​I am often asked by those considering my midwifery services if I take insurance.  I do not and I would like to share why.

One factor in my decision to not accept insurance is that insurance does not accept me.  Insurance often covers the services of Certified Nurse Midwives but not Certified Professional Midwives, or they may cover a hospital birth but not a home birth.  It is extremely rare for a health insurance company to cover my services.


​Money from insurance companies does not come without strings attached.  I do not want to be told who I can serve and who I cannot.  I do not want to have to do certain labs or procedures to meet the requirements of an insurance company.  I operate from the principle of fully informed consent and I am concerned that insurance requirements would intefere with informed consent. I am also concerned that meeting insurance requirements may mean unecessary tests or procedures, or that the insurance company may disagree with what my client and I agree is necessary to provide the best care.

When my oldest son had his wisdom teeth removed, the insurance company decided that my son only needed one dose of anesthesia so I had to cover the second dose of anesthesia out of pocket.  I was appalled that the insurance company was using a "one size fits all" guideline for medical procedures instead of taking into account individual diferences such as metabolism which would affect how long the anesthesia remained effective, or that my son's teeth had to be broken up to be removed instead of just pulled out.  The insurance company decided they knew more than my son's medical provider.  I have dealt with health insurance restrictions in my own health care.  I had to take the "cheaper" medications and get proof (labs in my case) that they were not effective for me before I could take the more expensive medication my doctor wanted to prescribe that worked best for me.  My health insurance policy dictated my health care, instead of my provider's expertise.  

Not accepting health insurance gives me the freedom to provide the best possible care I can for my clients without delays or having my clients jump through hoops.  I can use my best judgement without navigating restrictions or requirements.  Not accepting health insurance ensures my clients know I am working solely for them, not an insurance company.  Not accepting health insurance gives me the freedom to use all my knowledge and skills to provide the best care I possibly can for every client I serve. 

Recently I have been able to attend some trainings on perinatal mental health issues.  I have learned a lot in those trainings, but I wanted more than an "academic" understanding of what a mom may experience, I wanted an up close and intimate understanding.

Brooke Shields wrote about her personal experience with postpartum depression in her book Down Came the Rain.  The book was first published in 2005, and helped focus attention on something that was more on the back burner in maternity care.

As I read Brooke's book,  I could see all the red flags that indicated she was at increased risk of postpartum depression.  It was her intimate description of her feelings and thoughts during this time of her life that really touched my heart.  Her emotional journey into depression was raw and heartrending to read.  It brought the abstract learning I have to life.

Mental health issues can come up at anytime during pregnancy and the postpartum period.  It is now recognized that postpartum mental health issues can occur up to a year after birth.  In my practice, I do my best to support Moms in all aspects of pregnancy, birth and postpartum.  I watch for red flags such as overtiredness bordering on exhaustion, concerning mood fluctuations , lack of appetite and other possible signs that may indicate Mom is heading towards having issues.  If I have concerns, I will discuss them and may suggest my client have an evaluation with a mental health professional who specializes in postpartum mental health issues.  There are so many tools and ways to manage postpartum depression that just don't let mothers cope, but help them thrive that there is no reason to suffer.  In an ideal world, no mother would experience postpartum mental health issues, but if I notice something concerning, I will support my client and ensure she gets the help she needs.