So I got a letter in the mail today. My OB-GYN practice is getting rid of all their midwives, effective two weeks from now. They are moving all their current midwives’ patients to the practice’s owner, a male OB-GYN.

Argh! Not good. :-( I am over 30 weeks along and to be honest, the last thing I want to do is change doctors again. I moved to this practice when I was 16 weeks along for two reasons – 1) the other doctor and hospital were far away from my current place of living, and 2) I didn’t care for some of the things she said (like criticizing my choice to stay home full-time after the baby). I really liked the midwife I had been seeing, and was looking forward to finishing this pregnancy with her.

So a few other complications. My current practice takes my insurance but is not considered “in-network” which means insurance only covers 70% of the cost. I was just telling Paul earlier today that despite the increase cost, I was glad that I had switched because I liked my midwife so well. I also like this hospital a lot, which fortunately is also in-network. However, I wonder if this is the time to look into finding a doctor who is in-network since I have to change anyway.

I probably need to make a decision really soon. Here are my options as I see them:
1) Stay with the current practice and the same hospital. The pros: They have all my records; the transition would be the easiest; I’d be able to deliver at the hospital I like. The cons: They’re out-of-network; the doctor is a male (which I’d really rather not have); I anticipate long waits at the office as they go from 3 practitioners to 1.
2) Move back to my original doctor at a different hospital. The pros: While she isn’t my top choice she would be okay; she’s in-network. The cons: I’d prefer not to deliver at the other hospital; I’m not sure the doctor and I are in-sync and the last thing I want is to be dealing with that while in labor; that practice was really busy and I often waited 45 minutes to an hour at my appointments.
3) Move to a midwife my friend recommends who is also at the same hospital. The pros: High recommendation; she would be more in-sync with what I am wanting; the practice is in the same place as my current one and the hospital would be the same. The cons: She is also out-of-network so I’d be paying 30% (as opposed to 10% of the cost).
4) Find an in-network doctor affiliated with the same hospital. The pros: I’d pay less and would still be able to stay at the same hospital. The cons: I don’t like the thought of moving to a randomly selected doctor this late in the game (with less than 10 weeks until my due date); if I dislike the doc I really don’t have time to find a new one.

I’m trying really hard not to freak out; my pregnancy hormones have been especially out of whack today as I have burst into tears at least three different times.

16 thoughts on “yuckity-yuck

  1. I think you should go Gilmore Girls on this and write your pro/con lists on paper so you can see them all together. (Just re-watched the one where Rory decides on Yale over Harvard…) :)

    But seriously, it sounds like your heart is in number three. The other ones would all work; I don’t think there’s a truly bad decision in the mix, but if you can swing the midwife financially, I think your spirit will be so much more at peace.

    If you want my special decision-making secret, email me and I’ll let you in on it. It sounds too silly to post for the world to see. :)

  2. that really stinks!!! but my two cents is find a new Midwife that is in network at the hospital you want. The reason I say this is because no matter how much you like the dr you see, there is a bigger chance you’d end up with a different doctor come delivery time anyway. More than likely you’d end up with whatever dr is on call at the time.

    If you find a midwife, more than likely she will feel the way you feel about delivery, more midwives have more open minds than most doctors.

    So to me it would make the most sense to find a doctor in network to save the money, but that delivers at the hospital, cuz really, hospital is more important than doctor. you only deal with the doctor for an hour or so during delivery, and a few check ups. The hospital you have to deal with for 1-3 days.

  3. If the doctor knew what he was doing, he would have said “the midwives aren’t accepting any new patients” and then phased them out gradually. I can’t believe you just lost your primary care professional this late in the game. Wow. I don’t know what I’d do.

    Have you checked to make sure there are no certified nurse-midwives that are in-network for you? I did a little research and found a few my insurance would pay for. (For future reference. Not for Now. I am not in need of a midwife for the foreseeable future) If no luck there, I’d probably go with choice #3, Midwives are less expensive than doctors, generally, so it may even balance out.

  4. Maria: Hehe Yeah you see my mini pro/con list here? ;-) I always have to list my options before I can make my decision or else I feel like I didn’t make a properly thought-out decision. By the way, that episode is one of my favorites.

    Jes: That’s why I want to go with a midwife. I don’t believe there are any midwives that are in-network with my insurance, but I am going to go through the list and see.

  5. BIG YUCK! I hope you’ll be able to find a provider that works for you. I vote for the place with the hospital you like best.

    The nurses are a huge part of your experience. Your L&D nurse will be the one with you for most of it. My midwife was there to check on me from time to time and when I was pushing, but that’s about it.

    If one hospital has great features (private rooms, showers you can sit in/jacuzzi tubs in the room, beds that change position for birthing) that might be worth it.

  6. The biggest reason I want to stay with this hospital is that it is the only one in Atlanta that allows water births. IF I decide to go naturally, I’d really like a water birth. (And if not, I’d love to labor in the water if I can.) Other reasons are that it has a low c-section rate and it is convenient for us to get to from our current apartment (if we buy the house, it will be far, but that’s still an if). Also, it’s on the bus line so if I should have an emergency while Paul’s at work, he can get to me easier. (Since we only have the one car.) I think otherwise the two hospitals are the same.

    I’m checking with all the in-network doctors who deliver at this hospital (4 total) to see if they have midwives at their practice.

  7. Personally, I’d go with option #3 if I were you. I wouldn’t want to start from scratch at 30 weeks. She’s a midwife, and she comes highly recommended from a friend (who I assume you grilled all kinds of questions at). And you get to keep your hospital, and from what you said in the comments, that sounds like a huge plus. You’ll still be paying the same amount you were before, so it’s not really a con so much as a lack of a pro. :-P It’s neutral.

    So sorry this had to happen… so frustrating. Did you ever get a hold of your midwife via facebook and ask if you could still use her? :)

  8. Yeah Paul’s point that option #1 and option #3 were basically the same, and option #2 was the least favorable. I’m really leaning towards option #3 right now. Or, a 5th option that I didn’t mention was try to follow one of the midwives I’ve been working with to her new practice, wherever she goes. I’m trying to figure out how to draft the email to ask her because I’m sure she won’t be able to talk very in-depth about the situation.

  9. You have another option not on the list….get a midwife that does home births!! :-) It’s one of the best experiences ever!!

  10. Based on the information you’ve given, it sounds like option #3 is the best. You were already looking at paying 30% of your costs with your current, soon-to-expire setup, so your costs aren’t changing if you use your friend’s midwife. In-network would be ideal, but sometimes it’s worth it to pay extra to get exactly what you want/need.

  11. Wow. I’m behind. So glad I tripped over you on Twitter. ‘Cause I’m excited about your baby (if not your unfortunate situation) and glad I at least got filled in before baby’s born.

    Have you announced name(s)?

    I suggest do what you can to get your water birth. That made such a difference for everyone I know (including me). I did all my births at the local birth center (despite encouragement– and even J– wanting to do it at home. For me, birth wasn’t this big “spiritual” event I wanted to happen in the midst of my “sacred space” (or even personal space). Birth was just a necessary (evil?) step for getting a baby, and I liked very much the idea of being in a separate place that I could physically leave behind when I was “ready” to resume life.

    Or my new life, or whatever.

    It still makes sense to me, J still doesn’t get it, but he was willing (like a good husband) to let the one doing all the work make the call ;o).

    I’m very excited for you and your new chapter.

    And, do you close comments to preclude spam, or what?

  12. Amy Jane: No names yet. You can see our current list here.

    I have been having a lot of trouble with spam these days – in the past few days I’ve gotten 3500 spam comments. It’s still up for debate about whether closing comments on old posts is helping or not.

  13. Ha- I’m one of those spam comments- I left a comment on the Michael Jackson post with a link in it, and it never showed up. The spam filter ate it!

  14. No, your comment didn’t get caught in the spam blocker. I actually put it on moderation while I tried to figure out how to respond

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