Breaking up with your OB: "It's not you, it's me..."

saenastarsley

*I'm reposting this from May 2012 Moms' board to try to get some more feedback. Thanks.

Lately as I'm daydreaming about labor and delivery, I keep picturing it in our house, with just me and FI and not a million people. I originally planned to go naturally in a hospital over a home-birth because the closest one is 30 minutes away, but a hospital birth is becoming less and less appealing to me. I am low-risk and, of course, if anything changes closer to delivery I'd go to a hospital, but it's really not my first choice.

Has anyone started out with an OB then switched to the midwife and home-birth route? Was it a PITA insurance-wise? How did you break up with your OB? I do love my OB but get nauseated and depressed whenever I think about giving birth in a hospital.

cros8380

I can half answer you! I switched from OB to MW at 24-25 weeks. I did not like my OB (he was not NB friendly), so I just left the practice. Sometimes I wish I had told him I was leaving, and why. But I still delivered at the local hospital.

I have United Healthcare and switching was not as hairy as I thought it would be, and did not cost us any extra. I did have a sit down meeting with the billing manager at MW office, just so she could thoroughly explain to me what the process would be. But that is my personality, I like to know all the details BEFOREhand!

pepomntpat

I didn't do a home birth, but I did switch to a MW at 28 weeks.  I called the insurance company first. They didn't care at all. They also didn't care when I ended up with a c/s and yet another provider. It was never an issue.

ETA: Also, my insurance company said they would cover home birth had I chosen it provided I used a licensed provider.  

My doctor's office did ask why I was switching. I just said I was looking for an out of hospital birth. I did like my OB, but it just wasn't a good fit. Of course it didn't work out anyway...but that is neither here nor there. 

elektra1835

I'm only on baby #1, but I just recently switched from an OB to a midwife (had my first appointment at 26w). I am not planning a home birth and our insurance wouldn't even cover it. We are going to be having this baby in the birthing center which is ideal for me. Insurance wasn't too difficult to deal with. They pretty much just told me not to go to my next appointment and to just make an appointment with the midwife. The birthing center actually handled calling the insurance company and getting a referral from them, so although I was initially stressed about it, I really didn't have to be. I liked my OB, but I didn't really feel a "connection" w/ her and wasn't really sure of her views on natural birth. During the first 6mos of the pregnancy, I had only seen her twice, so I didn't feel too bad about leaving. I would have liked to talk to her about it, but I didn't even see her at my last appointment. Anyway, I feel so much better after making the big switch. I think if you can talk to your doctor about it, that would be nice, but you shouldn't feel obligated. I figure they're so busy anyway, most might not even notice. GL.

pinksweetpea2

I switched to a homebirth MW from a hospital based practice at 25 weeks with my first.  I didn't inform them ahead of time because I really didn't care what they had to say about it- I obviously had a less than stellar opinion of the practice though.  

I informed the receiptionist over the phone that I was canceling my next atp. and switching care providers.  She told me how to get my records and that was it.

Homebirths are not covered by insurance in MA (at least with HMOs), so I didn't really have to do anything for that (other than pay out of pocket).  I did give the insurance company a call to verify there was no way they would cover it, but that is about it.    

Even if you have to fight to get coverage, that should never be a reason to not have a homebirth IMO. 

 

flyer23

I switched from a hospital-based midwife practice to a homebirth midwife at 36 weeks.

Insurance was a bit of a pain because I switched so late. I had to pay upfront and then file for reimbursement. And my insurance company was a bit of a pain about reimbursement, so it required about 6 months and a LOT of follow-up on my part to get all the money I was entitled to.

As for breaking up with my previous midwives, I sent over a request to get my records transferred to my new midwife. One of my old midwives called to ask why I was switching, and I explained that they had been great (because they really were!) but I just felt that homebirth was the right choice for me. She was very nice about it and said that she just wanted to make sure that there were no issues causing me to switch. Which there weren't. For that reason, I still adore that midwife practice and recommend it to anyone in my area who wants a NB-friendly hospital birth experience -- but I'm VERY glad that I made the switch to homebirth.

mstroud23

I love my OB too! I decided to switch before getting ku, so no idea about the insurance thing. But, my OB was very supportive of my home birth choice and recommended I check out a few MW groups in the neighboring county (I live fairly close to the county line).  Breaking up is easy when your OB doesn't feel like they have anything to prove, and they have your best interest in mind. I just told her that it is what I want and she said that if I ended up delivering in the hospital for any reason she would be there-but the MWs in the neighboring county are very good and have wonderful track records. 

Start by talking to your OB. See how your OB takes it-they might be open to it and/or help you make the switch. 

Mamasaurus

I did the switch, and my OB was very chill about it. I made sure to tell him that I wanted to come back to him for my annuals after having the baby, but I just didn't like the idea of playing "on call doctor lottery" birthing in a hospital and possibly having a bunch of strangers arguing with me while I labor. I feel ok because I didn't put him down at all or get negative about his practice, and it's more like "taking a break" than "breaking up," really.

My MW has a biller who handles the insurance stuff, so I got lucky! All I did was make an initial call to my PPO to make sure there weren't any hidden charges associated with home birth or midwife care. Ask your MW if she has a printout that explains her billing process if you need to call your insurance for your details so that you have something to reference when speaking with them.

cecilyandgautam

I switched midway through and the conversation was pretty easy. I genuinely liked the practice and I wanted to use a birth center and they only delivered in 1 hospital, and it wasn't even the closest one to my house so they understood. Insurance wise, there were a few birth centers & midwife practices in my area that were covered but the closest one had a long waitlist so that was kind of a pain but I got off it (yay!) and now I'm all set. I found that CNMs were generally covered and CPMs generally were not.

JustSomeChick

I am planning to deliver in a birth center with my midwife. I switched from my OB to my MW at 30 weeks. The insurance wasn't even an issue for me, my MW handled the entire thing. She's great.

As far as how I broke up with my OB... I didn't. I know it seems rude, but I am not very confrontational. I didn't say anything to her,