Recommendations for midwives in Allina network??

[lmj928]

I am in need of some recommendations for a midwife in the Allina network. Ive been going to Diamond Women Center to begin this pregnancy (my last appointment was at 6-7 weeks for an ultrasound b/c I've had 2 early miscarriages) but I also have a 2 year old who was delivered by an OB there and I wanted a more natural experience this time. I was really interested in trying the midwife/birth center that is coming to St Louis Park, until I thought of the cost. I really just can't afford it, as much as I love the idea, as they ask to prepay in cash/check up to $5,000. My insurance would cover some of this fee, but they won't be billed until AFTER the delivery, which is why the birth center asks us to prepay. And I have a $4,000 deductible anyway so I know I'm going to have to pay close to that $5,000 in the end there. But it would make it easier to put it on a credit card or have smaller payments like insurance allows me to do later on. I have, however, applied for a financial hardship thru the Allina network to help pay off a big bill I had there, so they will pretty much waive most any medical bill I encounter there next time. The hospital I delivered at last time, Abbott, is also in the network, but my OB clinic is not. I was thinking the next best thing would be to get a good midwife and deliver at Abbott again, as I'd be better prepared and experienced this time and would be able to be a better advocate for a more natural birth, and it would make the most financial sense for this midwife to be in teh Allina network as well. Anyway, sorry for the long story, but I am looking for any recommendations (or non-recommendations) for a midwife in that network. I am now 14 weeks and have still not had my first appointment since that early ultrasound, so Im tryig to make a decision very quickly... Thank you so much.

[hmbay]

I'm not sure Allina has midwives. It's been 2 years since I've needed to consider the OB side of things but at the time I delivered I think my only option with Allina was drs.

If they don't have midwives available I went to the Coon Rapids Women's Health center and saw several of the drs over various appointments. I will say I really really liked Dr Slama. He was very reasonable, knowledgeable and actually listened to my concerns and presented facts very unbiased (IMHO) when I was weighing a repeat c/s or a VBAC with my 2nd child. I would say out of the 7 drs I saw there over 3 pregnancies he was hands down the one I liked the best. there were 2 I did not care for at all and the rest were somewhere in the middle.

ETA: i was wrong. I do see a couple CNM on the list which I assume stands for certified nurse midwife but they are few and far between on the provider list:

http://www.allina.com/ac/homepgs.nsf...archFuzzy=True

[lmj928]

Thanks!

That link was so helpful! Thanks a lot for your input! I also realized Allina doesn't really *have* midwives (just a few deliver there) and I saw Abbott's C-section rates just recently and I decided I'd be better off somewhere else anyway. I'm going to start seeing North Metro Midwives, which are affiliated w/ North Memorial in Robbinsdale. I hope it goes well!!

Thanks again!

[snguyen]

Deborah Haqq, CNM in Burnsville?

I looked over the Allina list mentioned in a previous post-- does anyone have any info or opinions on Deborah Haqq, the midwife at Quello Clinic?

[homebirthing]

Honestly, if you were looking into the birth center, have you considered homebirth? There is no difference between the midwives, they are all CPM's. We carry all of the same equiptment (in case of type of things) as a birth center has. Plus, a homebirth midwife charges between 3000-4000 dollars on average, and it could be paid throughout your pregnancy and postpartum.

Just something to think about!

[snguyen]

Originally Posted by homebirthing

Plus, a homebirth midwife charges between 3000-4000 dollars on average, and it could be paid throughout your pregnancy and postpartum.

Just something to think about!

Actually, I LOVE the idea of homebirth. Here is my dilemma-- everyone talks about how much cheaper a midwife is than a conventional birth by thousands of dollars. Yes, they are cheaper overall, they are cheaper to the insurance companies, but how often are they actually cheaper out-of-pocket to the MOTHER?

I'm not including c-section costs, intervention cascades, and all that in my personal calculations here. But when my first child was born naturally at the local hospital without any complications, the grand TOTAL cost from the beginning of my pre-natal care to actual birth to postpartum was about $1500.

My pre-natal care at the local in-network Allina clinic? 100% covered. Well baby check-ups afterward? 100% covered. The $1500 was our out-of-pocket share of the multi-thousand dollar uneventful delivery and 2-day stay at the hospital. To me, THAT is my cost of the pregnancy and birth, and we paid it off $100/month with no problems. Until more insurance companies start really covering midwife and homebirth costs better, the $3000-4000 cost of a midwife effectively doubles and almost triples my expenses, no matter how much I would prefer them. (And I do!)

So is it possible to see any type of midwife just for pre-natal care, which would be 100% covered by my insurance like before? Because honestly, unassisted childbirth has a strong appeal for me now. The cost of the actual birth would be just a fraction of even that $1500 from my hospital bill. So if I could see an in-network CNM (thus my question about Haqq above) or other type of covered midwife for all my pre-natals, I wouldn't be bound by a comprehensive fee to having her at the actual birth, right?

I'm just trying to process all of this, it's all so ridiculously complicated! I haven't made any concrete decisions here by a long shot.

[snguyen]

Homebirthing-- I just realized you were probably directing your post to the OP and not me. Sorry! However, this is a several-months-old thread I resurrected if you look at all the post dates, and would still be interested in any other comments or insights you would have for my current post. (Or anyone else for that matter!)

[MidwifeErika]

Originally Posted by snguyen

Actually, I LOVE the idea of homebirth. Here is my dilemma-- everyone talks about how much cheaper a midwife is than a conventional birth by thousands of dollars. Yes, they are cheaper overall, they are cheaper to the insurance companies, but how often are they actually cheaper out-of-pocket to the MOTHER?

I'm not including c-section costs, intervention cascades, and all that in my personal calculations here. But when my first child was born naturally at the local hospital without any complications, the grand TOTAL cost from the beginning of my pre-natal care to actual birth to postpartum was about $1500.

For a very significant portion of our population it is cheaper to see a homebirth midwife, even with insurance. Nearly every family I know has high-deductibles plans that then cover at 80/20 after that. You can call your local hospital and find out what their delivery fee is, the facility fee, the newborn nursery fees, and your doctor/midwife's office to find out the average cost of prenatal visits and see very quickly that even with a normal, spontaneous, vaginal birth it can cost more than 10-15K.

When insurance covers homebirth fees, then it ends up being even cheaper for a mother. Many of us take credit card payments via paypal, so the parents could make payments on it in small amounts. I know that I have a sliding fee scale (I am assuming others do as well) for women who fall at 200% or less of the poverty guidelines. Many of us also accept barter (I don't know of an OB office that will accept chickens as part of the payment, but I do!), so I think most of us try very hard to make our care accessible to women who would otherwise have a hard time affording a midwife.

[snguyen]

Originally Posted by MidwifeErika

For a very significant portion of our population it is cheaper to see a homebirth midwife, even with insurance. Nearly every family I know has high-deductibles plans that then cover at 80/20 after that. You can call your local hospital and find out what their delivery fee is, the facility fee, the newborn nursery fees, and your doctor/midwife's office to find out the average cost of prenatal visits and see very quickly that even with a normal, spontaneous, vaginal birth it can cost more than 10-15K.

When insurance covers homebirth fees, then it ends up being even cheaper for a mother...

Wow, which insurance companies cover a home birth? Mine (BCBS) says flat out on the maternity coverage page, "NOT COVERED: health care professional charges for deliveries in the home."

I'll offer myself up here as a measuring stick for anyone else researching their choices.

Given that BCBS won't cover the actual home delivery, my plan covers "health care professional services for prenatal care / hospital or facility charges for prenatal care" at 100% in-network. For out-of-network providers it is still 100%, plus I pay any charges billed to me that exceed the "Allowed Amount." I have no idea what that amount is.

Health care professional services for delivery in a hospital/facility and post-partum care is 80% after deductible in-network, 60% out-of-network plus those charges above the Allowed Amount again.

So as an example, Erika, what would I be paying out-of-pocket to you if you were my midwife? We have a $2000 deductible and are living on one school teacher's salary--certainly above the poverty line but below a typical white-collar salary.

Thanks for your input!

[homebirthing]

I didn't see that this was an old thread!

I agree with Erika's 80/20. For many, homebirth is cheaper then a non interventive hospital birth. Add anything to it (which a lot do) and it only goes up. For me, a hospital birth would have been free.

I chose to birth at home.

It just depends on what matters to you. For me, my pregnancy,birth and postpartum experiences aren't based on money. (That comes out snotty and it isn't supposed to.)

And FWIW, we went through a bankruptcy during my last pregnancy.

[MidwifeErika]

Originally Posted by snguyen

Wow, which insurance companies cover a home birth? Mine (BCBS) says flat out on the maternity coverage page, "NOT COVERED: health care professional charges for deliveries in the home."

I'll offer myself up here as a measuring stick for anyone else researching their choices.

Given that BCBS won't cover the actual home delivery, my plan covers "health care professional services for prenatal care / hospital or facility charges for prenatal care" at 100% in-network. For out-of-network providers it is still 100%, plus I pay any charges billed to me that exceed the "Allowed Amount." I have no idea what that amount is.

Health care professional services for delivery in a hospital/facility and post-partum care is 80% after deductible in-network, 60% out-of-network plus those charges above the Allowed Amount again.

So as an example, Erika, what would I be paying out-of-pocket to you if you were my midwife? We have a $2000 deductible and are living on one school teacher's salary--certainly above the poverty line but below a typical white-collar salary.

Thanks for your input!

Quite a few insurance plans pay for midwives. It varies by company as well as plan. I do recommend that even if you do not plan to have a homebirth, you should write to your insurance company and complain that they do not cover homebirth services even though it would save them money and outcomes are excellent. It may improve their services in the future if they hear it from enough people!

If you have a $2000 deductible and 80/20 after that for the birth at the hospital, I would almost certainly be less out-of-pocket than what you would pay the hospital. That is even if your insurance did not cover a single penny towards your homebirth or prenatal care.

I can't tell you exactly where you would fall on the sliding fee scale as I would need to know your exact gross household income and how many people are in your family, but if you are curious and want to pm me with that info, I can tell you exactly. Or if you pm me your email address, I can send you the table that shows the different discount levels for income levels. I don't mind sharing the info, it just feels a little strange asking you to share your exact household income on a public forum