When to "sign up" with midwife?

Xstatic3333 · August 2015

This is probably a silly question, but bare with me...

H and I will TTC in Dec. or January, and are getting excited! For the last few years I've gotten all of my gynecological care from my PCP, who is about an hour away from me, near where I used to live. I LOVE her, and don't go to the doctor very much, so I've kept her as PCP and just drive up when needed.

I'm not planning on a preconception visit since I have no preexisting conditions that I expect to be an issue. I'm not due for a physical until December, and, because I'm 30, don't need even a pap every year anymore. I've identified a midwife practice that I think I'd like to use for my pregnancy that is close to where I live now. Should I try to "become" a patient with them now, or wait until I'm actually pregnant? Are these practices like PCPs in that they sometimes are "full"? I need to get a referral for each new doctor visit, and am not sure there is a reason for my PCP to write one until I'm PG. At the same time, I don't want to be left hanging once I need to see someone.

Thanks for any insight!

satuttle1014 · August 2015

Well I have not worked with a midwife but I didn't actually find a doctor until I got a positive pregnancy test. My normal gynecologist did not do OB so I had to find a different doctor. I saw my doctor once a year and at my yearly this year I talked about TTC and she gave me information that I may need. I really would not worry about anything until you are pregnant. You may want to browse and read reviews on doctor and have one or two in mind for when you do become pregnant. They usually say as well if they accept new patients or not.

Xstatic3333 · August 2015

Thanks! Sounds good.

AL_TwinCities · August 2015

I am interested in going to a freestanding birth center when I do get KU (TTC now). They also do well woman care, and so this year I went to them for my annual exam. After that I knew I felt comfortable with them so I had my medical records sent to them. One less thing to worry about when I get KU. They also fill up fast each month as they are small and only have a few birthing rooms, so I wanted to be able to call them as soon as I get a BFP to set up my first appointment and reserve my spot!

Xstatic3333 · August 2015

AL_TwinCities said:
I am interested in going to a freestanding birth center when I do get KU (TTC now). They also do well woman care, and so this year I went to them for my annual exam. After that I knew I felt comfortable with them so I had my medical records sent to them. One less thing to worry about when I get KU. They also fill up fast each month as they are small and only have a few birthing rooms, so I wanted to be able to call them as soon as I get a BFP to set up my first appointment and reserve my spot!

Hmmm, when you say "well woman care" is that a full physical or a pap? I don't think my insurance will cover a pap this year, but it will cover a physical. I'm hoping for a birthing center too, and I didn't realize that they can fill up very quickly.

jenfarm3 · August 2015

Xstatic3333 said:

I am interested in going to a freestanding birth center when I do get KU (TTC now). They also do well woman care, and so this year I went to them for my annual exam. After that I knew I felt comfortable with them so I had my medical records sent to them. One less thing to worry about when I get KU. They also fill up fast each month as they are small and only have a few birthing rooms, so I wanted to be able to call them as soon as I get a BFP to set up my first appointment and reserve my spot!
Hmmm, when you say "well woman care" is that a full physical or a pap? I don't think my insurance will cover a pap this year, but it will cover a physical. I'm hoping for a birthing center too, and I didn't realize that they can fill up very quickly.

"Well woman care" is physical exam including pap, if necessary. I never heard of this "well woman" appointment thing until I moved to Texas. We always just said exactly what we wanted to schedule when I made appointments back up north in Oregon. Lol. "I need to schedule my annual physical and pap, please."

I did something similar this year. We had just gotten married and I was due for my annual pap and exam. I used to just go to a regular family practice clinic for those appointments. But the regular clinic I would go to was starting to piss me off for other reasons. And I knew we'd be starting to TTC soon, so I figured it was a good time to maybe visit and find a good OBGYN. One less thing to worry about when we finally do get pregnant. Finding a new doctor is such a hassle. I always hate it. I didn't wanna have to worry about that when we were finally pregnant.

Xstatic3333 · August 2015

jenfarm3 said:

Xstatic3333 said:

AL_TwinCities said:
I am interested in going to a freestanding birth center when I do get KU (TTC now). They also do well woman care, and so this year I went to them for my annual exam. After that I knew I felt comfortable with them so I had my medical records sent to them. One less thing to worry about when I get KU. They also fill up fast each month as they are small and only have a few birthing rooms, so I wanted to be able to call them as soon as I get a BFP to set up my first appointment and reserve my spot!
Hmmm, when you say "well woman care" is that a full physical or a pap? I don't think my insurance will cover a pap this year, but it will cover a physical. I'm hoping for a birthing center too, and I didn't realize that they can fill up very quickly.

"Well woman care" is physical exam including pap, if necessary. I never heard of this "well woman" appointment thing until I moved to Texas. We always just said exactly what we wanted to schedule when I made appointments back up north in Oregon. Lol. "I need to schedule my annual physical and pap, please."

I did something similar this year. We had just gotten married and I was due for my annual pap and exam. I used to just go to a regular family practice clinic for those appointments. But the regular clinic I would go to was starting to piss me off for other reasons. And I knew we'd be starting to TTC soon, so I figured it was a good time to maybe visit and find a good OBGYN. One less thing to worry about when we finally do get pregnant. Finding a new doctor is such a hassle. I always hate it. I didn't wanna have to worry about that when we were finally pregnant.

Nice! Maybe I'll look into whether the practice I like does well woman care too. I feel the same way you do about the hassle factor, so it would be nice to get in with the practice without adding an unnecessarily appointment to my life.

AL_TwinCities · August 2015

@jenfarm3 explained it perfectly. This year I didn't need a pap so it was more like a physical, but they would have done the pap when I went if I had been due for it.

LDSJM123 · August 2015

A couple years before we were planning on trying, I started researching midwives and switched practices then. I saw her for my annual appointments. I wanted to make sure I liked the midwives, the office staff, wanted to see how long it would take me to get appointments etc. I liked doing it that way because if I ended up not being happy, I wasn't strapped on time (and pregnant) trying to find someone new.

penelope4612 · August 2015

The recommendations on this may have changed, but I believe that you should still get a yearly pelvic exam even if there is no pap. The pap is the part where they swab your cervix and send the cells to be looked at to make sure you don't show changes consistent with cancer, etc. The rest of the exam is your doctor visually and physically making sure there are no skin changes or lumps or bumps in your lady parts, feeling your ovaries and uterus, etc. I see my ob/gyn yearly and I don't get a pap every year but I do get a pelvic exam.

You could find out if this practice offers well woman exams and see if you can schedule a pelvic exam with them around the time that you would normally get your physical (because insurance will not cover a pelvic more than once a year). Obviously, the disadvantage to this is that they only do a pelvic and not the rest of the physical. This may vary by state, but in my state OB/GYN is considered "primary care", as is psychiatry, so you don't need a referral from your PCP. However, if you like your PCP, you might reach out to her by phone and ask what she usually advises, because I'm guessing this has probably come up before.

hgsurvivor · August 2015

You can definitely schedule an appointment as a sort of "interview". Just as you would anyone else providing a service, schedule a consultation if not a full appointment and bring your questions and see if you like the midwife. Then go from there. Just ask how they would file that appointment with insurance so you can see in advance what the cost would be and if it's covered.

jojomama25 · August 2015

I know the midwifery group I wanted to get in with has a bit of a wait time for new patients to get in (about 2 mos), so once DH and I decided to take the plunge to TTC this fall, I did my research because I wanted to know I was set with them whenever I get a BFP. They offer just regular women's healthcare too, so I scheduled my annual pelvic exam with them instead of having my PCP do it, since I'll be due for one this fall anyway. That way the appointment is covered by insurance too. Make sure you have coverage for a midwife on your policy - I had to dig deep to find info on it in my policy and there were some stipulations regarding hospital associations, certifications, etc. I couldn't even make an appointment until I proved this.