Starting to have doubts about birth center

Mrs.A&J · August 2012

After googling our birth center, I'm feeling a little unsure about them. They have a 2.5 star out of 5 star rating, the negatives primarily being related to how hesitant they have been to transfer care in high risk birth situations. And they have been investigated for allowing a woman with a breech baby to labor there for quite a while before finally transferring (Oregon does not allow birth centers to deliver breech or multiples). I actually had a dream about a week ago about getting into with them regarding finances. I started to wonder after we paid our $300 deposit, then received an EOB from our insurance showing they had been billed only $250 to insurance. ?? Thoughts?

blueeyedgirl27 · August 2012

I'm confused as to why you had to pay the birth center a deposit if your insurance covers services there. Did the birth center give you any kind of client packet that also includes a list of all their fees? Perhaps there's an explanation of what the deposit is for. My birth center gave me a complete list of their fees, and my insurance covers it 100% after deductible (which DH's employer pays for anyway). My MW also made me sign a contract stating that complications may arise and if need be I'd be transferred to the hospital they're affiliated with. It'd concern me greatly if past clients commented about a birth center's lack of due vigilance over identifying transfer-worthy situations. Personally if I'd found this out about my center, I'd contact the center and address these concerns. That way you can make an informed decision about whether you feel comfortable continuing your care there. GL!

Mrs.A&J · August 2012

They basically have billed us for what insurance will not cover and require we pay $300 of it as a deposit, the rest due at 36 weeks. I did not feel they were very up front about their fees. I'm concerned that if we end up overpaying (because they are assuming we will pay our full deductible plus the 20% after insurance), that they will keep the overpayment. I'm sure that by late February we will have met at least a portion of our deductible, so insurance will end up paying for more of the birth expense than they are calculating.

blueeyedgirl27 · August 2012

Okay that makes sense, as even hospital births/prenatal care are billed to the insurance companies as lump sums and anything not covered under insurance usually has to be paid in full before delivery. However, as their client you have a right to their schedule of fees so that you know exactly what you're responsible for after insurance coverage (and hence, avoiding being ripped off). I recommend requesting their fee schedule for your records.

wannabigfam · August 2012

My thought is that a mom needs to be able to 100% trust her care provider. Imagine the WORST case scenario during pregnancy or child birth. You want to be able to listen to their advice and TRUST that they know what they are doing - that they have your (and your baby's) best interest in mind. You don't want to be in a crisis or emergency situation and in the back of your mind second-guess their intentions or their ability to make the right decision. I'm not an overly dramatic person, but honestly, it could be the life of yourself or your baby, you know? (and I'm ALL about birth centers, natural birth, home birth, etc - but only with trusted providers).

If you are having questions about this birth center or struggling to trust them, you need to either have those questions answered by the proper people at the birth center or you need to find a physician somewhere else that you DO trust.

Personal story - I really didn't want to have a hospital birth, but I didn't click with the midwives at the local birth center. I felt like 2 of the 4 didn't have enough experience, one of the other four I didn't feel comfortable with personality wise, and then the forth I liked but was nervous enough about the other 3 that I didn't feel comfortable w/ the "what if the one I like isn't available when I go into labor" scenario. Also, in the end, I was only comfortable with delivering with a nurse midwife rather than a direct entry midwife. I had to weigh my fears of interventions in a hospital vs. not completely trusting the midwives at the birth center. I decided to go w/ the hospital birth - I'll labor at home as long as possible (like I did with my first) and then head to the hospital. I just couldn't let those fears about the birth center go. Also, I didn't like the fact (financially) that we would have to pay out of pocket for the birth center (our insurance pays for birth centers, but only if a nurse midwife is the provider, not a direct entry midwife). On top of that, if we transferred during birth (or even during pregnancy) to the hospital or another OBGYN office, we would be on the hook for 100% of the birth center fees PLUS our entire co-pay/deductible/out of pocket max. for insurance. This would add up to $6000 for us which was way too expensive.

Mrs.A&J · August 2012

Well, it's been decided. After further digging, I discovered the midwife owner just had her license suspended for a year. She was not my midwife, however, her and one of the midwives assigned to me have the poorest ratings of all Oregon midwives on oregonmidwifeinfo.com, with concerning numbers of lawsuits and infant deaths.

I will definitely be switching. My mom says I should demand the deposit back because they failed to disclose that the owner had lost her license. Do you think I have a leg to stand on there? I was just going to ask them to prorate based on the two appointments we've had so I can get the heck out of there.

oliversmommy32912 · August 2012

Mrs.A&J:
Well, it's been decided. After further digging, I discovered the midwife owner just had her license suspended for a year. She was not my midwife, however, her and one of the midwives assigned to me have the poorest ratings of all Oregon midwives on oregonmidwifeinfo.com, with concerning numbers of lawsuits and infant deaths. I will definitely be switching. My mom says I should demand the deposit back because they failed to disclose that the owner had lost her license. Do you think I have a leg to stand on there? I was just going to ask them to prorate based on the two appointments we've had so I can get the heck out of there.

Awful! Good thing you did some digging. I don't think it would hurt to try and get your deposit back but don't be surprised if they won't do it.

Tarta · August 2012

I'm curious where you are in Oregon, if it's the freestanding birth center I opted not to go with. Are you in the Willamette Valley by any chance? I was just second guessing myself a smidge today about choosing a hospital birth, even at Silverton Hospital (a bit of a drive for me) with midwives which is renown for their birthing center. Now I'm feeling better about going with my gut. I feel really safe with my choice, and from what I'm seeing here, that's important.

Mrs.A&J · August 2012

I am about 30 minutes south of Portland. I imagine it is the same place, if you came across concerning information online.

Silverton hospital would have been where I delivered if I hadn't been laid off this year, I worked for them (not in Silverton) until May. They are well known for their birthing center, I think you'll be very happy there. It's quite a drive for us. I think I may go with Providence Newberg now, they offer Waterbirth services.

perplexed59 · August 2012

I'm glad you did more digging. I hope you can get your deposit back. One of the first questions I asked my midwives was their transfer protocol. This pregnancy my midwife told me that they have a reputation as a little too transfer happy and I'm perfectly happy with this. I want to know that if they even sense something is wrong that they will call in an OB to get their opinion. My midwives have a great relationship with the local OB's so often they tag team it during complications so I will get the best of both worlds.

AmyRI · August 2012

Mrs.A&J:
Well, it's been decided. After further digging, I discovered the midwife owner just had her license suspended for a year. She was not my midwife, however, her and one of the midwives assigned to me have the poorest ratings of all Oregon midwives on oregonmidwifeinfo.com, with concerning numbers of lawsuits and infant deaths. I will definitely be switching. My mom says I should demand the deposit back because they failed to disclose that the owner had lost her license. Do you think I have a leg to stand on there? I was just going to ask them to prorate based on the two appointments we've had so I can get the heck out of there.

I'm very glad you found this out now and can switch to someone else! How scary. Good for you for being proactive about it.

I absolutely think you should get your deposit back. From what you said, they were paid in full so far for the services they provided, correct? If that is right, you should get the entirety of the deposit because you are not going to use them for the delivery, which is when you'd actually incur the expenses that they're making you pay for in advance. Otherwise, I'd offer to cover the amount of $$ the insurance didn't pay and ask for the rest back.

Good luck, hope you find a provider you trust!

RockyMtnMama · August 2012

It sounds like your center had a lot of issues, but I did want to mention that I did deliver a breech baby in a free-standing birth center that was not authorized to do so in our state. Basically, none of us knew (me or midwives) and an ultrasound showed the baby head down. I did not get checked prior to being complete (well 9.5cm) and at that point the birth was "imminent" and so we proceeded to birth a frank breech baby with no complications in 25 min from discover (and with two great midwives who had studied under a doctor who still teaches breech vaginal birth to OBs/CNMs). As the mom, I was impressed with their care and attention to detail and very glad that I didn't have to transfer to a hospital for surgery (the doctor who does breech delivery at that hospital was on vacation that week we found out after the fact when I visited with him for another reason).

That being said, the birth center still had to go under a license review and passed with flying colors since they did everything right for care in the imminent birth situation. So...if that was your only compliant was a breech birth issue on the center, after being the mom in that situation, I wouldn't have jumped to conclusions, but since the main midwife had license suspension problems and you had billing issues and other transfer complaints not related to that one breech birth, I understand.

Also, where did you find the ratings of birth centers vs. just caregivers? I'd love to look at that info for my current caregivers/practices.

ETA: Oh I saw it was on Oregonmidwives, so since I'm out of state, I need to look for something similar. Thanks.

Tarta · August 2012

Mrs.A&J:
I am about 30 minutes south of Portland. I imagine it is the same place, if you came across concerning information online.
Silverton hospital would have been where I delivered if I hadn't been laid off this year, I worked for them (not in Silverton) until May. They are well known for their birthing center, I think you'll be very happy there. It's quite a drive for us. I think I may go with Providence Newberg now, they offer Waterbirth services.

Hmm, I imagine it is the same place. Funny thing, I am planning to have one of the midwives there encapsulate my placenta since I can't find anyone else in my area. I hope their encapsulation practices are better than their midwife services... hmmm....

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