# Options, Options *planning ahead



## OnErth&InHvn

I just got back from a HB meeting. The one midwife i was leaning towards would not be a good fit apparently. She has too high of a transfer rate. I also found out that im not a good fit for the one and only birthing center near me. I got a list of midwives and back up OBs. 

basically when the time comes i have a couple choices:
1) go with same OB who delivered DD2/did my VBA2C. $4000 out of pocket. 
2) go with midwife and her back up OB. $3000 for midwife and $0 for back up. ( id only see OB one time though). 
3) go with new OB. $0. _risk being they may not let me VBA2C_

I could also do #1 and #2 at the same time but thats a major cost. 

Im getting educated now to prepare. Its not like the last 3 kiddos where i just went with who my insurance said or DD2 when i googled the hell out of VBA2C in my city.

Thoughts? Feelings? :shrug:


----------



## MindUtopia

Why not have a consulation with a new OB and see how you feel about them? There are many very supportive pro-VBAC OBs out there, especially as you have had one before. Could you ask your previous OB who supported your VBAC to recommend some of her colleagues who might be covered by your insurance? 

As for the home birth midwife, why does the transfer rate concern you? Is it because of the added cost, as in, you'd end up paying for a midwife and then also a hospital birth? Generally, first time mums birthing at home have about a 40% transfer rate (most of those for pain relief or long labours where they get tired, not because there's anything actually wrong) with about a 10% rate for 2nd time or more mums. Things like distance to hospital can also have an affect. If many of her clients are far from a hospital (like if it's a large, sprawling rural area where she attends births), they might be keen to recommend a transfer sooner rather than waiting to account for transport time. I wouldn't necessarily be too concerned about transfer rates unless they were over the top high, like greater than 50% across all clients, even those with a previous vaginal birth.


----------



## OnErth&InHvn

MindUtopia said:


> Why not have a consulation with a new OB and see how you feel about them? There are many very supportive pro-VBAC OBs out there, especially as you have had one before. Could you ask your previous OB who supported your VBAC to recommend some of her colleagues who might be covered by your insurance?
> 
> As for the home birth midwife, why does the transfer rate concern you? Is it because of the added cost, as in, you'd end up paying for a midwife and then also a hospital birth? Generally, first time mums birthing at home have about a 40% transfer rate (most of those for pain relief or long labours where they get tired, not because there's anything actually wrong) with about a 10% rate for 2nd time or more mums. Things like distance to hospital can also have an affect. If many of her clients are far from a hospital (like if it's a large, sprawling rural area where she attends births), they might be keen to recommend a transfer sooner rather than waiting to account for transport time. I wouldn't necessarily be too concerned about transfer rates unless they were over the top high, like greater than 50% across all clients, even those with a previous vaginal birth.

he wont recommend anyone because the one he would have got arrested a few years ago. 


and she has a very very very high transfer rate compared to other MW


----------

