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In many countries around the world, midwives are the entry-point to pregnancy care.  Our midwifery training tells us that pregnancy and birth is a normal and healthy state. We don’t consider pregnancy to be a disease, though there are complications of pregnancy that can arise at any time and might require intervention and the expert care of our physician colleagues.  This kind of care pathway feels right – start by assuming that all is well, initiate care with midwives who focus on the whole person and who are highly trained to identify variations from normal, and create integrated systems through which midwives can refer patients to higher levels of care (such as doctors who specialize in Obstetrics or Maternal Fetal Medicine) as the situation warrants.  This idea drives our general philosophy at Oula – everyone needs a midwife, and some people need a doctor too.  But how do you find a midwife, and how do you know if midwifery care is right for you? Let’s think about the questions to ask yourself as you consider midwifery care for your pregnancy. If you’re confused about midwifery, check out our blog What actually is a midwife?


Where do midwives work?

In New York City, midwives provide care to pregnant people in a variety of settings – in hospitals, at birthing centers, and at home.  Your search for a midwife in NYC should start with a personal exploration about the birth setting that feels right for you.  Each midwife or midwifery practice generally offers one birth setting to their patients.  So, if you want a home birth you’ll want to look for a home birth midwife, or if you want a hospital birth, you will look for midwives who attend births at hospitals.  This is the first choice you’ll want to make as you search for a midwife – where do I want to have my baby, and therefore, what kind of midwife am I looking for? Are you looking for a solo practitioner or a group practice?  In NYC, there are midwives in solo practice – meaning that you would see the same midwife for every prenatal visit and that midwife would attend your birth.  The downside of this model is that these midwives tend to accept very small numbers of patients so it can be hard to get on their roster. These solo or small group practices often cost more out of pocket (see below for more information about the costs of midwifery care). Midwives in larger group practice take larger volumes of patients, and are more likely to be in-network with insurance companies which can mean lower costs for care.  This also means that you may meet several midwives over the course of your prenatal care and birth.


How to know if a midwife is qualified?

In New York state, midwives are required to be licensed by the state to provide care.  In order to obtain a license, midwives are required to prove that they have completed masters-level training in midwifery and passed a national certifying exam. In New York, not all licensed midwives are trained as nurses, though the majority of midwives have a degree in nursing before they train as midwives. As you’re meeting midwives, you can ask about their licensure, their training, and their experience.


Is midwifery care covered by my insurance?

Many insurance carriers cover care with midwives, though not all midwives are covered as “in-network” providers.  This means that you may find large variation in out-of-pocket costs from one midwifery practice to another.  Cost is another important question you need to ask yourself as you choose your prenatal provider – can I afford to pay for some or all of my care out of pocket or do I need to utilize the full benefits of my health insurance?  If your midwife is an “in-network” provider with your insurance, your insurance company or the midwifery practice can offer you clear details about what your out-of-pocket costs are likely to be (costs might include co-pays at prenatal care visits or an out-of-pocket portion until you meet your annual deductible, for example).  If your midwife is “out of network”, you might pay more out of pocket to have your care with that midwife.  Cost is an important consideration for so many birthing families.  At Oula, we take real pride in offering in-network care with many insurance companies, even medicaid! We offer each of our patients a one-on-one encounter with our billing specialist to ensure that you have a clear understanding of the costs of your care from early in your conversations with Oula.


How do I choose a midwife?

To help you understand what people do and don’t like about their pregnancy and birth care, we encourage you to talk to the people in your life who have had babies.  These insights might help you to formulate some ideas and questions about the kind of provider that you’re looking for. Provider referrals and recommendations are a great place to start, but not everyone has the same goals for their birth so remember that what worked for your cousin or a friend might not be the right choice for you.  Then you need to think strategically about where you want to have your baby. Do you want to deliver at a specific hospital or birth center?  Be sure to look into a midwife’s facility affiliation, because midwives can’t attend births at any hospital, just at the hospital or birth center where they have established admitting privileges.  Next, look for reviews and testimonials from patients on internet search engines – this can be a great way to get a flavor for the style of care that a midwife might offer, and to see how satisfied clients are with the care they received. You can also check professional organizations for lists of practicing midwives in an area – https://www.nycmidwives.org/find-a-midwife or https://www.midwife.org/

You might find that a practice has a social media presence or a website that can help you to understand their offerings, or they might have a regular “info session” event for prospective clients. There are lots of ways to learn about midwives in your community!


Meeting a midwife in NYC

At Oula, we make it easy for you to learn about our team.  Start with our gorgeous website, dig into our amazing patient portal, sign up for one of our monthly open house events (or if you can’t attend in person, watch a recording on our YouTube channel), check out our social media @oulahealth. But don’t forget to see what we’re most proud of – the patient testimonials and reviews that will tell you first hand what it feels like to be a patient at Oula.


What questions do I need to consider when searching for a midwife?

  • Where do you want to have your baby – in a hospital, at a birthing center, or at home? Which hospital are you interested in giving birth in?
    • Oula is a hospital-based practice.  We attend births at Mount Sinai West hospital in Manhattan, which is a hospital that has valued midwifery care and allowed midwives to have admitting privileges for fifty years! Mount Sinai West has policies that support our style of care and we are well integrated into their systems.  We’re also proud to say that MSW has among the lowest intervention rates in any private hospital in NYC.
  • How will I pay for care?  Is the midwife in-network with my insurance?  What can I expect my out of pocket costs to be? Can I afford to pay some portion of my care out-of-pocket if the midwife is not in network?
    • Oula is in-network with many large insurers, even medicaid!  We have a dedicated billing specialist who can examine your plan and help you to anticipate your out of pocket costs.
  • How do I find a midwife?
    • Luckily, you’ve come to the right place! If you’re ready to book with our midwives, you can go ahead and book an appointment now. We’re so excited to start the pregnancy journey with you.

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