Going thru confinement agency or going direct to the confinement lady - which is better?

Each has its pros and cons - there are good confinement nannies from agencies as well, and you can have up to 2 replacements if you hire a nanny from PEM. For freelance confinement nannies, you really have to do your research because I've read horror stories of lousy confinement nannies who do a lousy job yet demand that they get paid in full.