Homebirth but did prenatal under CNM or OB for insurance?

[JF1212]

I just found out I'm pregnant. I'm a former birth doula who's adamant about homebirth, but my husband's concerned about money and gently suggested that I consider doing my prenatal under someone that insurance would cover.

Has anyone planned a homebirth from the start, but did their prenatal under a CNM or OB for the coverage, and then switched to a homebirth midwife? What was your experience?

I'm not sure how much money that would save or how much of a pain it is to meet with a provider who doesn't work in your ideal environment...

[cristeen]

Call around - I know most of the midwives I've talked to still charge full price if you transfer care in the 2nd or 3rd trimester. Really, the bulk of the price is for the labor anyway.

And the later you transfer, the less chance you have to get comfortable with the MW. Not to mention the less time you have to pay off the fee - around here most MWs will give you a payment plan... if that's broken up over 9 months, each payment it going to be a lot smaller than if it's broken up over 2-3 months.

[srlpenny]

I switched to HB at 35 weeks and still paid the full fee last time. This time I am doing complimentary prenatal care with a CNM at a hospital the whole time and insurance is covering that, but I am still paying the full CPM fee.
Most I've heard of have one "all-inclusive" fee, not charge by the visit etc. Plus, there is a lot to be said for getting to know the person/people who will be at your birth throughout the pregnancy, not just for delivery. And the advantages of homebirth midwifery care are not just at delivery, but at many things that could be normal, but may not be interpreted as such by an overzealous OB. Whatever you do, make sure ALL your care providers are on your wavelength. Make Sense?

[Peony]

I've found a MW twice late in my pg, I still had to pay the full fee with the 1st. With DS's pg, every single MW but one, still charged the full fee regardless of when I started care. I ended up goign with the one that gave a reduced rate, not for that reason, but for others.

[ShwarmaQueen]

I think it's really important to establish a bond with your MW. Maybe you could work out a payment arrangement with whomever you decide to go with?

[GoldmanBaby09]

I knew I wanted a homebirth since before I even got pregnant and have been seeing a CPM the whole pregnancy. Agitated that my insurance will pay nothing for my midwife (and we paid $3300 out of pocket), I also got concurrent with a CNM at an OB practice so that at least my insurance company would have to pay for labs and ultrasounds and whatnot. I wish I had just stuck with my mw. The CNM was nice enough, but it was still too OB oriented for my taste and their office policies were terrible. The CNM wasn't doing anything at my prenatals that my mw wasn't doing already. It is also hard to keep your homebirth plans to yourself when you start getting questions about a hospital delivery. My mom had 5 homebirths, and I'm pretty sure for her fourth, she was able to find a mw that would reduce the rate because she got prenatal care at Kaiser in California. So, ask around, but honestly, if home birth is what you want, your homebirth midwife is your best bet. And all those office co-pays add up too!

[JW1021]

Could you not find a CNM that does homebirth? That's what I did, and in my opinion, she was pretty accommodating to my birth plan, and hands off unless necessary. I'm sure if you searched around, you could find what you are looking for.

[srlpenny]

JW - I don't know where the OP lives, but in a lot of places, like where I live in NY, having a CNM for a home birth is not an option, there are none in the area. Mostly due to OBs being unwilling to sign the agreements needed by law, etc.
Just pointing out that different places have different circumstances.

[dylan1984]

I'm doing just that - I guess I'm lucky that my MW has delivered my best friend's three kids and has no problem reducing the cost to reflect only doing delivery and post partum. We've also had some time for bonding as she was treating me when I miscarried last summer. Still there are some nerves as I have never been able to visit her on a regular basis, but I still think this alternative is better than delivering with my OB. I live 7 hours away, so will be traveling to her (delivering at my parent's house) the week before I am due - hopefully meeting with her once when I go home for 4th of July. My insurance only covers the OB, so I'm going to one here who I could really care less about - guess its mostly just the comfort of getting the labs run and hearing a heartbeat at the appointments, he really hasn't done much else for me as far as I can tell and I always just think "thank GOONESS he's not delivering my baby".