The question “Where’s my midwife?” has suddenly become very personal for me. I am pregnant! My estimated due date is 12/12/12, wouldn’t that be an awesome birthday!?! We will be a family of five! So now that I have somewhat adjusted to all that excitement and caught my breath, I need to find a midwife! My last baby was born at home in North Carolina with the most wonderful CPM. Now I am living in Salt Lake City, Utah. The two states could not be more different as far as midwifery options go.
The state of North Carolina does not license CPMs, even though it is perfectly legal to have your baby at home, it is not legal for your midwife to be there supporting you. And CNMs are required to have a physician’s signature to obtain a license, so only a handful of them practice home birth in the entire state! These restrictions limit the number of midwives who will work in NC. In Wilmington, where I lived, there were three CNMs practicing in hospital and one CPM practicing home birth. We really wanted a home birth, as our first child was born at home in Boston. But choosing the CPM meant that, throughout my entire pregnancy, I had to live with the very real possibility that my midwife may get arrested or be forced to quit working. It was her loving support that turned me into a birth activist! How could health care that was so personal, so wonderful NOT be an option?
Now in Utah I can have a midwife that is licensed and doesn’t have to break any laws to help me out! I don’t have to press my ear to the underground to find someone. Oooo maybe I can even have one that is covered by my insurance and not pay for my entire birth out-of-pocket, wouldn’t that be neat!
So I went was my insurance company website. First I searched for “home birth midwife”, but alas that was not a recognized term. When I did I search for “Salt Lake City” and “midwife” I got 68 matches! Wow, surely some of these ladies will do a home birth, right? After further internet exploration I found that there is only one midwife, Rebecca Williams, a CNM, who is considered to be “in network” by my insurance. When I went to her website I saw that she is already booked through January! Yikes, I guess I am not on the ball enough to have the option of maximum insurance coverage. Oh well, going out of network opens things way up. I am not sure how many home birth midwives there in my area, my guess is more than ten.
My next step was to get recommendations from folks I knew in the birth community. From their advice and a little more help from Google I set up three consultations and interviewed five midwives. I love that I have options here, I get to choose! All five midwives were wonderful to meet with and highly skilled. I would trust them all with the details of pregnancy and birth. That makes choosing actually rather tricky. They all answered my questions perfectly, no red flags, five fabulous midwives.
My first consultation was with a pair of CPMs, Melissa Mayo and Heidi Sylvester. One is licensed, and one is unlicensed. In Utah an unlicensed midwife is not illegal, so not everyone chooses to license. The benefits of licensure include being able to carry certain medications, such as things that would slow a postpartum hemorrhage. Some of the draw backs to licensure are being banned from attending breech and twin births. So midwives choose what works best for them. If the licensed and unlicensed work together theoretically you have the best of both worlds.
The second pair I met with run a birth center and also attend births at home. The duo consists of Becky McInnis, a CNM, and Adrienne Trahnstrom, a CPM. They use the centering model for their prenatal appointments, all of that peaked my interest. With the birth center they also have the capacity to do ultrasounds and other clinical tasks at their offices and a CNM can prescribe medications. They had a lot of resources.
My last appointment was with Cathy Larson, the midwife I ended up choosing. She is licensed CPM with a solo practice. We met at her home office, but all of my other appointments will be at my home. I love not driving! In the end my decision was based on geography and temperament. Simply put, I thought her style would best serve my needs. I feel so fortunate now to have access to so many high quality midwives. I didn’t even meet with half of the midwives in my community! What are the birth options like where you are? I would love to hear from you!