Using a private midwife

[min]

Hello mums and mums2B!

I've been pondering the issue of "birth personnel" and birth location for a few months now. (And I must say, the info and advice on the threads here have been very helpful!) After going over the pros and cons of it all, I think my preferred option would be to have a private midwife who'll come with me into the maternity centre of my local private hospital. But I have no idea if this scenario is even possible! Would the hospital allow it? And is it horrifically expensive to have a private midwife as your "primary caregiver" during pregnancy and birth??

I'd be most grateful for any advice!

(My second favourite option would be our local birthing centre, attached to a public hospital - but the waiting list is so long it's very, very hard to get in :( )

Min

[JanetF]

Congratulations on choosing the midwifery model for your pregnancy and birth. It is by far the safest and best for mamas and babies as shown by countless studies internationally.

You can engage a private midwife as your primary carer and then birth pretty much where ever you wish. However, some things to consider are that hospitals are opposed to giving midwives visiting rights so your MW would only be an advisor, like a doula, to you in birth. In a private hospital it could be even more opposed because the medical model of managing labour and birth is so entrenched there which is why they have such poor outcomes for mothers and babies and outrageous rates of unnecessary caesareans.

To really achieve the safest possible birth, you should engage your private midwife plus a back up midwife and birth at home. The World Health Organisation says that home is the safest and best place for most women to birth and the statistical outcomes across the world, and in Australia, clearly show this to be true. It would also be cheaper for you than birthing in a private hospital.

Midwives' charges vary greatly from place to place and some health funds will cover all or part of their care. It is important to remember however that you cannot put a price a birth that empowers the mama and brings the babe safely earthside. PND and PTSD are almost unknown in home births, breastfeeding is well supported with MWs often lactation consultants as well. And what you get for your dollar, apart from the well evidenced superiority of midwifery care over obstetric models, is totally different from any other care. Generally, your monthly appts are no shorter than an hour, and mostly longer as you chat and get to know one another plus she is available 24/7 by phone to you. You have a birth plan meeting at your home for several hours at around 36 weeks. Your MW comes to your home when you need her during labour and stays with you until your babe is born, or goes with you if you choose to transfer to hospital. Most importantly, you are at all times in control of what happens. Midwives practice evidence based care and are happy to offer you lots of information so you are able to make the best decisions for you. She also visits you up to 5 times, sometimes more often, at home after the birth and often stays an important part of your life forever. Many women employ the same midwife for each baby as they are intimately connected with their family. The same care is not possible with a surgeon - that's what OBs really are. They are supposed to specialise in complicated births not care for women through perfectly healthy pregnancies and births. In countries where midwifery care is the norm, such as NZ or the Netherlands, the health of women and babies is significantly better than in Australia and the health budget significantly less strained.

Now just to give you a quick glimpse of how superior the care is from private midwives, listen to this. In 2003 according the goverment collected perinatal data, the women in Victoria's hospitals/BCs who gave birth over an intact perineum was 8%. Of women who birthed at home, with midwives in attendance, 98.7% birthed over an intact perineum. Who are you going to trust your precious peri to? ;)

To make contact with other home birthing mamas, or mamas investigating midwives, got to http://www.joyousbirth.info/forums It's Australia's home birth network and you can access your local home birth group from there and get about making a really informed decision!

I look forward to reading a beautiful birth story from you some time in the future :D Feel free to PM me for some of those studies or any more info!

[cosmic]

Wow, Janet! That is great information!! I booked into my local birth centre last night, and during the tour/info session, my DH and I changed our mind about seeing a private obstetrician and birthing in the birth centre and chose to have all our care handled by the mid-wives instead.

I feel very reassured that my decision was a good one after reading your post, so thanks!

[JanetF]

You're so welcome! PM me for more info :D

[AM]

Janet, you've said it all... as usual! ;)

I would also like to sing the praises of using a private midwife, even though my homebirth ended up at hospital at the 11th hour, I know my hospital experience - as brief as it was - would not have been as easy for me as it was without my lovely midwife advocating strongly for my well thought out choices to be completely respected, every step of the way.

I'm pregnant again, and am lucky enough to be able to have the same midwife this time around, something which means a lot to me, as pregnancy and birth are very important experiences to me, and I am grateful to be able to share them with the one caregiver who knows me and my family really well.

Best of luck with your decision.
As for price, it does vary, but I paid $2000 last time, so probably about the same this time, or a little more I think.
Mind you, that is for all pre natal care, labour and birth (obviously!) and care up to 6 weeks later, and throughout the whole period, I had my midwifes mobile, and she was completely available to me any time.

You can claim the expense back on tax, but it is only a portion, but every bit helps, right?

Angie

[min]

A big thanks to you both, Janet and Angie - the info and encouragement are very welcome!

I called my health fund at lunchtime and discovered that they'll give me a rebate for each consultation (antenatal and postnatal) with a midwife. The rebate is only $16, but it's better than nothing! So I think I'll just save up to cover the rest of the cost.

Now I just need to find an independent midwife in Canberra - I don't suppose anyone knows of one?? Otherwise, I'll get in contact with one of the representative bodies (I think there's an Association of Independent Midwives) and ask them for some names and numbers.

And now that I'm getting organised, I'd better actually fall pregnant again!! Three weeks 'til next ovulation - can't wait!

Min

[JanetF]

There's no doubt a link in the bubhub services directory for ACT. Joyous Birth is in the links there too.

Hi Angie :)

[wattle]

OK wise women, I have a few more questions....

I have decided to birth at the Monash Birthing Centre, it seems lovely there. As I'm only 7 weeks pregnant I haven't met the m/w's there yet, but have spoken to a few on the phone who are lovely.

I am still unsure whether to have my own private m/w or doula. The birthing centre does not allow a private m/w to do any medical procedures, so they would effectively be the same as a doula, would that be right?

So would it cost less to have a doula? (I know money shouldn't come into it, but it's good to know as much as possible) If medically there was no difference there doesn't seem that there would be a benefit in employing a private m/w. Perhaps in the aftercare? The birthing centre has very good aftercare, so this would really be of little concern.

Perhaps I should wait and meet the m/w's at the birthing centre and then re-evaluate? (as you can tell I'm in the dark a bit)

I guess my biggest concern is that last time I had such a wonderful m/w, but her shift ended just as I was about to go into transition, and I ended up with a complete and utter dud. She was terrible. I was NOT impressed at all. I really want to try and avoid that scenario happening again.

Comments please.....
Thanks girls.:)

[JanetF]

You can get your prenatal care done by a private MW who accompanies you in the role of support person. This would give you greater continuity of care although not as much evidence based care as using the midwife to birth at home. The BC still has a 42 week cut off after which time you're turfed out and pressured to induce. Best avoided! I know someone who took a MW to Monash and was happy although she also consented to an induction purely on dates which wouldn't be my choice. If you only want your own MW for continuity of care in birth why not employ a doula? Taking a MW somewhere where she can't actually practice her skills seems a waste to me, yk? You can have more than one doula/supporter too, that's up to you, but I really really really recommend that you have at least someone with you who's clued in about hospies and won't leave you when the shift ends. Shocking system that! At least having a private MW for prenatals gives you brilliant, relaxed care in your home or her office which is usually much more personal than the hospy and the appts are at least an hour each month. Why not ring a few and just chat to them? They're happy to chat! As are doulas!
:)

[meglet]

I'm reading Sheila Kitzingers Birth Your Way atm, it answers a lot of these questions (as JanetF did). The book is about birth at home or in a birth centre and will definitely put your mind at rest with ANY worries. You will KNOW you're doing the best thing;)

[Rikred]

I had a private midwife of sorts... and it was fantastic! We birthed in NZ where such a thing is fully funded by the govt so there were no costs involved at all. We used a birthing centre (which was a close to a home birth as you can get!) and had a fantastically positive pregnancy and birthing experience with no intrusive testing, no internal exams (except one at the 11th hour to see how bubs was progressing), the pace was set by us, and we got to snuggle up in bed as a family for a couple of hours before letting the paediatrician get his mitts on her for the obligatory weighing, measuring and testing.

If the chance arises again, I'll do a proper home birth, since I don't know of any centres in Oz who offer that sort of service. We also escaped with little more than a few grazes (no tearing, no stitches) and excellent hands on advice with BF and bathing/caring for newborn etc. I do know that they only take mums2Be who are healthy and not in any of the risk categories for difficult births, and they have a good emergency plan in place should anything go wrong.

I think this is what saved our girl from having to go into an incubator as she was under the 'allowable' weight for hospitals (was only 2.4kg), but because she was born into a nice warm bath, and was able to stay there with me while she warmed up, she ended up being able to stay with us instead of dashing off to hospital.

Now - for any new Mums I talk to - I thoroughly recommend getting a like minded midwife and telling the over zealous doctors to go jump! LOL