What to do when IMs are scarce???

I'm 20 weeks and currently live in Sydney but we are moving to the Blue Mountains in the next 2 months. I've been trying to find an independent midwife so that I can birth at home... but because I'm halfway already and bub is due right around New Year, so far no one I've contacted is available. :cry:

I've managed to find one, Sydney-based MW who is willing to travel to the mountains and support a homebirth provided I'm "low risk". The thing is, she is an 'eligible' MW and as such, collaborates with an OB at Westmead hospital. My understanding of this arrangement means that the OB gets the over-riding say over whether I can birth at home. Last pregnancy I was borderline for gestational diabetes and, despite perfectly managing my blood sugars throughout the entire third trimester, and delivering a perfect-for-dates sized bub (3kg), my private OB tried to frighten and then force me into an induction. So I'm pretty wary of decisions of risk being made using standard norms rather than taking into account my individual case (not to mention preferences!)

I don't know what to do... go with the available MW where there's a chance I can home-birth but risk having to again birth at hospital (and at that, a hospital that's 50-odd km's from where we'll be living).

What would you do? Go with one of the local public hospitals and hire a doula? Or go with the Sydney-based MW?

Thanks for your thoughts,

I would book the IM and depending on what happens, if you need to transfer to a hospital, see if you can transfer to a closer one with her acting as your doula. Otherwise, you're definitely heading for a hospital birth anyway. Irrespective of what hospital you end up in, I always recommend having an IM with you - not just for the birth but for postnatal care as well.

When planning a homebirth, I believe in having 3 birth plans. 1 for birthing at home and 2 for transferring (1 for VB and 1 for CS). If you plan for the possible outcomes then you will feel more empowered no matter where you birth. (btw, I believe in having 2 birth plans for hospital births as well)

Thanks Lions & Bears. The IM is clear upfront that the hospital birth must be at westmead, so transfer to another hospital wouldn't be an option with her. But I hear what you're saying.. if I don't go with her, then I'm definitely looking at a hospital birth, so at least this way I would have a chance at a home birth. It hadn't occurred to me to do 3 birth plans... it's a great idea, thanks.

The reason I suggest 3 birth plans is because I think they should be no more than 1 page each. With DS1, we hadnt had the birth plan meeting before labour started, so when it looked like it would be a C/S, our IM quickly wrote down a birthplan for us, made copies and had them signed off by the consultant. When we changed to a VB, we forgot to do a birth plan. So things like episiotomy and delayed cord clamping werent communicated to the doctors. I didnt have an epi and bub's cord was cut immediately, but the doctor was ready to give me an epi if she thought it necessary and I wouldnt have known about it until afterwards.

A page on care for baby after birth is a good idea as well, so if bub ever needs to go to SCN or NICU, the staff know what your wishes are, e.g.. no formula or whatever. That page goes with bub.

I would try contacting another IM. My m/w and my second m/w are both out your way and travelled to me (upper north shore). That's what you get when your EDD is 1 Jan!

If you want to PM me I can give you their details and put you in touch with their monthly meet up group. You'd be more than welcome and it wouldn't hurt to appeal in person. ;) They are part of a group practice so hopefully could work something out between the six of them.
Unfortunately, demand is high in Sydney and we need more IMs! If only the govt would provide a bit more stability in their ability to work and baseless complaints by hospitals against them be chucked out. :(

I was under the impression that although the midwife is 'eligible' you can choose not to claim Medicare rebates and then the collaboration is not necessary.
Others may have more information but you may want to discuss this with your preferred midwife.

is there a Maternity Coalition branch that may have names of other IMs? I don't know what I'd do in your shoes but I hope you can find a care provider you're happy with. Good luck x

Do not go with MM! she will not be the care provider you want!!

Keep looking you will find the right midwife :) you may also find when you are in the new "community" others might be able to help with names

Thanks everyone for your comments... they are SO helpful.

Jennifer, I have PMd you. Thanks for the offer.

Eutra_phalia, that's exactly what I was worried about! I thought it was a bit odd that I couldn't find out that information up-front without having to pay a hefty fee for an initial consultation. Don't get me wrong, I completely support MWs being paid for their time and understand there's a cost involved with meeting each one, but I would have liked more transparency about the 'OB collaboration' before paying a lot of money. I am totally open to a lay or unregistered MW... I'll look into finding a maternity coalition today.

Glorious, thanks. Contrasting her approach/ style/ marketing etc with many of the other IMs I've spoken with so far, she seems very different. Much more clinical, even entrepreneurial. I already had a few doubts about going with her (more of a gut feel.. in addition to the concerns about the OB collaboration). Thanks again for your input.

xxxx

check this out http://www.maternitycoalition.org.au...index.php?id=3

Just an update for everyone... I tried another IM today who came highly recommended to me from a local doula, only she hadn't responded to my email that I sent last week. When I caught her by phone she said she had at first thought she couldn't fit me in, but when she double checked the EDD of her other clients, she can do it. We are meeting a fortnight from now to get to know each other :dance:

She specifically offers home birth AND it seems she's available over the Xmas/ New Year period. Now just to cross fingers that we are a great match for each other.

Thanks again wise women.. :grouphug:

Great news Amber, I'm glad things are looking up!

Just a word of warning about an unregistered or lay midwife, if you did decide to look down that route. There is a large variance in their skills, experience and up to date knowledge. Some may be recently de-registered for lack of agreement with national policy and remain very skilled and up to date, but others may be de-registered for lack of skills or may never had had any formal qualifications. A lay midwife may not have the skills, equipment or backup to respond in an emergency so please consider very carefully if this was something you choose to look into. Having said that your current IM contact sounds great and I'm sure you'll have a wonderful birth :)

Good news! Hope you like her. That time period was awful for me in finding an IM too.