OB/GYN or midwife?

[anyone4tea]

Or can I have both?

I have an OB/GYN but I have heard from other mothers that they only
come in at the end of the labor (ie the birth! :D). However, it seems
that midwives are present throughout the labor.

Is this right, and would I be able to have both a midwife and an
OB/GYN?

I have a PPO healthcare plan - would it cover both?

Thanks!

Anyone4tea

[JennP]

"anyone4tea" > wrote in message
oups.com...
> Or can I have both?
>
> I have an OB/GYN but I have heard from other mothers that they only
> come in at the end of the labor (ie the birth! :D). However, it seems
> that midwives are present throughout the labor.
>
> Is this right, and would I be able to have both a midwife and an
> OB/GYN?

In a nutshell, yes. That's pretty accurate.

I see a midwife for all my healthy stuff and an OB/GYN for when things get
unhealthy which isn't often.
> I have a PPO healthcare plan - would it cover both?

Mine does.

JennP.

[Ericka Kammerer]

anyone4tea wrote:

> Or can I have both?
>
> I have an OB/GYN but I have heard from other mothers that they only
> come in at the end of the labor (ie the birth! :D). However, it seems
> that midwives are present throughout the labor.
>
> Is this right,

Like most things, it depends. In general, however,
it is usually the case that you won't see much of an OB
during labor and he or she will show up at the end, and
it is usually the case that a midwife would spend more
time with you during labor (with "more time" being anything
from with you for practically the whole labor to a bit
more than would be typical of an OB, depending on the
type of midwife, the type of practice, and the individual).
Obviously, this would be one of the questions you'd ask
while interviewing midwives.

> and would I be able to have both a midwife and an
> OB/GYN?

? Why would you want both? Because midwives
are not authorized to handle some complications, if
there are any concerns or complications with your
pregnancy or labor you will be referred to an OB for
a consultation. If the OB determines that there is,
in fact, a complication that makes the pregnancy
higher risk or requires specialized ongoing care,
then your care will be transferred to the OB. All
CNMs are required to have a backup agreement with
an OB (though you could see a different OB for a
consult or transfer of care--you're not locked into
using that OB).
However, if the pregnancy and birth continue
on low risk, then the midwife will be your caregiver
and there won't be any need to see an OB.

> I have a PPO healthcare plan - would it cover both?

Well, I highly doubt that *any* insurance is
going to pay twice for the same care. Most PPOs have
some midwives in network. If you select one, that
midwife will be your primary caregiver and the insurance
will pay. Insurance will also pay for any referrals
for consultation or transfer of care to an OB if
necessary due to complications (or if you just want
to switch back to an OB). What they're not going to
do is pay for both an OB and a midwife to attend
your perfectly normal birth, or for you to do prenatal
care with both a midwife and an OB.

Best wishes,
Ericka

[NotMyRealName]

What Ericka said! I've used two sets of midwives (CNMs) for two
pregnancies, and I've loved both sets. With my first labor, the midwife was
present for the entire labor, but she mainly stayed in the other room and
let my DH and me be on our own. She came in periodically to check on us and
the baby, and if we needed her for anything (like to stay with me so DH
could use the bathroom or something), she was right there. If we had wanted
or needed her to be with us more, she would have been in the room more. She
was there the entire pushing time, of course, and immediately postpartum.
She called the OB to come over for a consult on me after the baby was born,
because they thought I might have had a complication that I turned out not
to have, but most of their clients never see an OB at all, and I hadn't seen
the OB at all during the pregnancy. This pregnancy, the midwives are the
same -- they'll come to our house when labor starts and will stay, in the
background or not, as much as we need, throughout the labor. They'll be
there for the pushing and for about four hours postpartum. If any sort of
complication arises between now and postpartum, they'll consult one of their
backup OBs or transfer us to the hospital.

I personally feel totally comfortable with midwives. The ones I've used
really seem to know when they don't know enough, and so they call or consult
one of their OBs. With my first pregnancy, I was a little nervous about
possible complications and things going wrong and not being in a hospital
and all, and they were able to reassure me about what steps they take to
make sure that any problems are detected early enough to seek an OB/hospital
if need be.

You might be able to find a practice that has both midwives and OBs in the
same group. Some practice in hospitals, and some practice in birth centers.
It doesn't mean you'll have both for the birth, but I assume it means that
if the midwife encounters a problem, she calls the OB in her practice
instead of another OB.

--
-Sara:)
Mommy to DD, 2 3/4
And Someone Due 2/05

"Ericka Kammerer" > wrote in message
...
> anyone4tea wrote:
>
>> Or can I have both?
>>
>> I have an OB/GYN but I have heard from other mothers that they only
>> come in at the end of the labor (ie the birth! :D). However, it seems
>> that midwives are present throughout the labor.
>>
>> Is this right,
>
> Like most things, it depends. In general, however,
> it is usually the case that you won't see much of an OB
> during labor and he or she will show up at the end, and
> it is usually the case that a midwife would spend more
> time with you during labor (with "more time" being anything
> from with you for practically the whole labor to a bit
> more than would be typical of an OB, depending on the
> type of midwife, the type of practice, and the individual).
> Obviously, this would be one of the questions you'd ask
> while interviewing midwives.
>
>> and would I be able to have both a midwife and an
>> OB/GYN?
>
> ? Why would you want both? Because midwives
> are not authorized to handle some complications, if
> there are any concerns or complications with your
> pregnancy or labor you will be referred to an OB for
> a consultation. If the OB determines that there is,
> in fact, a complication that makes the pregnancy
> higher risk or requires specialized ongoing care,
> then your care will be transferred to the OB. All
> CNMs are required to have a backup agreement with
> an OB (though you could see a different OB for a
> consult or transfer of care--you're not locked into
> using that OB).
> However, if the pregnancy and birth continue
> on low risk, then the midwife will be your caregiver
> and there won't be any need to see an OB.
>
>> I have a PPO healthcare plan - would it cover both?
>
> Well, I highly doubt that *any* insurance is
> going to pay twice for the same care. Most PPOs have
> some midwives in network. If you select one, that
> midwife will be your primary caregiver and the insurance
> will pay. Insurance will also pay for any referrals
> for consultation or transfer of care to an OB if
> necessary due to complications (or if you just want
> to switch back to an OB). What they're not going to
> do is pay for both an OB and a midwife to attend
> your perfectly normal birth, or for you to do prenatal
> care with both a midwife and an OB.
>
> Best wishes,
> Ericka
>

[Clisby]

anyone4tea wrote:

> Or can I have both?
>
> I have an OB/GYN but I have heard from other mothers that they only
> come in at the end of the labor (ie the birth! :D). However, it seems
> that midwives are present throughout the labor.
>

That was true of my experience (first time with OB, 2nd with midwife.)

> Is this right, and would I be able to have both a midwife and an
> OB/GYN?
>

Not sure what you mean. There wouldn't be any point in having both at
the birth. However, there are practices that include both OBs and
midwives - this is like the practice I used with my 2nd birth. There,
I saw the OB for about the first half of the pregnancy (I had had 2
miscarriages and I knew I was going to have an amnio; if it hadn't been
for that, I might have been able to start out with the midwives.)
Anyhow, once I got to the 20-week mark and everything was fine, I could
choose whether to continue with the OB or switch to the midwives. I
switched. If anything had happened during the rest of the pregnancy or
the labor that required an OB, the midwife would have called in the OB;
but they wouldn't both have shown up routinely to assist at the birth.


> I have a PPO healthcare plan - would it cover both?
>

I had a PPO that covered the OBS and the CNMs in the practice I used. I
can't imagine it would have covered duplication of services; but then, I
don't think the practice would have agreed to duplicate services. That
is, I had chosen the midwife; I don't think they would have sent the OB
over just for the heck of it (and vice versa).

Now, if you want an OB to be present but also want birth support the
whole time, you could hire a doula. I don't know anything about
whether insurance covers that.

Clisby

[Min E]

Clisby wrote:

>
> Now, if you want an OB to be present but also want birth support the
> whole time, you could hire a doula. I don't know anything about
> whether insurance covers that.
>

Clisby said it! That's what I'd recommend, and personally I am
considering hiring one.

Min

[Kelly]

If you are interested in having both, then try to find a group that consists
of midwives and OB's. It will be unlikely that both would attend the birth
and you'd need to decide who your primary caregiver, but you have the option
of choosing who you feel best with. Most midwife groups have OB backup if
the need arises, or they use a certain OB group for any complication that
comes up prenatally.

I saw two OB's that were "midwifey" to me, and am seeing midwifes now that
are very experienced and use an OB group that I really like and respect.

I think it is important for you to write down what you are looking for in
prenatal care and for birth. Then obtain recommendations and meet different
providers and go with who best fits your needs and personality.

I've met midwives and OB's that I would not come near, and I've met OB's
that are very low key gentle birth like. Good luck in your search and have
fun thinking about your care and birth.

Warmly,
Kelly
#4 2/12/05

"anyone4tea" > wrote in message
oups.com...
> Or can I have both?
>
> I have an OB/GYN but I have heard from other mothers that they only
> come in at the end of the labor (ie the birth! :D). However, it seems
> that midwives are present throughout the labor.
>
> Is this right, and would I be able to have both a midwife and an
> OB/GYN?
>
> I have a PPO healthcare plan - would it cover both?
>
> Thanks!
>
> Anyone4tea
>

[Victoria F.]

>> Now, if you want an OB to be present but also want birth support the
>> whole time, you could hire a doula. I don't know anything about
>> whether insurance covers that.
>>
>
> Clisby said it! That's what I'd recommend, and personally I am
> considering hiring one.

I swear by doulas. I think they're the best, and would never consider
having a baby without one present. I know I only went natural with my
second because of the incredible support from my doula.

V

[Diana H.]

Midwives don't always stay throughout labor at least not in my case she came
in when I first came to the hospital introduced herself then left and did
not come back until I was ready to deliver -GRRRRRRRR-
She left an evil nurse with me the rest of the time- bad memories!!

Diana

[Jenrose]

"anyone4tea" > wrote in message
oups.com...
> Or can I have both?
>
In the vast majority of cases, if you have a midwife, there will be "OB
backup" somewhere as an option.

> I have an OB/GYN but I have heard from other mothers that they only
> come in at the end of the labor (ie the birth! :D). However, it seems
> that midwives are present throughout the labor.
>

Depends on the midwife. Ideally, yes. At home, generally yes. At the
hospital? Some do, some don't.

> Is this right, and would I be able to have both a midwife and an
> OB/GYN?
>

You don't really *need* both... if you have a midwife, and everything goes
right, you may never need to see the doc. If something goes wrong, the doc's
available.

> I have a PPO healthcare plan - would it cover both?
>

If the midwife is your primary care provider and refers you to an OB (even
in the sense of grabbing one passing in the hall and bringing them in) then
it is highly unlikley you would run into problems with a PPO, depending on
how broad it is.

In my case, planning a homebirth, my insurance doesn't cover homebirth
midwives, AFAIK (haven't really tried to find out thus far--we're bartering
with my homebirth midwife) but even if I had to pay her out of pocket, if I
felt it necessary, I would do so because having the support I want and need
at the level I need it in a birth is something I can't go back and "fix",
while money--that can be worked out. You can't buy back a botched birth.
Insurance does cover, (loosely--we have a huge deductible) all the hospital
stuff. If we transport, I have backup OB care that will take care of me and
be covered under my policy.

Jenrose

[Renee]

Min E wrote:
> Clisby wrote:
>
> >
> > Now, if you want an OB to be present but also want birth support
the
> > whole time, you could hire a doula. I don't know anything about
> > whether insurance covers that.
> >
>
> Clisby said it! That's what I'd recommend, and personally I am
> considering hiring one.
>
> Min

I used a doula in my first pregnacy and plan to use one again when I
deliver this baby. The hospital I delivered at has them on call for
free. She knew a place on my feet to squeeze which really cut down the
pain (I went natural, but was induced.)

Renee

[Todd Gastaldo]

"Diana H." *> wrote in message
...
> Midwives don't always stay throughout labor at least not in my case she
> came in when I first came to the hospital introduced herself then left and
> did not come back until I was ready to deliver -GRRRRRRRR-
> She left an evil nurse with me the rest of the time- bad memories!!
>

If the woman wants the midwife there during labor, it seems like that has
traditionally been part of the job.

Put nurses and CNMwives and OBs on a schedule in an institution and the
result can be "evil", IMO.

Health care becomes medical care...

Etymology of midwife and obstetric...

Word History: The word midwife is the sort of word whose etymology seems
perfectly clear until one tries to figure it out. Wife would seem to refer
to the woman giving birth, who is usually a wife, but mid ? A knowledge of
older senses of words helps us with this puzzle. Wife in its earlier history
meant "woman," as it still did when the compound midwife was formed in
Middle English (first recorded around 1300). Mid is probably a preposition,
meaning "together with." Thus a midwife was literally a "with woman" or "a
woman who assists other women in childbirth." Even though obstetrics has
been rather resistant to midwifery until fairly recently, the etymology of
obstetric is rather similar, going back to the Latin word obstetrx, "a
midwife," from the verb obstre, "to stand in front of," and the feminine
suffix -trx; the obstetrx would thus literally stand in front of the baby.
http://dictionary.reference.com/search?q=midwife



Todd

[Todd Gastaldo]

Women who have had babies: If you gave birth with your birth canal closed
the "extra" up to 30%, there is nothing you can do about it except make sure
your birth canal is not closed the "extra" up to 30% in your next
delivery...

Having a midwife is no guarantee...

Sara "NotMyRealName" > wrote in message
...
> What Ericka said! I've used two sets of midwives (CNMs) for two
> pregnancies, and I've loved both sets. With my first labor, the midwife
> was present for the entire labor, but she mainly stayed in the other room
> and let my DH and me be on our own.

Sara's comment that the CNM "mainly stayed in the other room" reminds me of
Michel Odent, MD saying that women should labor feeling unobserved.

According to Odent, women who labor feeling unobserved will spontaneously
get off the sacrum (let their birth canal open the "extra" up to 30%).

> She came in periodically to check on us and the baby, and if we needed her
> for anything (like to stay with me so DH could use the bathroom or
> something), she was right there. If we had wanted or needed her to be
> with us more, she would have been in the room more. She was there the
> entire pushing time, of course,
<snip>

Yale CNMwifery Prof. Helen Varney says "Midwives...encourage...semisitting."
[Midwifery. Sudbury, MA: Jones
and Bartlett. 4th ed. 2004:839]

Yale CNMwifery Prof. Varney also advocates KEEPING the birth canal closed
the "extra" up to 30% (lithotomy) when babies get stuck.

CNMwives who encourage birth-canal-closing/semisitting - and keeping the
birth canal closed (lithotomy) when babies get stuck - should NOT be there
during pushing time - not if the mother does not know about the "extra" up
to 30%.

Women shouldn't have to ask for the "extra" up to 30% and CNMwives should
not encourage denying it.

Sorry to harp on this, but I think 100% of babies would want me to.

Todd

PS Yes, I know, women push babies out all the time semisitting and dorsal
with birth canal closed the "extra" up to 30%. I myself was pushed through
a birth canal closed up to 30%. Pushing the baby out is only part of the
equation. I'm bothered by the unexplained deaths and unexplained
paralyses - and the estimated 4.6% of "healthy" babies born with unexplained
brain bleeds.

Yale CNMwifery Prof. Helen Varney says "Midwives...encourage...semisitting."

It's not just CNMwives. Dagny said that her direct entry midwife didn't let
her have the "extra" up to 30% - which accords with Midwifery Today editor
Jan Tritten promoting semsitting...

Midwives encouraging birth-canal-closing/semisitting is simply wrong.

[SandyofGreatExpectations]

On page 279 of "Great Expectations: Your All-in-One Resource for
Pregnancy & Childbirth (Sandy Jones & Marcie Jones, www.bn.com, search
"pregnancy") in our section on "Who Will Oversee Your Labor," we note
that in a 2002 survey sponsored by the Maternity Center Association
(www.maternitywise.org) found that out of 1,500 women who had recently
given birth, 19% were delivered by healthcare providers they hardly
knew or who were strangers. Most of these women were scheduled for
delivery with their chosen obstetricians, so if you choose an
obstetrician, it's important to ask about his, or her, backup plans.
The survey is worth reading, too, as are all the other very
informative, evidence-based articles on that site, including important
information about cesarean sections.

Sandy Jones

[Anne Rogers]

In the UK all births are attendended by midwives, with OB intervention as
necessary, which means no nurses on the delivery suite, personally even if
the midwife wasn't in continous attendence, I'd rather it be a midwife who
checked every so often than a specialist nurse.

As for pregnancy care, for a normal pregnancy, you only need what a midwife
can give you, if you have any medical issues or problems develop with the
pregnancy that's when you need an OB. In my opinion you a doctor is for when
things don't go right, not for when your body is just doing what a women's
body has got to do!

Even if you need intervention from an OB before delivery, that shouldn't
stop you having a midwife led birth, and it should be possible to have a
midwife even if OB intervention is needed at the time of delivery, as I was
induced I was technically under the care of which ever doc was on duty, but
that just meant they told the midwife what to do and then the midwife calls
for them if necessary, which wasn't.

The other thing I've found is midwives tend to have time to talk to you and
get to know you, so I'm finding it a bit tricky at the moment not being able
to talk to a midwife (they don't really exist here), back in England if I
had a problem I would call her and she would advise, which was great, you
can't do that quite so easily with an OB.

Cheers

Anne

[Anne Rogers]

In the UK all births are attendended by midwives, with OB intervention as
necessary, which means no nurses on the delivery suite, personally even if
the midwife wasn't in continous attendence, I'd rather it be a midwife who
checked every so often than a specialist nurse.

As for pregnancy care, for a normal pregnancy, you only need what a midwife
can give you, if you have any medical issues or problems develop with the
pregnancy that's when you need an OB. In my opinion you a doctor is for when
things don't go right, not for when your body is just doing what a women's
body has got to do!

Even if you need intervention from an OB before delivery, that shouldn't
stop you having a midwife led birth, and it should be possible to have a
midwife even if OB intervention is needed at the time of delivery, as I was
induced I was technically under the care of which ever doc was on duty, but
that just meant they told the midwife what to do and then the midwife calls
for them if necessary, which wasn't.

The other thing I've found is midwives tend to have time to talk to you and
get to know you, so I'm finding it a bit tricky at the moment not being able
to talk to a midwife (they don't really exist here), back in England if I
had a problem I would call her and she would advise, which was great, you
can't do that quite so easily with an OB.

Cheers

Anne

[Anne Rogers]

In the UK all births are attendended by midwives, with OB intervention as
necessary, which means no nurses on the delivery suite, personally even if
the midwife wasn't in continous attendence, I'd rather it be a midwife who
checked every so often than a specialist nurse.

As for pregnancy care, for a normal pregnancy, you only need what a midwife
can give you, if you have any medical issues or problems develop with the
pregnancy that's when you need an OB. In my opinion you a doctor is for when
things don't go right, not for when your body is just doing what a women's
body has got to do!

Even if you need intervention from an OB before delivery, that shouldn't
stop you having a midwife led birth, and it should be possible to have a
midwife even if OB intervention is needed at the time of delivery, as I was
induced I was technically under the care of which ever doc was on duty, but
that just meant they told the midwife what to do and then the midwife calls
for them if necessary, which wasn't.

The other thing I've found is midwives tend to have time to talk to you and
get to know you, so I'm finding it a bit tricky at the moment not being able
to talk to a midwife (they don't really exist here), back in England if I
had a problem I would call her and she would advise, which was great, you
can't do that quite so easily with an OB.

Cheers

Anne

[Anne Rogers]

In the UK all births are attendended by midwives, with OB intervention as
necessary, which means no nurses on the delivery suite, personally even if
the midwife wasn't in continous attendence, I'd rather it be a midwife who
checked every so often than a specialist nurse.

As for pregnancy care, for a normal pregnancy, you only need what a midwife
can give you, if you have any medical issues or problems develop with the
pregnancy that's when you need an OB. In my opinion you a doctor is for when
things don't go right, not for when your body is just doing what a women's
body has got to do!

Even if you need intervention from an OB before delivery, that shouldn't
stop you having a midwife led birth, and it should be possible to have a
midwife even if OB intervention is needed at the time of delivery, as I was
induced I was technically under the care of which ever doc was on duty, but
that just meant they told the midwife what to do and then the midwife calls
for them if necessary, which wasn't.

The other thing I've found is midwives tend to have time to talk to you and
get to know you, so I'm finding it a bit tricky at the moment not being able
to talk to a midwife (they don't really exist here), back in England if I
had a problem I would call her and she would advise, which was great, you
can't do that quite so easily with an OB.

Cheers

Anne

[Anne Rogers]

In the UK all births are attendended by midwives, with OB intervention as
necessary, which means no nurses on the delivery suite, personally even if
the midwife wasn't in continous attendence, I'd rather it be a midwife who
checked every so often than a specialist nurse.

As for pregnancy care, for a normal pregnancy, you only need what a midwife
can give you, if you have any medical issues or problems develop with the
pregnancy that's when you need an OB. In my opinion you a doctor is for when
things don't go right, not for when your body is just doing what a women's
body has got to do!

Even if you need intervention from an OB before delivery, that shouldn't
stop you having a midwife led birth, and it should be possible to have a
midwife even if OB intervention is needed at the time of delivery, as I was
induced I was technically under the care of which ever doc was on duty, but
that just meant they told the midwife what to do and then the midwife calls
for them if necessary, which wasn't.

The other thing I've found is midwives tend to have time to talk to you and
get to know you, so I'm finding it a bit tricky at the moment not being able
to talk to a midwife (they don't really exist here), back in England if I
had a problem I would call her and she would advise, which was great, you
can't do that quite so easily with an OB.

Cheers

Anne

[Anne Rogers]

In the UK all births are attendended by midwives, with OB intervention as
necessary, which means no nurses on the delivery suite, personally even if
the midwife wasn't in continous attendence, I'd rather it be a midwife who
checked every so often than a specialist nurse.

As for pregnancy care, for a normal pregnancy, you only need what a midwife
can give you, if you have any medical issues or problems develop with the
pregnancy that's when you need an OB. In my opinion you a doctor is for when
things don't go right, not for when your body is just doing what a women's
body has got to do!

Even if you need intervention from an OB before delivery, that shouldn't
stop you having a midwife led birth, and it should be possible to have a
midwife even if OB intervention is needed at the time of delivery, as I was
induced I was technically under the care of which ever doc was on duty, but
that just meant they told the midwife what to do and then the midwife calls
for them if necessary, which wasn't.

The other thing I've found is midwives tend to have time to talk to you and
get to know you, so I'm finding it a bit tricky at the moment not being able
to talk to a midwife (they don't really exist here), back in England if I
had a problem I would call her and she would advise, which was great, you
can't do that quite so easily with an OB.

Cheers

Anne

[Anne Rogers]

In the UK all births are attendended by midwives, with OB intervention as
necessary, which means no nurses on the delivery suite, personally even if
the midwife wasn't in continous attendence, I'd rather it be a midwife who
checked every so often than a specialist nurse.

As for pregnancy care, for a normal pregnancy, you only need what a midwife
can give you, if you have any medical issues or problems develop with the
pregnancy that's when you need an OB. In my opinion you a doctor is for when
things don't go right, not for when your body is just doing what a women's
body has got to do!

Even if you need intervention from an OB before delivery, that shouldn't
stop you having a midwife led birth, and it should be possible to have a
midwife even if OB intervention is needed at the time of delivery, as I was
induced I was technically under the care of which ever doc was on duty, but
that just meant they told the midwife what to do and then the midwife calls
for them if necessary, which wasn't.

The other thing I've found is midwives tend to have time to talk to you and
get to know you, so I'm finding it a bit tricky at the moment not being able
to talk to a midwife (they don't really exist here), back in England if I
had a problem I would call her and she would advise, which was great, you
can't do that quite so easily with an OB.

Cheers

Anne