I had found a midwife who was covered under our insurance and who was able to deliver in hospitals before I even got pregnant. I had a plan and I knew exactly what I wanted to do. I want the feel of a natural, hippie home birth but in the safety of the hospital. A birthing center would have been ideal, but unfortunately Nevada doesn't have birthing centers. The moment I knew I was pregnant I made an appointment with the only midwife covered under our insurance and I prepared a ton of questions (of course, when I say "I", I mean my husband and I).
My midwife (Charlene Hanna-Manfull) is wonderful. She answered all of our questions, seemed to understand our needs and what we were looking for in a health care provider, and said that I could limit my number of internal exams (since those cause me severe panic and stress). When I experienced bleeding at 12 weeks, she was able to see me almost right away and even called me at home, herself when she had test results. The only complaint I have is that she began talking to me about induction when i went in for my 20 week appointment. She advised me that the hospitals don't allow anyone to go over 41 weeks and that most women are induced at 39 or 40 weeks. I threw a bit of a fit for a while but decided that we weren't there yet and that we would cross that bridge when we got there.
The only hospital that my midwife has delivery rights at is Mt View hospital. That has not been a problem for us since it's only about 10 minutes away. Centennial hills is more ideal because its 2 miles away, but she has not received delivery rights from them yet. Charlene has advised us that she should get delivery rights at Centennial Hills prior to our birth. BUT- she started out saying January 1. Then March. Now, its any time now.
We took our Mt View hospital tour on 3/19/11 because we expect that we will deliver there with the way that the contracts between the midwives and Centennial Hills seem to be going. Our "hour" tour was 1/2 hour. It was conducted by a post partum nurse who didn't seem to know much about the labor and delivery side. I think the important questions are generally regarding labor and delivery. The post partum part seems to be the easier of the two, don't cha think? She advised us that after birth the nurses take the baby for 1-2 hours or until the baby heats up. During that time, they wash the baby and give them all their shots and ointments. I asked "what if we don't want our child bathed?" She looked at me a little funny and said that if the child isn't bathed then the nurses wouldn't touch our baby without gloves. Well, that's fine lady. I would prefer if the baby stay in my husbands arms anyway for all procedures instead of some stranger in latex.
We head up to the elevator and need to go to floor 3. It's a pretty simple tour: "here's the labor and delivery room. Here's the post partum room. Here's the nursery." When I saw the nursery, the babies were under heat lamps and it reminded me of fast food french fries. Why do they need to take my baby for 1-2 hours to cook him under a heat lamp? Why can't he be skin to skin with me under a blanket or with clothes on to heat him? She can do all the shots and tests with him in my arms. Next, when we went into the labor and delivery room she said "You come into this room and get checked to see if you are actually in labor. If you are then you get your epidural and have your baby in here." Wait! What? You just assume that I'm getting an epi? Well, I'm not! I asked her if I could give birth in different positions than my back and her response was "Well, I don't work in L&D but I don't see why it would be a problem." That's not a real answer. We are standing right here in the L&D wing. Why don't you go and get someone who knows the answer to my question? It all felt very factory to me: "come in, get epi, give birth, check out. NEXT!" I was not comfortable with the experience at all.
I'd been dwelling on it for a few hours and decided to do some research about my options, yet again. I feel like I'm back at the beginning of this whole process. I thought I had it all figured out but with this new development of not wanting to give birth in the only place that my midwife can deliver really complicates things. I asked around (mainly to the mommy group) for advise, looked online for options, and struggled with it for a while. Then, I talked about all the scenarios with my husband. Although he didn't seem very concerned at the time (Saturday night), he seemed to get a fire under his butt about it through the night and came to me Sunday with his concerns. He had looked back on the questions we had asked our midwife throughout the last 20 weeks or so and decided that she hadn't really answered or questions in a way which he was comfortable with either. She answered with things like "that shouldn't be a problem" and "that's an understandable request." Also, he felt like she had hinted a few times that she may be out of town mid-July and that she may be pushing induction on us early on to prepare us for either getting induced or having another doctor (altho we asked her in our interview if she would be going out of town or on vacation around our due date and she said no). So, we weighed our options together.
The problems we are having with a home birth are 1. I'm scared of something happening with the baby that we need a hospital setting for. 2. It would be an out of pocket expense of $3000 or more. 3. I really hate to switch care providers this late in the game. 4. What if I can't make it through the pain and need to go to the hospital for an epi. I'm really going to try and have a natural birth but I've never done this before and I don't know what to expect. That means we would pay out of pocket 3k or more and then still go to the hospital and end up with a hospital bill. Plus, a stranger would be delivering my baby. I just don't know! To complicate things just a little further, my current midwifes office is requiring our portion of their bill (about $800) prior to delivery and that is due on our next visit. So we need to decide at our next visit if we are paying them or going with someone else. The clock is-a-tickin.
We talked about it throughout the day and decided that our action plan will be:
Regarding the hospital birth and my current midwife:
1. call mt view hospital and complain about the tour. Ask to speak to a L&D nurse to get more questions answered
2. Talk to our midwife at my next appointment and see what her take on the hospital tour is and see what she has to say about our concerns. Also, ask her direct questions regarding this induction plan and what happens if we refuse.
3. Tour Centennial Hills hospital to find out if its even worth it to hold out for her to get rights there. If we still hate Mt View and Centennial Hills sucks too then we will know for sure to switch doctors.
Regarding the home birth:
1. Call well rounded momma (who our doula is through) and set up a free consult with a midwife. Also, find out about safety, what happens if the baby is hurt or sick and what experience she has. Since Centennial Hills hospital is very close, I may feel OK doing it at home if the midwife is trained well.
2. A friend of mine told me that her insurance (same company as ours) was willing to cover an at home midwife at 60% as an out of network provider. If they will cover that, it will save us some money and alleviate some concerns regarding financials. I need to talk to my insurance co and find out what the rules are.
3. Another friend of mine told me that one midwife (Sherry- owner of WRM) has delivery rights at Summerlin hospital. IF the insurance will cover an at home midwife at any percent and then Summerlin is covered in network, then it won't cost much more to switch. Plus, I can try the birth at home and if I can't do it then we can transfer over to Summerlin. So, I need to talk to Sherry and then tour summerlin if this is all the case. THIS is my best option so far and the one I am hoping for.
I have a busy few weeks ahead of me to figure out what I want to do. What I do know is that I don't want to be just another number for nurses in L&D. I don't want them to take my baby from me unless it's life or death. And, I don't want to feel like I'm doing my birth based on someone elses agenda and procedures. I am doing this birth the best way for me, my husband, and our baby!
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