What would you do?

[mamatogirls]

I am feeling a little freaked out right now. When I became pregnant I knew money would be tight to pay for a homebirth but was confident that we would be able to do it. Well my husband has been having issues with 2-3 day work weeks which was causing us to struggle, now he is laid off and more than likely no work for the winter. He is an ironworker and work has been bad but getting worse. He can't even be sent out of state b/c there is no work out of state either(he did this my last pregnancy). If he doen't get work then there is no way we can pay for this midwife. Unemployment here only pays max $360/week. My midwife is charging $3800 and wanted $500/month which I told her there is no way we can do that. We were originally going to pay her with our tax refund(which I don't even know what that amount is going to be) but now we will probably need our refund just to pay our mortgage and bills. I have an appt with her on Thurs and was thinking of telling her that I will not be able to afford her.

We have insurance but I don't want a hospital birth and having 3 c-sections already, no hospital will let me have a vbac. How am I supposed to pay for this now? This midwife will not barter. I know there are less expensive midwifes around but she seemed to be the match for me and only lives 15 minutes away. I am only 14 weeks right now so I have some time. I hate our crappy economy

[sweetpea_119]

I would lay it out for her & see what her response is first. Then if she isn't willing/able to work with you, maybe start calling other local midwives to see if they'll work with you & fit your style well enough.

I had two c/s before I had a homebirth & I can tell you that a homebirth would be worth a less than *perfect* fit midwife!

[Happiestever]

I would look into the other midwives.
When I was planning my vbac I looked all over the place trying to find the perfect match. Well I thought I found her (1 hour drive each way), until at 38 weeks she dropped me from care because my babe was going to be born 17.5 months after my son (the whole 18 months between for vbac rec ) She became uncomfrtable with the situation and it's risk right before I was due.
She transfered me to my second choice (who was 15 min away), but I felt that midwife was rather burnt out on vbac's, so I went to see yet another mw. The third midwife was 30 minutes away and was willing to cut her price for me for several reasons
1) I was not prepared to have such a drastic change in providers and their fees, with no choice in the matter
2) She wanted to help me out because she really believes in vbac
3) SHe wanted me to have choices

While she may have not originally been my perfect match it turned out wonderfully.

[laughingfox]

Talk to your midwife on Thursday about what's going on. She might be willing to work out a payment arrangement with you, or if she works on a sliding fee scale, she might adjust your level of payment because of your new circumstances.

I also agree with the previous posters' suggestion to check out the other midwives. It can't hurt to see what their policies and fees are like.

Good luck!

[moonglowmama]

I would fully investigate my options for getting coverage with my insurance.

With each of our births (this will be our 4th) they have said they don't cover homebirth, but we protested loudly and often, with studies and the law to back us up, and they ended up covering every time at 80 or 85%. In our case, they allow CNM care, but not at home. We have had to tell them that they do not have the right to dictate our place of birth, since it is legal to birth at home. We're in the middle of this battle again- you'd think they'd learn after dealing with us so many times about this same issue.

[magrat]

What a hard situation. Another thing to consider is how much will be covered if you end up needing to transfer to a hospital for a C/S. If you'll have to pay another large amount on top of your midwife fee, I'd seriously think about what that will do to your family financially. As much as I can understand your desire for a VBAC and homebirth, ruining yourselves financially to do it is just not a good thing for your family.

[at_the_hip]

If you have insurance coverage, I would personally consider doing a mw attended hospital birth. I did this with #2 because that was what we could afford...you just have to manage your birth a little more and it won't be as comfortable as home, granted. If that is what you can do right now, then it is OK to just do the best you can! Plenty of women have had good low-intervention hospital births with a mw.

[MidwifeErika]

Originally Posted by at_the_hip

If you have insurance coverage, I would personally consider doing a mw attended hospital birth. I did this with #2 because that was what we could afford...you just have to manage your birth a little more and it won't be as comfortable as home, granted. If that is what you can do right now, then it is OK to just do the best you can! Plenty of women have had good low-intervention hospital births with a mw.

Generally speaking, it is very, very difficult to find a MW or Dr in the hospital who will attend a VBA3C though.

[MidwifeErika]

I think your best option is to lay it all out for the midwife. Discuss your income and what you will actually be able to pay. See if she can work something out with you. If not, then search for a different midwife who may be able to work with your situation.

[at_the_hip]

Originally Posted by MidwifeErika

Generally speaking, it is very, very difficult to find a MW or Dr in the hospital who will attend a VBA3C though.

My apologies - I missed that detail somehow. I'm not familiar with that situation personally but it sounds like MidwifeErika has some good advice.
kind regards,

[mamatogirls]

Thanks for all the advice. I was trying to figure out if I should go to my appt on Thurs b/c is will be the 3rd visit and I have only paid her $200 so far. I didn't want her to be upset if I couldn't pay her anything and then have to drop her. I know she doesn't do a sliding scale, just a flat fee for everyone, she laid that out my first visit. I did originally tell her that the fee would be hard for us but she didn't say anything then. I will just call other midwives in the area and see if they can work with me if she won't, and continue with the trying for insurance to pay still, I'll keep trying.

[MidwifeErika]

Call her on the phone if you are concerned about doing another appointment. Open communication is so important if you want to get things sorted out and figured out. I hope you are able to find a solution that works out perfectly!

[mamatogirls]

I can't believe it but I found a solution. I heard about a woman who was D.O. but also CPM and did homebirths. I found her website and gave her a call. She just called me back and said her normal fee is $3500 but she would drop it to $2500. She is an out of network provider for my insurance(being a D.O.) and my insurance would cover half the fee, the rest she would barter. My husband used to have a tree service and she said they could use some tree trimming, etc at her house, but anything leftover, if any, she would make payment arrangments. She can also order the 20 week ultrasound for me, which was another worry of mine. I didn't know there were Dr's out there that did homebirths. I am so excited, I meet her next week. What a relief!

[maotmsmi]

Edited by maotmsmi - 5/21/11 at 12:54pm

[firewoman]

Originally Posted by mamatogirls

I can't believe it but I found a solution. I heard about a woman who was D.O. but also CPM and did homebirths. I found her website and gave her a call. She just called me back and said her normal fee is $3500 but she would drop it to $2500. She is an out of network provider for my insurance(being a D.O.) and my insurance would cover half the fee, the rest she would barter. My husband used to have a tree service and she said they could use some tree trimming, etc at her house, but anything leftover, if any, she would make payment arrangments. She can also order the 20 week ultrasound for me, which was another worry of mine. I didn't know there were Dr's out there that did homebirths. I am so excited, I meet her next week. What a relief!

How awesome! What wonderful news!

[at_the_hip]

That's great news, mama!!

[babycatcher12]

Awesome news! Glad you get to have the birth you want!