Latest News

 1/28/09

 Dear Homestyle Midwifery families, childbearing families whocurrently seek Homestyle Midwifery care, and all members of the  community who have generously offeredHomestyle your time, material donations, advice, encouragement and love.

I hope this email finds you and your family well and that 2009brings you well-being and joy.

We are sad to report that, in spite of all our best efforts overthe last year and a half, and the incredible support of Homestyle families andour community, Homestyle Midwifery, as we have known it, will not be reborn

Homestyle Midwifery’s mission was to meet the needs ofchildbearing families for compassionate, unhurried, 24/7 midwifery care in ahospital, self-determination for their childbirth experience and a personalrelationship with their care provider. By the time we were laid off in August 2007 we had provided that kind ofcare to over 400 families. In October 2006 we received a certificate of honorfrom Mayor Gavin Newsom, and in 2007 we were voted “Best Place to Have a Baby”by San Francisco magazine.

The current health care system presented insurmountable obstaclesto a midwife-directed private practice. To

recap: in April 2007 Homestyle was informed by the new CPMCadministration that our program would be laid off as of August 2007. Theofficial reason was that the mission of the St Luke’s Women’s Center was toprovide basic care to the medically underserved. Because Homestyle providedsignificantly more care than what is considered basic care, Homestyle  did not fit within that definedmission. From that moment on, we spent hundreds of hours to try and saveHomestyle by rebirthing it as a private practice. Perhaps we could title thestory of that attempt: Let No Stone Be Left Unturned.

One of our first tasks was to fulfill the requirement of obtainingmalpractice insurance. We thought this would be easy because we had animpeccable record  - none of the Homestyle midwives had ever been sued.After four months of begging, pleading, working with several differentinsurance brokers and invoking legal advocacy we were bereft of malpracticeinsurance. NO reputable malpractice company would give our consulting physiciana policy because … Why? Explain this to me again…Homestyle was a midwife-ownednot a physician- owned practice.

Just as it seemed as though this hurdle could be overcome via acomplex legal arrangement whereby our consulting physician would officially ownthe practice, in October 07 CPMC announced the impending closure of St Luke’shospital. Now we no longer had a hospital in which to practice!

Homestyle joined the impassioned powerful community and citywidenine month SUCCESSFUL! effort to keep St Luke’s open.  By July 08 we wereback to negotiating to have the consulting MD own Homestyle, although it wasnot clear that this was going to work. Meanwhile the remaining Homestylemidwives (besides Yeshi) took other jobs to feed their families.

In the fall of 08 a new problem emerged that was the finaldeciding factor in eclipsing the dream of Homestyle Midwifery as a privatepractice at St. Luke’s’ Hospital.

Until August 07 Homestyle clients’ insurance paid the hospital aset global obstetric fee for our services (the same fee as clients receivingmore basic care). St Luke’s paid for Homestyle’s malpractice insurance,administrative costs and midwives’ salaries; i.e., it subsidized the provisionof Homestyle care even though it was more costly than the basic care reimbursedby insurance companies.  Our business plan for Homestyle rebirthed as anindependent private practice projected 1) a huge malpractice premium and 2) theneed to account for the elements of Homestyle care which were core to ourmission, unhurried time spent with our clients, one to one labor support andservices such as home visits, that were not reimbursable by insurancecompanies. It became clear that in order to be economically viable we would beforced to charge our clients a significant fee over and above their insurancecoverage.

As we discussed bringing Homestyle back to St. Luke’s we now hadto confront the fact that, if we were successful, it would mean a two-tiersystem of care at St.Luke’s: Homestyle care for women who could pay for it,andthe Women’s Center Midwifery Care (which wonderful as it is, does not yetinclude a guarantee of a midwife at your birth, nor, because of the largenumber of families the midwives take care of, the unhurried time and attentionthat characterized Homestyle) for those who could not. This two-track systemwas antithetical to our vision and commitment that Homestyle Midwifery careshould be available to everyone regardless of their ability to pay.

During this last year and a half we also explored bringingHomestyle to other hospitals.  However UCSF does not have a big enoughLabor and Delivery unit to accommodate another practice, SFGH does not acceptprivately insured patients, and CPMC has no MDs who are willing to be theconsulting physician for Homestyle care.

We want to thank you with all our hearts for your belief inthe value of Homestyle Midwifery and for all the incredible support wereceived from you, our community, to make the attempt to continue to provideHomestyle care.

May all the efforts we have made together bear fruit so thatchildbearing families everywhere may receive the compassionate, unhurried,empowering, gentle and safe care that they deserve as they birth theirchildren.

With Love and Gratitude

Yeshi,

Director of Homestyle Midwifery

  There is a large community of very satisfied former Homestyle parentsas well as many wonderful midwives, doulas, nurses, doctors, lactation consultants, alternative health care providers who have organized themselves into a Homestyle Midwifery Community Collective. This group is dedicated to keeping the kind of care that Homestyle Midwifery embodies alive as an option for childbearing families in the SF Bay Area. If you are interested inbeing part of that group please contact hmfriends@gmail.com