How did you make your decision for prenatal care?

[pibblemom]

Are you going with a midwife, OB, something else? Did you choose based on hospital preference, insurance, beliefs?

I'm having a tough time swaying myself from deciding to go with a MW practice that is out of network for me (with no out of network benefits). For the birth they are able to bill through the hospital that IS in network so that gets covered (assuming after deductible), but prenatal care is OOP. If I go to an in-network provider, prenatal care is a whole $25, one time copay. BUT, there are no MW locally that are in network, and the ones that are closest (20 miles) do not go to my hospital of choice. 

I'm fairly certain I want a MW attended birth because I don't agree with the rising csection rates, and I think its pretty common in this area for drs to be like "oh, its been 12 hours, you need all the drugs and then we need to slice you open"

Have you made your decision? Is it up for change? How did you decide what you wanted to do? Am I a nutcase?

[meerkatmillie]

Thanks for posting pibblemom  I'm still with my RE, but will need to transition to an OB in the coming weeks. I don't think you're a nutcase. I have the same concerns and am not sure how to sort it all out.

Hospital preference is a big driving factor for me, but second to that I'd like to find someone that will tolerate all the questions I have as a FTM. I've been reading google and yelp reviews at the different practices in my area, but they haven't helped me get a feel for how receptive the practice will be to spending time to answer my questions. Do OBs allow you to just meet with them for free without booking appointments? I really have no idea how Im going to pick one beside taking my best guess and hoping I get lucky...

[pibblemom]

meerkatmillie, FWIW, I use Facebook reviews a lot. I know there is always bound to be someone that will complain, but that is one of the reasons I'm so stuck on using this MW practice. Plus they've been really open to my stupid questions, and when I went for my pap a year ago, it was the most comfortable I've ever been getting one. Bedside manner is a big deal for me.

[thelittleredm]

I went with a midwife with DS because I wanted to try one out. It went really well so that's what I'm doing again.

[peaseblossom55]

I am still with my RE and I graduate I believe next week. I will be seeing my OB and a MFM now because of the twins. I really liked both from my last pregnancy, however deliver at different hospitals.
The hospital through my MFM is where I delivered DD, it was a great hospital and everyone was wonderful despite the shitty situation. I'd prefer to deliver at the hospital where my OB delivers because it's way closer and no bad memories. I have no idea what the plan will be at this point. I feel comfortable with the care of both groups. My OB practice is a group so I rotate through all of the doctors and midwifes there.

[siouxsieq]

Funny you should ask! I'm currently debating a midwife practice versus OB. I'm shooting for a VBAC, so I have to be at a hospital either way. My doc does do VBACs, but I'm just wondering if I would have a better chance of success with a midwife.

[heybulldog56]

I went with a MW last time and it did not go well. I never really clicked with them and there were a few in the practice that were a little... Rude? Dismissive? I haven't been able to put my finger on it but it didn't feel the way I thought it should. I never felt very supported or confident.

I ended up being induced after 26+ hours and eventually had a c-section.

That being said, I would absolutely do MW again because it lines up more with my ideas/ beliefs on pregnancy/ labor/ delivery. However, I currently see a CRNP who I really like. She can see me throughout my pregnancy. This is more important to me than who is at the receiving end of the birth canal (because I am going for a VBAC).

After my first experience, I do feel more confident as far as advocating for myself, whether with OB or MW. My first appointment as a pregnant woman at the practice is in half an hour. Let's see how I feel about this practice of OBs after that.

[jrun2013]

I'm also trying to decide right now where I want to go. For my DD I delivered with an OB at a hospital near my house. It wasn't the experience I had been hoping for.

This time I'm contemplating a midwife practice associated with OBs and they deliver at a hospital. There is a birth center here that I was also interested in, but you are sent home a few hours after giving birth, which I'm not comfortable with.

Good luck making your decision! I hope you can find a way to have the experience you want and to have it covered by insurance.

[heybulldog56]

jrun2013, I was with MW that delivered at a hospital last time. That was one of the big pluses for me.

[ellabee]

You're not a nutcase. This stuff is important!

For me:
We have a hospital <5 mins down the road for us that is very well known for being a great place to give birth. We picked it for our DD (born in 2014) and then researched what OB practices had rights there. Then we picked our OB office based on that.

The hospital is known for having a super friendly natural birth environment (which is what we wanted) and very low c-section and episiotimy rates. They have midwives groups there, but I guess I just felt like I wanted an OB.

I had a wonderful fully natural birth last time and want the same experience this time around, so we'll be going to the same OB/hospital.

I'm in MA, so I'm not sure where you'd find a similar resource in your area, but some research institute put together this interactive map for our state to rank hospitals based on rates for different birth factors. I found it informative. If our hospital had ranked lower for the stats I was interested in, I probably would have picked a different one even if it was further away.
commonhealth.wbur.org/2014/01/interactive-childbirth-massachusetts-hospitals

[NariaDreaming]

Well, my insurance sucks, so I have the choice of one hospital. Since I have autoimmune issues and a history of loss, my option is an OB/MFM monitored pregnancy.

DH is currently interviewing for jobs, and if he ends up with an employer that covers care at the other hospital, we will be switching practices. The only in-network hospital for me is a Catholic hospital, and I am worried that I will find myself in a situation where I may not be able to access the care I desire.

[siouxsieq]

May 25, 2016 15:23:34 GMT -5 NariaDreaming said:

Well, my insurance sucks, so I have the choice of one hospital. Since I have autoimmune issues and a history of loss, my option is an OB/MFM monitored pregnancy.

DH is currently interviewing for jobs, and if he ends up with an employer that covers care at the other hospital, we will be switching practices. The only in-network hospital for me is a Catholic hospital, and I am worried that I will find myself in a situation where I may not be able to access the care I desire.

I had this concern with kid 1.  It was, like, a major fear.  I had long talks with my husband, my doctor and with the NP, who used to be a labor and delivery nurse at that hospital.  I wanted to make sure everyone knew my fears.  I feel like they thought I was nuts, and maybe I was, but I don't care.  I found out what paperwork needed to be done in my state in order spell out specifically what I wanted to happen if those kinds of situations arose and if the Catholic hospital's policies didn't allow for that, that I needed to be transferred.  I gave a copy to my doctor, put a copy in our safe, gave a copy to the admission people when I checked in, and had a copy in my hospital bag.  I've seen a lot of Lifetime movies.  No fucking way.  LOL.

[aprilz81]

When I graduate from my RE I will be seeing an OB for prenatal care, but I still need to decide if I am going to switch practices or not. I will be switching doctors though, my current OB/GYN and I do not have a great connection and her bedside manner is a little abrasive. Not too bad for an annual exam, but I don't want to see her on a regular basis during pregancy.

The "easy" thing is just to see another doctor in the current practice (about a 20 minute drive each way and the office seems to be notoriously behind schedule).

The "harder thing is to switch practices, but the one I'm interested in is 5 minutes away. The downside is that I'm not guaranteed my hospital choice. If my doctor is already at hospital A and I go into labor I have to go to A and not hospital B. Both hospitals are good and centrally located, but for convenience I would like to deliver at the hospital where my sister had her kids. I'm more familiar with it and how it works since I visited her there when here kids were born.

[irish14]

Seems like I might be the minority but I'm all about going OB. I wanted continuity in the event I did need surgical intervention. It helps that I love my OB practice - it's large and there's only one out of 9 that I'm not a huge fan of. Pretty good odds for one of the other 8 being on call for my labor...

I also picked my OB based on recommendations from friends + where they delivered. I wanted a specific hospital. I'll go back there for sure, it was mostly awesome the first time.

[biscotto]

We have no decisions. One hospital. Voilà, decided for me.

The hospital is fine, midwives are used more than nurses and doctors. Doctors are only used when there's a complication. The maternité floor is midwives. All midwives are LCCs. It's very pro-BF and there's no nursery. Most of the midwives are fabulous women, but I had some older midwives that I'd rather not see again.

My experience with DD's birth was an unscheduled c-section because she was breech at the last moment, only discovered when I went into labor. The head doctor on call that night (there is never the same doctor) was great. Her assistant doctor was fine too. The midwife I had throughout the external version and the birth was fabulous (there are L & D midwives and midwives who work maternity). She was incredibly calm and kept me calm during the miserable external version and stayed with me through the surgery until I was taken to my room a few hours later.

I was given morphine directly after the surgery, but after that no "hard" painkillers besides tylenol and motrin were offered. I asked for something more since I was in so much pain and the rude, old midwife I had that afternoon (12 hours post OP) said "You had a lot of visitors, you should have been resting, thats why you want the medicine." And never gave me anything. Finally the midnight shift midwife was kind enough to give me something stronger and I finally could relax.

I hope that old midwife is gone this time around.

[otepoti]

Standard practice here is Midwife care unless I have any complications, which fingers crossed is the case, but if there was then I'd have a consultant. Works for me because I don't like a lot of appointments and messing.

[bepandnick]

May 25, 2016 22:20:52 GMT -5 irish14 said:

Seems like I might be the minority but I'm all about going OB. I wanted continuity in the event I did need surgical intervention. It helps that I love my OB practice - it's large and there's only one out of 9 that I'm not a huge fan of. Pretty good odds for one of the other 8 being on call for my labor...

I also picked my OB based on recommendations from friends + where they delivered. I wanted a specific hospital. I'll go back there for sure, it was mostly awesome the first time.

This is pretty much me too. Except my practice has 5 and there's one that I didn't click with. She was actually the on-call dr when my water broke (at 34w) with DS but I never even say her. My OB was in the office (attached to the hospital) and she delivered DS.

[ashtog]

We live in a really small town and the way it works here is we have one hospital, and an ob clinic made up of 5 rotating Drs, two who are actual Ob's.

With my first 3, I had them in town with the ob clinic, but after we lost Sawyer, for my rainbow pregnancy we did shared care with the mfm in the city, from 28 weeks on and then I was induced at 37w in the city where they have a nicu available if needed etc. It was a great experience all things considered, and we will be following the same path again with this little one.

Although all the extra ultrasounds will make staying team green a little nor difficult lol.

[badwolf]

Absolutely no question about sticking with my OB and a hospital birth for me. My OB is not only fantastic, he specializes in high risk and late-life pregnancies so anything else wasn't even an option. Plus DH really wants Spot born at a specific hospital because of family ties.