Initial Decisions in Maternity Care

4

November 28, 2011 by Leah

I haven’t been writing much lately. The overwhelming themes of the past three months have been my pregnancy, my job, and the whole home-buying process. Well, we’re in the house. It’s unprofessional to blog about one’s employment situation, no matter what the provocation. And Baby Bailey is now public (I’m 14 weeks along – second trimester, woohoo!). So, I guess I’ll be writing about baby stuff for a while.

After the initial shock of finding out I was pregnant wore off, I decided the most important thing to do would be to find a maternity care provider. (A note on that shock: This baby was completely planned, thanks to things like education and access to birth control for which I’m very thankful, but it was still shocking to find out I was pregnant. I was like, “Now what?” and then after about a week of being all freaked out, I realized that the answer is, “We wait.”)

I’ve been a homebirth wannabe for years, having been introduced to the idea that birth experiences are important to women and society by “The Business of Being Born,” and then having done a lot of further reading. I also have an innate mistrust of doctors, hospitals, and the conventional medical model. Let me clarify: I like having a father-in-law who is an internist. He gives excellent advice when I do things like leave my thyroid drugs at home over Thanksgiving. I liked doctors when they removed my ruptured appendix and my skull tumor. I didn’t like them when they prescribed psychiatric drugs to my still-developing adolescent brain. I haven’t had good times in hospitals. I’ve seen nurse practitioners for primary and specialty care for years, and have found that I tend to get a lot more time and genuine care from such providers.

All told, I had no desire to call an OB/GYN clinic full of surgeons for the completely normal condition that is pregnancy. First, I scheduled a consult with a naturopathic doctor who is also a homebirth midwife, who practices in a larger city about an hour away. The meeting was edifying, but I didn’t walk away feeling all happy-gooey about this particular care provider. She was a little intense for me. She was also an out-of-network provider, which means our insurance wouldn’t cover a cent of my care with her (let alone the expense of driving back and forth to the Tri-Cities every few weeks). Plus, she didn’t “do” known twins or breeches, which kind of irritated me.

There are two other certified midwives in the Tri-Cities, but after testing out the drive once, I wasn’t enthused about commuting for prenatal care. My next step was to schedule a consult with a CNM (Certified Nurse Midwife) who works in a practice that includes two CNMs, three OB/GYNS, and various assistants. Big bonuses include: the practice and affiliated hospital are within walking distance from my house and completely covered by our insurance. Biggest bonus of all: I really, really like this CNM.

I met her when she’d been up all night and she still exuded calm, which is very good for me. She also told me to stop reading so darn much and instead to direct my attention inward, to listen to my body and follow my instincts. (Apparently Aaron and I fit a profile which sometimes alarms birth professionals. Namely, we’re over 30, have a lot of education, and have or have had careers, which leads people to assume we are used to things being perfect and going as planned. Luckily, we don’t actually expect things to be perfect and go as planned.) I’ve followed this advice, except for a few random Googles, and have been much calmer for it. (I’ve also been mostly staying off those insipid pregnancy websites and message boards and have instead been directing my obsessive tendencies to researching cosleeping, breastfeeding, and chemicals in crib mattresses.) By the end of this initial conversation the CNM with my only question was, “Where do I sign up?”

So, I had my care provider. I assumed I’d deliver at the hospital with which this women’s health practice is affiliated, but according to all the initial paperwork I filled out, I had a choice. (Yes, Walla Walla has two hospitals!) I chose Walla Walla General over Providence St. Mary’s based on 2009 c-section data (24.9% vs. 29.5%). Plus, I’d heard anecdotally that St. Mary’s “likes to cut.” Try getting that out of your head.

I thought a lot about these decisions in the first weeks after making them, but my reasoning seemed sound every time I looked at it. $2500 out-of-pocket and hours on the road vs. $100 out of pocket (I know, I know, we are incredibly lucky) and a hospital and provider within walking distance. And, since we are so lucky as to be spending next-to-nothing on prenatal care and birth, I don’t feel bad about spending a little extra on prenatal exercise videos and equipment, a membership at the Y, high-quality food, and, I hope, a doula – if one can be found in Walla Walla.

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4 thoughts on “Initial Decisions in Maternity Care

  1. Kim_F says:

    I don’t really have anything constructive to say since you’ve covered it all (and, I work REALLY hard on not being THAT know-it-all friend when it comes to pregnancy & childbirth.)

    Mostly I’m just. SO. EXCITED.FOR.YOU! I am shocked, given what I know about Walla Walla, that there aren’t any homebirth midwives there. BUT– I’m really happy to hear you’ve found a CNM– and I’m very excited to hear you’ve got two hospital options!

    Oh, I lied. One tip re: doulas… if you consider getting one who is still working on her hours for certification, you can get one for a lot cheaper! (Frequently, even free.) Yes, it means they have less experience… but if you like each other during the interview, why not?

    • Yeah, it’s interesting that there aren’t homebirth midwives here. All the Tri-Cities midwives do deliver here, for a distance fee, but when the one I talked to talked about transporting me to Kennewick to work with a doctor she liked if something went wrong DURING labor, I was like, “heck, no.” I hate commuting on principle, and I’m not coming from a place of reacting to a bad hospital birth experience as a lot of people are – instead I’m working on stacking the odds in my favor so I don’t have a bad hospital birth. And, I’m seriously planning to walk to the hospital when I have to go. One thing that’s kind of bothering me is that there are no Bradley or Hypnobabies classes within a several-hour radius of Walla2, but I know the latter at least has a self-study program, if I decide to go that route.

  2. lahancock says:

    Kim, you may never see this comment, but I try hard not to be that person too. LOL. It is very, very hard sometimes. It makes me happy though that Leah is being very proactive in her journey instead of relying on, well, Doc/midwife knows best.

  3. Annelise says:

    I came across this site looking to see if theere were any other Doulas in Walla Walla that i could connect with… and it appears I am the only one. If you would like I would be happy to help you find tthe information you need.

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