Choosing A Provider - Guest Blog!

Whether you are an expecting mother or preparing to grow your family, you have many birth options in the Dallas/Ft. Worth metroplex. Some count it a blessing to have so many options, and others may find choosing between them overwhelming. This blog aims to help you make a provider choice that fits you and your growing family. Included are tips and questions for you to either ask yourself or your potential provider.

Your Birth Options

In Dallas/Fort Worth you can have a homebirth, planned C-section, and everything in-between. If you have never birthed before, consider asking others about their birth stories. Try to hear stories of all different perspectives. Consider listening to The Birth Hour podcast, a podcast where each episode is a woman sharing her birth story. This podcast is good at sharing all types of births.

Q: Whom do you want delivering your child? CPM (Certified Professional Midwife), CNM (Certified Nurse Midwife), MD (Medical Doctor), or DO (Doctor of Osteopathy)

Q: Where do you want your child delivered? Home, a birthing center, or a hospital. 

Dallas/Fort Worth has many midwives. Something that you may not know is that there are two avenues one can take to become a midwife: a CNM is a certified nurse midwife, and a CPM is a certified nurse midwife. A CNM has a background first in nursing and then in midwifery. They can prescribe certain medications and may have rights at a hospital. A CPM has devoted all of their study solely to midwifery. Another interesting fact is that some midwife practices deliver exclusively at a hospital, some only attend home births, and others have birthing centers where they may offer home or birth center births. 

We also have a plethora of OBGYNs in DFW. Each of them has unique qualities as well. Some may be well versed in natural birth; others are highly sought after because of their skills in surgery, which is very important for mothers who require or choose repeat C-sections. Each OBGYN also has a specific hospital that they deliver at (as do midwives who deliver at a hospital), and some may have rights at multiple hospitals. In addition to the culture of a practice, consider the hospital’s culture. 

Q:  What hospital do you deliver at? What kind of room will I labor in? What kind of room will I birth in? What kind of room will I recover in?

Q:  Does the hospital allow water birth? May I labor in the shower? 

Q:  Does the hospital have a NICU unit? What level is it?

Processing a Previous Birth

Even when births go entirely to a birth plan, it is still hard to make accurate expectations of all aspects of birth and postpartum. During a postpartum visit, especially if you hire a postpartum doula, you will hopefully have a time where the mother can process the delivery. This process looks different for each mother, and it may be an ongoing occurrence. Pregnancy is a typical time when mothers need time to process it again. 

For some, choosing the next provider is easy because they grew to trust and like their first provider. As long as they are still local and that provider is available, then you are all set! If a move has taken place or they aren’t taking new clients, consider reaching out to them ask if there are any providers that recommend who have similar philosophies and practices. 

When choosing a provider after having a birth that was not what you desired, there are a few things to consider. What specifically gave you the most angst? For example, if your birth center birth ended in a transfer to the hospital, what specific parts of that gave you the most emotion stress? The added expense, the care provided by those at the birth center, specific experiences had at the hospital, or something else? It is good to recognize that many birth plans need to make changes, regardless of the setting the birth took place in, but sometimes a provider can be a contributing factor to a birth plan going astray. When choosing your next provider, ask for consultations with many places and share with them your birth and ask them what they would have done in a similar situation. Could any of your angst been avoided? Do any of the complications that occurred during the previous delivery make future complications more likely? It may be helpful to ask your first provider for the birth notes from your previous delivery to make your consultations more helpful. 

Tip: If you are struggling with processing a previous birth, try reaching out to your doula and ask if she can help you process your delivery and offer a doula’s perspective. 

The Cost

Hopefully, the cost of birth does not need to be the first thing you consider when choosing a provider, but the reality for some is that they are cash-pay with limited finances. For those, the cost is a significant consideration, especially since the cost of birth varies significantly between the DFW options. If you don’t have health insurance, you may consider applying for Medicaid. If your household income is low enough, then you may be eligible for some valuable health benefits.

Q: How much does giving birth with your practice cost? Does this include labs and sonograms? Does this include the facility use (hospital or birth center)? Does this include a birthing class?

Tip: If you qualify for Medicaid, reach out to your doula and ask if knows any area providers that accept Medicaid. DFW has OBGYN, CPM, and CNM options.

One assumption is that delivering at a birthing center is the most affordable option. The cost depends on the birthing center you go to, and it assumes no transfer of care at any point in the prenatal care, delivery, or postpartum care. There may be thousands of dollars difference in price between birthing centers. This is also true of OBGYN practices. Each practice is also different in the discounts they offer. Some practices provide discounts for things they think are essential, such as paying your bill by 30 weeks, taking a birth class, or hiring a doula.

Tip: Call many practices for price quotes. Ask if they offer any discounts for cash-pay, paying early, taking a birthing class, or having a doula. 

When comparing costs with practices that deliver at hospitals, you may need to call the hospital directly to find out what the hospital cost will be. For cash-pay clients, they usually have a pre-negotiated price set for vaginal births and another price set for C-sections. This price typically requires that you pay before being discharged, or the price may go up by as much as double. This price only includes hospital services. For example, if you get an epidural, then that will be billed separately by the anesthesiology department and is an additional cost. 

Q: How much is it to deliver at this hospital? What does this include? What are some examples of things not included in this price? When must this be paid?

Though this was a lot of information, there is still many questions that can come with choosing your provider and birth location. That is why we are here to help you in anyway!

Doulas Are Here! 

You do not have to make your provider choice alone. Doulas are a unique resource because they attend all types of birth in all types of settings. To learn more about our doula services click here!