Choosing an OB GYN or Midwife in Baltimore
A flow chart to lead you straight to me. Or not! With clarity.
OB GYN or Midwife?
I try not to give unsolicited advice to pregnant family members. But if I do sneak in one word, it’s “midwife!” Here’s a link to an article with lots of information on why choose midwifery care, whether you want to go natural or not, to give birth in a hospital or not. The only reason to go with an OB GYN in my opinion, is if you have predisposing medical factors that clearly require an MD surgeon’s attention during pregnancy and birth.
Generally speaking, midwifery care is health care, where OB GYN care is medical care. And pregnancy is usually a healthy event, rather than a medical event.
I do not currently have a list of fabulous OBs on hand, but feel free to reach out if you’d like some more resources to help you find one.
Natural or medicated birth?
Even though birth is a normal, natural, healthy event, it’s no small thing! You’re producing a new human being, after all! Committing to feeling your way through the whole process is a big deal and requires intention and preparation. Most women in the US do request epidural pain medication to block the sensation of contractions and giving birth.
But giving birth naturally is an awesome, life-changing, potentially empowering, healing, and transformative experience, which, in my opinion, is a unique and very worthwhile opportunity, both for humans giving birth and those being born.
Here is my blog post all about this topic!
Home or Hospital
If you are committed to giving birth without pain medication, your options for where to give birth open up. In Maryland, we no longer have any operating free-standing birth centers, so the choice is between home and hospital. Now, it doesn’t have to be your home - you could go over to your aunt’s house, rent an airbnb, or stay in a hotel room for a few days to give birth!
Why not give birth in a hospital? Well, hospital policies are designed like a net to catch everything that can possibly go wrong based on risk categories. As we all know, a net usually catches more than it’s designed to catch. Interventions and technology are often used to replace human touch and individualized care to save the hospital and doctors money and liability. The patient experience often ends up feeling impersonal, at best, and sometimes even traumatic.
But is home birth safe? What are the benefits? How much does it cost? Glad you asked! I have written multiple blog posts about all of these questions! Here are a couple of them:
Is homebirth a safe choice for me and my baby?
Is homebirth care worth the out-of-pocket expense?
Remember that this choice affects not only labor and delivery but also the kind of prenatal and postpartum care that you receive. Home birth care generally involves much more face-to-face time with one or two providers with whom you establish an intimate relationship over the course of your pregnancy, birth, and postpartum period.
Certified Nurse Midwife or Licensed Direct Entry Midwife, Baltimore area
If you want to give birth in the hospital with a midwife in Maryland, you will be looking for a practice of Certified Nurse Midwives (CNMs). Some OB GYN and women’s health practices include CNMs but do not guarantee that a midwife will be the one to attend your birth, but there are some practices run entirely by CNMs, with OB GYNs available if needed. I recommend Women’s Health Associates at Saint Joe’s.
If you are interested in planning a home birth in Maryland with a licensed provider, you could hire a CPM-LDEM or a CNM. CNMs have attended nursing school and trained mostly in the hospital and sometimes also in the out-of-hospital setting. There are a few CNMs who offer home birth services in the Baltimore area.
I am a Certified Professional Midwife (CPM) and Licensed Direct Entry Midwife (LDEM), which means that my training is specific to out-of-hospital birth. I chose not to attend nursing school, because most of what is taught is not applicable to midwifery care. Education and apprenticeship for CPMs is very thorough and includes nutrition, lab work, phlebotomy, emergency skills, pharmacology for midwives, IV therapy, skillful communication and counseling, and other clinical skills and knowledge needed in our profession. We refer our clients for medical care as needed and will not hesitate to facilitate transfer of care to the hospital when needed.
Reach out to me if you’d like to learn more! You can schedule a consult directly from my home birth midwifery care page or my doula services page.
For more local and online resources and options for care, education, and support during the childbearing cycle, check out my community resources page.
Frequently Asked Questions
How much does a midwife cost in Maryland?
Check to see if your insurance will cover midwifery care in the hospital and/or at home and whether they require providers be in-network. You may be able to file for a GAP exception to get out-of-network coverage for a home birth. Home birth services are paid out of pocket and may be reimbursed by insurance. Rates for home birth care in Maryland generally range from $4000-$8000. I work with a billing services who can often get insurance reimbursement for my clients.
Are midwives legal in Maryland?
Yes! Both Certified Nurse Midwives and Certified Professional Midwives (CPMs) can apply for licensure to practice legally in Maryland. The Maryland Board of Nursing currently licenses and oversees both types of provider. Licensed Direct Entry Midwives, who are CPMs with a license to practice in Maryland, attend home births and cannot acquire hospital privileges.
How much does a midwife cost in Maine?
This is a strange question. I’m answering it solely for SEO purposes, to be completely transparent. The rates for homebirth midwives in Maine look to be comparable to the rates in Maryland.
Is a midwife cheaper than an OB?
Midwifery care is cheaper for hospitals and insurance companies to cover. If you give birth with a midwife in a US hospital with insurance coverage, you probably won’t see any of the savings. Hiring a home birth midwife incurs an out-of-pocket cost that is much less than your insurance company would pay for your birth in the hospital with either type of provider. But again, that’s not savings that you will see unless you don’t have insurance.
