I was just wondering: When you've contracted a midwife to be your primary provider, does anyone also shadow their care with OB pre-natal appointments? If you've done this, was it helpful? And if not, what made you decide not to?
I had only my midiwfe, If i didn't trust my midwife to do al of my appts i wouldn't have hired her in teh first place. She does all of my appts in my own home and does everything like check my urine, bp, fetal heart rate, fundal height and well she just asks me my weight. She spends about an hour with me and we'll talk about daily things and she'll give me nutritional counceling. She'll aso preapre me for things things and discuss way to repare for birth and all that. Amazing. My midwife has done far more than my Ob with my first ever did, I would wai an hour to get seen and see tehm maybe 5-10 minutes and Im sure they didn't rememeber my name, only by chart. If you're in the US some state law say you need a back-up OB for CPMs-LM but mine doesn't.
Some states (including mine) do require a back up OB---for CPM's and CNM's (CNM is considered an Advanced Practice Nurse and TX Nursing Standards require that all APN's have a back-up doctor, not just MW). However, I never saw him. I saw only my MW for the entire Pregnancy. I guess, depending on the feelings/practices of the OB and the practice agreement between him & the MW, it may be necessary to see the OB either routinely or if certain problems/situations develop.
I shadowed with an OB/CNM practice for the first 20 weeks for two main reasons: I wanted to be sure that I was having a normal, low-risk pregnancy before I opted-out of hospital based care (ie. that I was a good candidate for home birth), and I wanted to meet the people that I would see in the hospital if I ended up needing to transfer from my home birth. It was very educational to be under the care of my homebirth midwife (LDM) and a practice with 4 CNMs and 4 OBs. My care with the LDM has been vastly superior to the hospital-based care. Like Jillian says, my midwife spends longer with me, gives me ongoing nutritional counseling, provides true informed consent on all decisions, and has made me an active participant in my care (rather than just being the patient). The contrasts with the care from my OBs was amazing.
I started out with an Ob, then hired a midwife halfway through. I wanted to stop going but I needed my lab work done and my insurance only covered it ta the hospital. I had to pay out of pocket for the OB. I guess if I didn't have to go because of that I wouldn't have. I loved my midwife and felt very good about her care. Its really up to you. It is nice to make sure you are in the low risk category. I wanted to have an ultrasound done as well. I think its totally a personal assistance.
My midwife was also a RN, so she could order an ultrasound or anything else that came up. I didn't see anyone else and feel I got better prenatal care than my friends and clients who saw OBs (I teach pre/postnatal mind body fitness)
If you have an experienced midwife bringing in more opinions can stress you out if there are conflicting opinions on your care.
When she ordered an ultrasound for you or any other tests, did you have to pay for those out of pocket or were they covered by insurance? I'm just wondering how that works when a midwife orders tests and if the insurance company still covers it under pre-natal care since it's not with a doctor.
I saw only a MW for my entire pregnancy (two of them actually). She was able to order all tests, labs, and (although I never needed it) could have also prescribed me medicine. Since I wasn't having any problems it was never necessary for me to see an OB. Although she did have a Back Up OB (as required by state law) that she would have transferred me to if necessary. He was a wonderful dr that supports, VBAC, HBAC, and will, under most circumstances, vaginally deliver a breech baby. So, I felt very fortunate knowing that if I did have to see an OB it was going to be him.
I did all of my prenatal care with my midwife. She did blood tests right in her home office and could have sent me for an ultrasound if I had wanted one. I didn't want any pressure to get checked internally (which my midwife never did until I was in labor at my request), or have any ultrasounds, or an other unnecessary medical testing. That was my main reason I did not see an OB along with the midwife. I think it's more of a personal preference.