Phoenix Arizona Birth Centers: A Review & My Personal Experience
Updated: Oct 4, 2021
There are only two birth centers that come up when you Google "Phoenix Birth Centers", and I have now worked with both. The differences between them are mind boggling, so much so that I felt it necessary to write this blog outlining my experience under the care of each and giving an honest review of their practices.
My hope is that this article will save others the stress, mistreatment, shaming, time, and money that I had endured and spent. I have not had my baby yet, so I will be updating this blog as time goes on until baby Lux is born. Again, my focus will be on my prenatal care throughout this pregnancy.
Blossom Birth Center
My journey with Blossom began last year when I was pregnant with my first baby. I've spent a lot of time working in the health field and have come to appreciate the route of least intervention when it comes to health and wellbeing. With pregnancy, that means letting the body do what nature intended, and a birth center seemed like the best option for that.
Another reason why I wanted to work with a birth center was because they have a better track record of respecting mommas' autonomy and ability to make informed decisions. Hospital staff tend to be poor at communicating the nuances of every decision you need to make and often just make decisions for you, which I find to be completely unethical in many situations, but necessary in others such as in life saving interventions.
Now, for those mommas' that do opt for the conventional hospital route, I'm not discounting its potential value. Some women need to go that route for medical reasons, and other women may simply feel safer working with an OBGYN. For me, I have a lot of negative experiences in hospital care and would prefer to avoid it if possible. If I do end up needing to birth in a hospital because of complications down the road, then I'll be prepared with a doula and other advocates for my care.
Collectively, these were some of the foundations through which Blossom initially appealed to me. They advertise empowering women to be in control of their birth experience, giving personalized care to women with respect and dignity, allowing the birthing process to happen naturally within their facility, and having an OBGYN on staff to provide additional support if needed, such as heading up any hospital birth that ends up being required.
Unfortunately, I didn't have an empowering or dignified experience at Blossom.
One of the biggest issues I have with many folks in the medical field is that they are led by their ego. They think their credentials or experience grants them superiority over those they work with, which ultimately limits their ability to provide truly patient-centered care. I try to avoid working with these types as much as possible unless an emergency warrants it. We often forget that we hire our medical professionals due to the authoritarian nature of standard allopathic medicine.
Most of the staff at Blossom was respectful, but their two primary midwives (Mary and Erin) fit into this egoic category. The most common time it showed was when I would ask questions about my care, almost as if they interpreted my inquisitive nature as an attack on their knowledge and experience. The reality was that I just wanted to understand the rationale for decisions regarding my care.
Nothing degrades patient trust like “do what you’re told"
I'm not passive when it comes to my life. I ask questions. I seek understanding. Birth centers are meant to be patient-directed care, and yet I was scolded, shamed, and treated as a burden whenever I'd try to start directing my care. It did not at all seem like their goal was to help me make informed decisions, but rather to dictate to me what they believed was in my best interest.
And I'm not the only person who has been treated this way. I encourage you to look at other reviews too (Yelp, Facebook, Google, etc.). Some individuals had experiences similar to mine, while others had wonderful experiences opposite of me. I can only assume that these latter folks were the types who quietly do what they're told, don't ask many questions, regularly praise the midwives (stroke their egos), and don't have much background in medicine, scientific research, or integrative healthcare.
It's easy to think that birth centers in general are a great option if you are familiar with only the allopathic model of care, or have experienced only hospital births. If Blossom seems like a good fit for you, then I truly hope you have the birthing experience you've wished for. Many women have. For me, they weren't a good fit.
Aside from an incongruity of personalities, Blossom has some questionable billing practices that warrant caution. Even among women who had a great birthing experience, the financial side of things left a bad taste in their mouth per other reviews. I had a similar experience.
The overall financial agreement seems simple: You pay $5000 maximum for all prenatal care and the birth itself. Where things become complicated is when you want to understand how health insurance is involved, primarily because Blossom wants you to prepay the $5000 by 32 weeks gestation, or else they terminate your care.
Alex (my husband) and I had one hell of a time trying to understand how they could be contracted with our health insurance and expect payment for services not yet rendered. After spending a couple hours on the phone with their financial person, as well as in person with the owner (Mary), it became clear that they worked on a "good faith" basis where you prepay the amount, they bill your insurance at time of birth, and then you are refunded what insurance pays (if anything, assuming you have met your deductible).
We didn't have an issue with this billing practice because the up-front collection is simply a precaution against someone receiving prenatal care, giving birth in their facility, and then disregarding the bill for whatever reason. They are a small practice, so I can appreciate their desire to take precautions.
Where the issues popped up for us was (1) when we inquired about all of this and (2) when we left the practice. As mentioned, we talked to Blossom's billing person over the phone and to the head midwife / owner (Mary) in person. Their financial agreement was not easily understood when it came to how insurance was involved, and Mary did not take kindly to us trying to understand the nuances of their billing practices. She even told us several times that we could just go somewhere else if we didn't trust them.
Then, when they terminated care with us at 23 weeks gestation, they did not refund any money that we had prepaid towards the global cost. Rather, they said they would bill insurance for all the prenatal visits we had with them and keep what we owed. First, why would they not just do this from the get-go and bill insurance at services rendered? Second, this was despite them assuring us that they would refund the money if we ended up needing a hospital birth or other care for whatever reason.
Blossom wanted us to operate on a good faith basis with trust between us, so we did, and we ended up getting betrayed. Kudos, Blossom, for not giving the same trust you demand of your clients nor keeping your word in good faith.
This issue was compounded by the fact that they would be billing our insurance for all the "problem visits" I had, rather than just billing us for the standard of prenatal care. I put the term in quotes because it's Blossom's terminology, not mine, and because there was no medical "problem" that these visits addressed.
Blossom is huge on monitoring serum progesterone levels throughout pregnancy, which is likely due to he head midwife / owner (Mary) being an advocate of the Creighton Model FertilityCare System (CrMS) and Natural Procreative (NaPro) technology.
The CrMS and NaPro technologies are the developments of the Saint Paul VI Institute for the Study of Human Reproduction, founded by Thomas Hilgers, MD in 1985. Basically, they are based on empowering women to take charge of their body by charting various hormonal biomarkers throughout the menstrual cycle and using such information to help inform decisions regarding fertility and other reproductive disorders.
This method of reproductive care came about because the Catholic Church is strongly against assisted reproductive technologies like in vitro fertilization (IVF) and intrauterine insemination (IUI), claiming they are morally unacceptable acts against God. So, obviously this Catholic man (Dr. Hilgers) saw an opportunity to help women constrained by religious beliefs. Notably, the head midwife / owner (Mary) is catholic, so her embracement of this system makes sense.
Now, I became pregnant by working with my phenomenal reproductive endocrinologist to diagnosis my fertility problems and implement medicated strategies to overcome them. You can read about this part of my journey here. Part of that involved looking at hormones throughout my menstrual cycle, similar to what NaPro does, so I'm certainly not against charting and becoming more aware of your own biology. In fact, I support it.
What I don't support is unscientific prenatal care.
The big overarching problem with NaPro is that there is very limited credible evidence to support its efficacy. Most of the evidence comes from decades of observation by the Pope Paul VI Institute, observations that have not been peer-reviewed, are prone to confounding, and amount to no more than aggregated anecdotes (the plural of which is not data).
Of the few peer-reviewed studies available (published in 2008, 2012, and 2021), all are authored by the same family physician from the University of Utah, Dr. Joseph Stanford, and all are simply observational studies in which infertile couples undergo care with NaPro and have their pregnancy and birth outcomes reported. There is no way of isolating the effect of NaPro and determining that it was the cause of any observed outcomes, an intrinsic limitation of observational research.
More importantly, none of these studies deal with the whole of pregnancy, just conception. My issue with Blossom was that I had "problem visits" to monitor my progesterone without any good reason for why it mattered. Mary just wanted me to line-up with a chart she got from the Pope Paul VI Institute to reduce my risk of preterm labor. I had no indication that I was at risk of preterm labor (such as a previous preterm birth, short cervix, multiple pregnancy, etc.). So treating me based off her chart that has ample literature to refute it's validity, was akin to treating me based on an energy reading.
I was using vaginal progesterone during my first trimester, at the request of my reproductive endocrinologist, because progesterone levels matter greatly after conception to prevent miscarriage, particularly in women with a history of recurrent miscarriages, PCOS, and luteal phase defect (like me).
But, he said that I could come off the progesterone around 14 weeks gestation because the risk of miscarriage by that time is much lower and the placenta should be pumping out plenty of progesterone to support fetal growth. After that (i.e., second and third trimesters), there isn't a strong basis for using exogenous progesterone to prevent preterm labor or stillbirth.