Thursday, August 25, 2005

45 minutes in Hell (ok, maybe just Purgatory)

As a school librarian, I spend a lot of my time teaching people (students, teachers, and parents alike) how to find information. You might think that I’m reasonably capable of finding the information I need to solve problems in my own life. You’d be wrong (at least yesterday).

Being incapable of brevity, I already know that this post will be plenty long without detailing everything about Cait’s and my current thoughts on midwives vs. doctors and birth center deliveries vs. hospital, but suffice to say that at least for early prenatal care this go round we would like some kind of middle ground – ideally midwives with an OB (and perhaps more importantly an ultrasound) in the same office*. Unfortunately, there aren’t a lot of midwives in this area, and many of them are affiliated with the three freestanding birth centers, none of which have physicians or sonography on the premises.

However, I have long heard rumors from many people – our neighbor the midwife (not currently practicing except when she does home IUIs for us), several midwife-shopping friends, a neighbor who ultimately chose hospital birth and “my” gynecologist (whom I haven’t seen since Repropalooza began in earnest) – that there are some midwives who have a shared practice in a major hospital center with their supervising OBs. This sounded like the ideal situation for this stage of our pregnancy and nervousness, but I could not find the names of the midwives or the doctors in my files. Since “my” GYN – let’s call her Dr. Cool – is really, really hard to get a hold of, and her office staff can be just a wee bit brusque, I decided to use the “Find A Practitioner” feature on my health insurance website. It did indeed spit out the names of three midwives at the hospital, though some of the office addresses and phone numbers looked suspiciously erroneous or incomplete to me. However, yesterday I went ahead and began calling to see if they were indeed practicing and seeing patients at the hospital. That’s where the fun began.

Deciding that the name at the top of the list was as good as any other, I dialed the number. “You have reached the offices of the (garbled) program. No one is available at this extension. Please call back on (slightly different number) to speak to a staff member.” Oooo-kay. I have no idea what the Garbled Program is, nor if it has ANY connection to midwifery. On to name/number two – which, given that it ended in “8000“ seemed quite likely to be the main number for the hospital.

It was. And I was on hold, seemingly indefinitely. Eventually I gave up and dialed number three. Bee-bee-beep! The number you have reached is not in service. Damn! So it was back to #2. This time, an operator answered almost immediately – a miracle! I gave him the name of midwife #2, and after some difficulty spelling the name, he connected me to another voicemail for Garbled Program. "Aha!" I thought. "Garbled Program probably DOES have SOMETHING to do with midwifery, but I really want to talk to a person." Accordingly, I decided to call the slightly different number I learned during call #1. Sadly, this too, led to voicemail, and I decided I just was not ready to leave a message, since it would have been something like this: “Hi. I’m looking for a midwife and I think you are midwives. Can I make an appointment?” Too weird/risky. Thus, I dialed 0 and returned to another operator.

(As an aside, I was remarkably lucky in this irksome venture that every person I spoke with was cheerful and at least attempted to be helpful. That is SO unusual around here, especially when dealing with operators for large bureaucratic complexes like hospitals.)

I explained to Operator #2 that I am trying to find a midwife to provide prenatal care and I understand that there are practicing midwifes at this hospital, but I haven’t been able to reach them and I don’t know which obstetricians they’re affiliated with. I could almost see him scratching his head as he ponders the request. He finally offered, “Well, how about I connect you to Labor and Delivery?”

Now I don’t know how often you’ve tried to call hospitals but you could have knocked me over with a feather. Here he was offering to connect me directly to the floor nurse on Labor and Delivery!!! It was like winning the lottery – except in Monopoly money. I actually don’t need L&D quite yet, but I thought, “What the heck. Maybe they’ll be able to point me in the right direction.” So I agreed, and shazam! I was talking to another friendly & helpful hospital employee.

“Midwives?” he mused. “Well, I don’t know where to send you. Hmmm.” He thought a bit longer and finally said, “Why don’t I connect you with…

…Dr. Cool’s office.”

Having devoted more than half an hour to this fruitless endeavor, I agreed, and he patched me through. I began, yet again, my inane-sounding monologue, except now with the fillip, “I’m a patient of Dr. Cool (at her other office) and she once recommended some midwives to me, but I can’t find their names. Can you tell me who the midwives are at the hospital and who they practice with?”

To which the nurse replied, “No, but if you call her other office I bet they can tell you.”


Since I didn’t have it with me, she gave me the number of the other office, and I made yet another call. The receptionist (who was MUCH nicer than when I call to make an actual appointment) was somewhat baffled by my request, but put me on hold and checked with Dr. Cool. The verdict? Call the birth center.

Which I guess is what I should have done from the beginning. And which I finally did, to very little avail. Yes, they deliver at the hospital, but no, they don't see patients there for routine care, and no, they don't have ultrasound capabilities, and besides, they probably don't take my insurance.

And that is the end of that, at least for now. We've got an appointment with a more tradtional OB practice with nice high-tech screening equipment right there in the office, and we'll give it a try at least for the rest of the first trimester. We'll hang on to the possibility of midwives for later if/when we get a sense of whether or not things seem to be ok with this pregnancy.

But geez! I sure had better ways I could have spent that portion of my afternoon!

*Yes, we know this is somewhat contradictory, but we also know this model exists. And we thought it existed here. But we may be wrong.


  • Did I send you the info about the folks I've been seeing? I know that there are midwives at the practice I go to, and I had an ultrasound in their DC office, and that they deliver at Sibley... at least, thats what they told me when I was there in April/May. There are only a couple of midwives there but they are there.

    By Anonymous jenny, at 7:47 AM  

  • As a librarian with impeccable research skills, I'm sure you've thought of all this, so forgive me if my tips are redundant. But JUST in case, have you looked at...
    - hospital web sites? In their maternity info they'll often state whether they have midwives available.
    - local parenting web sites? People in your area can suggest midwives/Dr.s and answer questions you may have about ultrasound resources.
    Good luck!

    By Anonymous Julie, at 7:57 AM  

  • Hi,
    I don't know where you are in the country, but certified nurse midwives are the ones who are more likely to work in a hospital and be a little more traditionally medically oriented, as opposed to lay or certified practical midwives who tend to lean more toward the freestanding birth center/home birth part of the spectrum. Maybe that will help.

    a former nurse midwifery student

    By Anonymous Maria, at 8:49 AM  

  • I swear - there's nothing worse than the days when one feels like one has lost one's librarian touch in the face of bureacracy. I feel for you.

    The parenting site idea is a good one to investigate. Park Slope has a listserv and website devoted to parenting and such - maybe some baby-saturated area near you might have something similar?

    I'm sorry you had to spend such a long time on the phone - that's my least favorite thing to do.

    By Anonymous bri, at 8:59 AM  

  • I can't believe you guys read that whole thing! Thanks for the additional tips - I did leave out a few of the other complicating factors, but you have given me a couple of other ideas to pursue.

    By Blogger Jen, at 5:51 PM  

  • Oh god, I love that you're a librarian. I don't know how I missed that before. I'm a wannabee librarian myself.

    My most frustrating health care experience has involved trying to use the "find a provider" feature on my insurance company web site. I complained up several levels of customer service at my last insurance company -- at least 50% of the information was either inaccurate, or the practice no longer took that insurance.

    And although I'm going to guess you're in the DC area, where I can't help, if you happen to be in Atlanta, we love our combo midwife-OB practice. So far, they've been supportive, funny, helpful, and very lesbian-family friendly. The ultrasound people, however, are in a different practice. But they've been wonderful too.

    By Anonymous Liza, at 8:16 AM  

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