Any Recommendations on Good Ob's, Midwives or Doulas? and What Do They Cost?

Updated on June 19, 2010
A.R. asks from Beaverton, OR
8 answers

My husband and I are starting to try for a baby so I am doing lots of reading. At this point, I am thinking that a water birth in a hospital type setting sounds best to me which it looks like OHSU does but I am open to other options. I am trying to figure out the kind of bith I want so I can start working with the right person/people from the begining. Does anyone have a person or place that they went to that they would recommend? I have good insurance but am just wondering what kind of cost I am looking at so that I can be prepared before I get set up with people. Are midwives and doulas more/less expensive than an OB? Do typical insurance company's cover these alternative people? Unfortunaly, I don't know anyone in my area that has had a natural birth. Thanks for the help.

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L.R.

answers from Portland on

I used Helen Welch at Women's Healthcare Associates near St. Vincent. All the midwives there are wonderful. I believe St. Vincent now has birthing tubs in their delivery rooms, although I missed that perk by about a month.

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B.S.

answers from Portland on

Hi A.,

I, too, went to Natural Childbirth Clinic, though we didn't use Dr. Jen Gibbons, we used Dr. Liz Collins. She, like Jen, is a naturopath midwife. Shortly after I got pregnant with my first, I went to "interview" her and knew IMMEDIATELY that I didn't have to look any further. Dr. Liz was a PERFECT fit for our family.

We ended up doing a homebirth, though we originally considered using the clinic birthing suite. We didn't have insurance at the time of my first pregnancy, so we opted to save the $1600 it costs to use the suite. Everything went super smoothly at home. We couldn't have asked for a better birth experience! For our second, even though we had insurance this time around, it wouldn't cover Dr. Liz's services, so we again paid out of pocket, which was $3300.

I would make sure and contact your insurance and see what exactly they cover of the prenatal care and birth. Not all insurances cover everything. Keep in mind that your average hospital birth costs ~$10000, so depending on what your insurance may or may not cover, the cost may not be THAT different.

Good luck in choosing the practitioner that best fits your needs! :)

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S.L.

answers from Portland on

Hi there,
I have had two water births which were wonderful, so I highly endorse your water birth leanings. Choosing where to give birth usually comes down too a) money and b) where you feel the most comfortable. Home births cost less overall than hospital births, but usually more of it comes from out of your pocket and little, if any is paid for by insurance. Home births will run you $3000-$4000. Some midwives give a discount for paying in full by a certain number of weeks gestation (our second home birth cost $2700 instead of $3200 because we paid by 28 weeks, I think). That was nearly 4 years ago, mind you, so prices may have gone up, but probably not by much. If you go with a hospital birth it will be covered the same by your insurance whether you go with midwives or with an OB. If you have a healthy pregnancy I highly recommend going with midwives or family practice docs. OBs are specialists and great for complicated births or pregnancies, but they aren't the best for normal births--they're overkill.
And birth doulas are wonderful (full disclosure, I am a doula) for any kind of birth, but especially for a hospital birth. Hospital staff are great at handling the medical stuff, but they have no connection to you as a person like a doula will having gotten to know you before the birth. Also your doula won't leave when the shift changes. Doulas are an extra to your team, they provide continuous support in the form of massage, encouragement, breaks for your partner, reassurance, information, etc. Doulas are sometimes covered by insurance, but it's not common. You can find a student doula for free or very little, but if you want someone with more experience it can run you anywhere from $400-$1000 ish. With doulas personality fit is very important, so don't forget to interview a few different doulas and pick your favorite. Almost all (maybe all) doulas offer a free interview. I wish you a lot of luck. Having a baby is a wonderful thing! :)

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A.T.

answers from Portland on

OHSU has midwives, but really tI think of them as nurses doing the OB's job. Myexperience at OHSU was okay, but not the ideal birth that I would have liked. Lots of drugs pushed & not enough personal attention from midwives, a new one every shift. They are trained for hospital births with intervention & medication.
As for real midwives I'd highly recommend Kori or Laura at A. midwifery in SE. They are amazing & have a private birthing center with doulas & other professionals. They also take insurance! almamidwifery.com or call ###-###-#### Good luck!

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A.B.

answers from Portland on

I love questions like these... It makes me happy that you are exploring all your options! AND that you are in my area, so I can recommend Dr Jen Gibbons from Natural Childbirth and Family Clinic in N.E. Portland.

We had a home birth and LOVED her.
Andaluz is closer and has a nice facility but Jen was so much more up our alley in personality and in practicalities that it was a perfect fit. They have several other midwives (and a midwizard as one of my friends who went there calls the male Dr!).

I think to have a home birth it was close to 3,000 and it was a little more to have the birth at the center. This includes all exams leading up to and 6 weeks after the birth. We didn't consider them until I was about 30 weeks pregnant, so the cost was still the same. Good for you for getting on this so soon!!

Jen is a naturopathic Dr as well as a midwife (and a slew of other things) so she is very well rounded and takes lots of things into consideration when treating and seeing her patients. The only catch with naturopathic Drs is that some insurances dont cover them. Call the clinic and ask - they are very helpful =)

As you can tell, I love them... I can't wait to get pregnant again and go back (our insurance doesn't cover them, but the clinic has a payment plan to make it possible to still go with them.).

Good luck! I'd be happy to answer any other questions you have! AND, if you do see Jen, let her know that Zealand's mom sent you :-)

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A.K.

answers from Portland on

I saw a Dr at OHSU at the same time seeing midwives at Alma Midwifery Center, and I got MUCH MUCH better care from my midwives. They were watching my anemia and my UTI, and the OHSU Dr didn't comment about either one (I actually had to ask her to check my urine test results!).

My favorite mw at Alma, Laurie, is now at nest-midwifery.com with one of my most trusted friends, Kim, and I would recommend them highly as well.

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H.D.

answers from Portland on

Hi A.,

First, I'll answer your specific question: we had a home birth and used A Gentle Beginning midwifery practice. Catherine Schaefer is not only a midwife, but a naturopathic doctor and a CNM and has good working relationships with the medical establishment. I was always of a mind that, should I need to transfer due to emergency, I wanted a midwife that: A. was solely committed to helping our family have a healthy birth first and foremost (and not necessarily a home birth) and B. would be able to stay on as a doula. Our bill for services (aside from labs, herbs) ended up being around $3,000.

If you are using a hospital, it's likely that an OB or a CNM will deliver. You will need to discuss this with each different hospital system; what their practices are and who delivers, etc. I'm not sure the bill differs, as we opted not to go that route. But doulas generally do not deliver babies. (Perhaps I read your question wrongly in this regard?:) )

One other thing to think about is that we can have expectations about our births, but ultimately, only the birth itself reveals what exactly will happen. In our case, we rented a tub to labor in and I never even got into it...my labor was so fast. Other women discover that a cesarean birth is necessary. My advice would be to look at resources which empower you not to have a certain "type" of birth, but to be a present participant in whatever kind of birth happens. Sadly, I have known quite a few women whose expectations weren't met in the delivery room and they have had a lot of anger and pain around this disappointment. So, yes, be informed as to what you might like, and then, prepare yourself to be present and flexible--both physically and emotionally. Books like "Birthing From Within" (they offer local classes) offer exercises for exploring your own deeper feelings around many of the issues that surround modern birthing and a good prenatal class will hopefully help you and your husband to have a wonderful experience, no matter how it goes.

There are some things to consider on your search. For one, your insurance may or may not cover different providers or home birth.

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A.Z.

answers from Portland on

You should check out Andaluz Waterbirth Center (www.waterbirth.net). They are amazing and wonderful! We have had our 3 children with them and I would go there again if we had another child. You can go in for a free consultation and they will give you a tour and show you a video of some waterbirths so you know what to expect. They will also check your insurance and let you know how much is covered and what your out of pocket expenses will be. With my first child, the comparison between the hospital and the birth center (80% covered at the hospital and 50% covered at the birth center), it was still cheaper to go through the birth center and being allowed and supported to do a natural birth ensured me (with my beliefs) that we would have a better birth and less risk of complications. In fact, we had a great birth.

This last time, we were pregnant with twins and our insurance did not cover out of hospital births at all. But looking at the cost of the hospital with co-pays and the potential (much higher with twins) for a c-section and numerous other interventions. We felt the cost benefits were in our favor to pay out of pocket. We also had the support and encouragement that helped us make it full term with our babies and we had a quick and completely complication free birth of twins at home with the care of multiple midwives on-hand. That was worth every cent alone! I was back on my feet and going about my daily life the very next day and felt great!

So my point, go to appointments and meet with different doctors and midwives. Research and learn and figure out what fits your personality and desires. Follow your instincts! Feeling safe and relax is a huge factor in a succesful and much easier birth than when a mother feels stressed, pressured, or in fear.

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