Wednesday, April 18, 2007

Midwife Day

Our first consult today was with the Little Fruit Midwives (the practice is named for a little fruit). There are two of them; we met with Midwife Apple (so named both because her first name starts with an A, and because she does have red rosy cheeks, and is pregnant, so also round like an apple).

We both really, really liked her. She spent plenty of time with us and answered all of our questions. Their Caesarean rate is even lower than Dr. Mellow's at 13% (16% if you count breeches). She said they only perform episiotomies if the baby is in distress. They deliver at University Hospital nearby (the other option is Protestant Hospital*, where Dr. Mellow practices); she said they use U.H. because they can practice as they choose, which means no routine interventions during labor (no IV's, only intermittent fetal monitoring, eating and drinking during labor, changing positions, and two rooms with tubs). If we are sure to choose a specific pediatric practice and if the pediatricians cooperate (they don't always), we can be discharged after 12 hours (but have the right to stay longer if we wish).

They're very easy to get in touch with; one of the voice mail options rings directly to their cell phones, and we can also email for less urgent issues. That's a real comfort.

The Little Fruit Midwives have fewer, but longer pre-natal visits, which appeals to Co. Charmingly, they have a list of names of babies they've delivered on the wall, and even more charmingly, one baby is named after their practice.


Today's second visit was to Neighborhood Midwives. The neighborhood in their name is ours, but the only consult appointment available this week was in Large Jewish Neighborhood. That wasn't the most comfortable experience, but ordinarily we'd go to their office a few blocks away. Actually, the location of their neighborhood office is about 100 feet from the location of Little Fruit's office.

We met with Midwife R; there are two others in the practice. She was lovely. Their Caesarean rate (from last year) is the lowest yet at 10%, and she said that was high for the practice, they're usually closer to 7%. They deliver at Protestant Hospital and said they've been happy with it and are able to make their own rules for labor (which is to say no rules: you can get up and down, eat and drink, etc.). We can also likely leave the hospital after 24 hours, there's a pediatrician who almost always releases babies at that point. (The information from both midwives about getting released from the hospital totally contradicts Dr. Mellow; clearly we weren't getting the whole story.)

There's always a midwife on call and if you have an urgent issue the answering service will page her, and she will call back immediately.


Here's our verdict: We liked both midwife practices a great deal. Especially after the helpful comments to our last post (thanks so much, folks), we are definitely going with one of the midwife options. But which one??

What it seems to come down to is Mama Midwife (Neighborhood Midwives) or Older Sister Midwife (Little Fruit Midwives). Little Fruit felt more personally familiar: a waiting room with a sign that says "help yourself to tea" and papered with fliers for local nursing/mommming/hypnobirthing/prenatal yoga groups. They don't have a receptionist and Co helped Midwife Apple reboot her computer. Neighborhood Midwives have been in practice over 20 years, are clearly more organized with multiple receptionists and a waiting room with fliers for cord blood and backwards R store product catalogues.

We will come to our own decision, but if you, oh Internets, have any pearls of wisdom to throw our way, we'd love to hear them.

*Co says that it is best to entrust one's health care to the Catholics or the Jews, but in this neighborhood Protestant Hospital is what we got.


calliope said...

ok. remember when you guys where doing pros & cons about which sperm donor to use?
And it was SO clear which donor you preferred (at least to me!)based on how much you wrote about them?
I am going to use that same system here: based on amount written, I am going to say that it seems that you are leaning towards small fruit.

cristin said...

I totally agree with calliope.

oneofhismoms said...

I've been to both the small fruit and the neighborhood midwives. If I do get pregnant, I'm not going to use the neighborhood midwives (even though I used them for well woman appointments for years) because I don't want to deliver at Protestant Hospital-- that's partly because my partner works there, but also for other reasons I'd be happy to tell you about offline.

If I get pregnant, I'm actually trying to decide between the little fruit and the Presidential Hospital which is a much farther distance from home, but has much better reputation regarding hospital experiences from friends and aquaintences. I hope this was helpful. I do love the women at small fruit. It seems you do as well. Good luck with your decision.

bri said...

As I've said before, I would deliver with either set of neighborhood midwives if only I wasn't now wedded to the idea of Presidential Hospital. BUT at the beginning of my pregnancy, I didn't feel this way and wanted All! Monitoring! All! The! Time!, as you know. So I found an OB who is sort of midwifish. But not really. I do sort of wish I was getting the midwife experience.

Anyway, if I had to choose, I would go with University Hospital. And I agree with Cali that it sounds like you feel comfy with their slight disorganization. That would be the only thing that would give me pause - is it quaint and sweet now but will drive you batty when you really need them to do something? If you think it will be OK, it sounds to me like you should go with them.

(Did they mention anything about issues with U.H.? I did read they were having financial issues and may be closing, but I think I told you that before and I think the actual close will be MANY years off. Just curious)

Melody said...

Why is it best to entrust one's health to the Catholics or the Jews? We have two well-respected Catholic hospitals in our area, but I'm afraid to use either one of them b/c I have nightmares about Vanessa's position in my life not being respected in case of an emergency.

Co said...


The Catholic/Jewish hospital thing is just a joke that I find funny cuz of my upbringing.... In my family, you wouldn't dream of going to Presbyterian Hospital if you could go to St. Francis, e.g. But it's just a joke, and not really how I would choose a hospital or how I think others should.

lagiulia said...

Here is where I give you a bunch of random, anecdotal information that is probably not going to be very useful. But just in case any of it is, here goes.

I come from a very different perspective from you, because of a higher-risk pregnancy and need for NICU and PICU services. I will say that Protestant Hosp. had a very organized, lovely, parent-friendly PICU, and so if that is any reflection of what they're all about as a hospital, that's good. Our pediatrician is also associated with that hosp., and we love her. BUT. I had to go to the emergency rm twice there, and was very unimpressed (wrong diagnosis one of the times that almost led to me losing an ovary). I had to take Picchi to the emergency room and was also unimpressed (we were not kept in the loop of what was happening with him). I took my childbirth class there because it was close, and it sucked. I heard from other twins parents that the NICU isn't so hot, but I don't know for sure... that's hearsay.

On the other hand, I've heard good things about the University hosp. NICU, birthing center, and nursery. Also, I had to have a surgery there and had to stay 4 nights, and the care was good. I've had to go the emergency room, and the care was efficient and fine. I recently had to have a ct-scan there, and it was quick and the people were really nice. It just seems more organized over there to me.

One more thing: I met a midwife on the street one day who delivers at Protestant, and she really dogged my pediatrician to me, both personally and professionally. I know that not everyone is a fan of our ped., but I thought it was inappropriate and just weird, since we were strangers. She was just... abrasive. She had a baby at the time who is probably now 1 or 2. I don't know if she is one of the people you're dealing with, but, well,... take it as you will.

Good luck!