If the physician is covered, the midwife is, too. Duh. I’m glad that SOMEONE at my insurance company understands how it works, because the previous two people to whom I spoke had NO IDEA.

The moral of the story? If you’re hoping to have your birth attended by a midwife, search for your midwife’s attending physician. And don’t expect your insurance company to make things easy on you.

Photo by mkmabus