nurse midwives and childbirth

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Have any of you had experience with home birth and nurse midwives? I live in a very conservative area in this regard. We recently discovered that we are expecting our 5th child in March. I found the only practice in our area and am worried about whether insurance will cover much of it. If they dont then I may have to go the ob/gyn route and thus far I have been very disappointed (constant monitoring, IV, have to stay flat on your back etc.) The other option as I see it is a lay midwife which is illegal in this state, but I know they exist. It May be less expensive though.

-- Denise (jphammock@msn.com), August 09, 2000

Answers

Denise, my oldest daughter just had her second daughter (yesterday!) with a midwife, and insurance covered both home births. So do check out your insurance policy.

-- Kathleen Sanderson (stonycft@worldpath.net), August 09, 2000.

Hi,

Check with your insurance...depending upon that and what state you live in, you should run into no problems. However if you have Blue Cross (esp in Illinois) you will.

I have had four births with midwives, three with CNM (Certified Nurse Midwives) in hospitals and one with lay midwives at home. Don't disreagard a midwife because she doesn't have a CNM-many CNM 's in fact most all of them have to work under a doctor, and so have similar routine standards of practice they have to abide by-it all depends upon the doctor and hospital.

Lay midwives-well-like CNM's there are great ones and not so great ones. You have to do your homework! (True on just about everything.) But most operate within the law-example in my state midwifery is not illegal, but a lay midwife may not charge a fee. So most barter if they are not CNM's. However the CNM's have free reign to deliver at home or wherever. (Some hospitals do not accept them...depends upon the doctors and politics at the place) There are excellent lay midwives who operate within the confines of the law-and do not charege a fee-they barter (for example they will work out an arrangement if your husband does contruction to build or fix something they need, or you can buy so many groceries etc...and then there are those who don't charge at all-mostly within a Mennonite or Amish community or similar).

In the previous state I lived in, midwifery was under attack on all fronts. It was not illegal, but the doctors were nothappy with the reduction (no mater how small) in their practices seemingly because of midwives luring them away. In reality, a very small number of women choose midwives-so it was only a perception. Lay midwives were also under attack, but it was not illegal at all. It was completely a political situation. The midwives I used were all in that state, and I was supper happy with the outcomes and qualifications of all my midwives. It all depends on what is most important to you and you husband.

Feel free to email me if you have specific questions. Oh-I almost forgot-there is a number of sites that can tell you about the laws exactly in your state, and also give you contacts to area midwives. Let me know if you want more information. I can't off the top of my head remember the address...I will look to see if I can find it and post agin.

Peace and blessings, Sarah

Oh and lay midwives and CNM's (especialy those who work alone or in a practice), are generally very willing to work out payment arrangements if your insurance does not cover. Lay midwives especially. And yes the cost is cheaper with a lay midwife. Usually around $800-1500 is all compared to closer to $2000 for a CNM, and if in a hospital add the backup doctor and hospital costs. And a 'cost' to consider is having someone attend to you and your needs the entire time you labor-instead of just showing up to catch a fee (as some put it!) If you end up going with an OB, i would highly reccommend you look into a doula, who will work with you and deal with the medica people being YOUR advocate (as well as your baby's) Most run around $2-300 dollars I believe.

-- Sarah Cate (heartsong85@juno.com), August 09, 2000.


I have done some brief studying in this area and hope to do more to become a doula. If you can not find a suitable midwife in your area is one willing to come over from another town? I would definitly look into using a CNM whether you want a home are hospital birth. if truly none are available you really need to shop around for an ob/gyn who is interested in taking care of you and your baby's needs and not fulfilling their own agenda. If you do go the ob route you need to write out a birth plan that is signed by both you and you doctor. this is an outline of what you and your husband want and do not want to occur at the birth. i would be leary of any doctor that will not go along with this. he/she does not have your interests at heart. if you are interested in what to put in your birth plan just e-mail me and i can send you some stuff. also if none of the above choices seem to work out many couples have their babies at home with no assistance. I caution that only women who do not have ANY complications or PRIOR history even think about this. i still enourage you to get good medical care! again, i am not trained in this field but do have a little info if you need it to help you make a decision. just remember, you are the mother of this baby and you are in charge, not some doctor with a medical degree. good luck and congratulations.

-- Amber (ambrosia75_@hotmail.com), August 09, 2000.

First,I will admit to a huge bias..I am a Nurse Practitioner and have been one for 30 years..There is an enormous difference between a CNM and a lay person who delivers babies and that is education and more importantly, CONTINUING EDUCATION....Every state in the country requires a CNM to PROVE that he or she has attended a lengthy seminar each and every year to insure that his or her skills are current.A CNM cannot maintain her license if she has been convicted of a crime,is under psychaitric care for a serious mental illness,etc.etc....Advanced Practice Nurses such as Midwives,Practitioners,Anesthetists, jump through all sorts of hoops each and every year in order to maintain their license to pratice.I just got through with a test administerd by my national certification board,which I take every year to show I know what I am doing...If I received less than 75 as a score, my license would be pulled immediately and I would be required to take courses and THEN re-take a huge qualifying exam in order to practice again in any state.This test is not a token nor is it easy..I got a 94% (after 30 years of experience)...these requirements go way beyond what physicians must do....A CNM is a qualified,up-to-date provider of the highest degree of obstetrical care, and yes, they are bound by state practice laws just as MDs and DOs are...lay midwives deliver MOST babies safely....as a matter of fact,anybody can deliver a normal baby with a normal delivery,from a normal pregnancy....in the event of a problem...whom would you prefer?????? In OB, problems occur quickly,become very serious very quickly, and require immediate knowledge of how to intervene...please do not be swayed by cost..what are you and your babies worth????? God bless...

-- Lesley (martchas@gateway.net), August 09, 2000.

How about a commune in Tennessee--it's legal and as far as I remember even our government claims they have the best mid-wifes in the world. Try " The Farm" they have a website !

-- Joel Rosen (Joel681@webtv.net), August 09, 2000.


Hi, again, Denise. I had my last two boys ( 10 lbs 8 oz, and 10 lbs 14 oz) at home with a direct entry midwife. My experiences were beautiful, peaceful, healthy and private. Please email me if I can help you in any way. We paid out-of-pocket for our midwife, and she is worth every red penny. This isn't an illegal choice in MN (homebirth), but it IS illegal to practice medicine w/o a license, which puts midwives in a precarious position. My first child was a C- section, my second was induced in the hospital, but those last two birth experiences were among the most empowering and gratifying days of my life. Good health to you and congratulations!

-- Rachel (rldk@hotmail.com), August 10, 2000.

Hi Denise, I am holding my week old baby boy, born at home.Our midwife for the last two births was a very good, highly competent lay midwife. Most CNMs I have found do hospital births only, which means they have to go along with many hospital protocol,etc. But a hospital birth with a CNM is definitely much better than the same with a doctor. If you are going to use a lay midwife, you should have a low risk history, and find a GOOD midwife, one that is highly recommended by everyone who knows her. One you feel comfortable with. Ask if she is prepared for emergencies, and whther she will have oxygen, pitocin (in case of hemorrage, not for induction),and ask how many babies she's delivered, etc. Shop around. Get one that will be able to work with the doctors, if necessary, you don't want a midwife who is going to let things go too far in an effort to avoid going to the hospital, or something like that. If the midwife statrs saying things like, We just have to trust in God that things will be alright, shop elsewhere.Yes, we do have to have faith, but you also need a competent midwife who will give you straight answers. If you have to have a hospital birth, by all means try to use a CNM. They make all the difference in the world in a hospital birth. My first two births both were in the hospital, the first, with a doctor, was a C section, the secind one, with a CNM was a vacuum extraction, the last two were both home births, very uneventful,fairly easy births, no intervention or even stitches required. Home birth is wonderful, but be very choosy and get a really good experienced midwife.

-- Rebekah (daniel1@transport.com), August 10, 2000.

Hi Denise,

Contragulations on your new baby coming!!!!! How wonderful...we have 4children and my last two (girls) were delivered with a CNM and she was so wonderful I can't say enough good about her.

If you have to go the OB way find a woman.... and explain to her how you want to have your baby....and as someone else said if they aren't willing to go along with "your plan" then find someone else...after having 4babies yourself you should know what and how your body works...even though all births can be different.

I think a doula would be an excellent idea in your case if nothing else is a available... the main goal is to have you healthy and your baby born safely...May the LORD Bless you ... I will be praying for you as you search for just the right medical care for your baby and yourself.... Jenean.

-- Jenean Miller (1Wrangler1@excite.com), August 11, 2000.


My wife and I have a 2 1/2 year old that was delivered by a midwife. When we found out we were expecting my wife was hesitant about using a midwife, but our midwife does not do home deliveries and always has a backup doctor in case of problems. Our midwife would sit and talk with us for up to 1/2 an hour after my wife's checkup. She is very open and will discuss anything and is never in a hurry. Our insurance paid 100%! My suggestion would be to visit several until you find one that you are totally comfortable with! You won't regret it.

-- Michael W. Smith (kirklbb@penn.com), August 13, 2000.

Have you considered a doula?www.dona.com wil give the info and help you to locate one.Feel free to e-mail me as well.I have 5 tooo!

-- teri murphy (mrs_smurf2000@yahoo.ca), November 15, 2000.


I may be "just a teen" but I strongly advise against home births, my daughter was born with a "score" of 1, she had virtually no vital signs, she had the weakest heart beat my doctor had ever heard and that was it, no breathing, she had fluids gushing out of her mouth, she was turning blue and not crying. If it wasn't for the equipment that my hospital had, my daughter wouldn't be lying in her crib, alive, today. Just please, weigh your options and decide if a home birth is truly worth the risks, please. I know how devestating miscarraiges/stillbirths are, my daughter was a triplet, two were miscarried at 21 weeks due to abdominal trauma and the other one was carried to term, after I lost my plug, i was on bed rest the rest of the time and I wanted a home birth but I thought about what could go wrong. I've had to go every day thinking about Angel and Hope and realising that Savanah could have ended up in Heaven too.

Sorry if you don't agree, Snowy

*Hugz*

-- Snowy (hugging_calves@yahoo.com), January 01, 2001.


I had two of my children with midwives, both in hospital. The third was supposed to be a home birth but we ended up as a hospital transfer (I lived in England at the time where homebirth is a widely accepted practice so transfer wasn't stressful). Yet, if I had to do it over again, I'd use a midwife and try for another home birth because I firmly believe it is a wonderful and safe way to have a baby if you are low risk. You can call your insurance company and ask if midwifery care is covered by your policy. Actually, I'd be surprised if it wasn't covered. You can also check out the website for the Midwifery Alliance of North America (sorry, don't have the URL) to see if "lay" or direct entry midwifery is legal in your state. Not all states require a midwife be a nurse to practice. If you do go the home birth route, be sure your midwife arranges for OB and hospital back-up. I don't mean to scare you, but this is important in case you need to be transfered. It's not common to be transfered but it does happen, as it did to me!

-- amy (acook@in4web.com), January 01, 2001.

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