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Insurance/Midwife ?s WWYD

post #1 of 6
Thread Starter 
So I'm approaching the end of my first trimester, and having given myself til after the New Year and a move to midwife hunt, I'm feeling like it's time. I want to hear the heartbeat and just get that reassurance that we're right on track.

My issue is this:
I have Medicaid which does cover standard midwife care with midwives who do hospital births. Medicaid will cover nothing for homebirth here in my state. Supposedly DPs insurance will cover me sometime soon? We have no idea what it will cover in the way of maternity care or when it will "kick in" but we're hoping that it will cover visits with a homebirth midwife.

HB MWs are a rare breed around my area; I think there are two in town, both of whom are very Christian (which is fine, but we're not, not married, and I may feel inhibited, I am not modest, and I am pagan). There are a couple more hb mws within two hour's drive. In the best situation, we want a UC, but would like the reassurance of having a backup hb midwife. That would be really nice just to know we have an option besides going to the hospital if we feel like we want a professional assistant.

So for now, as far as we know, if we do find an hb midwife, we will be paying everything out of pocket, whereas we could be getting prenatals at the "regular" midwife office with a minimal Medicaid copay.

Would you see the medicaid/hospital midwife in the interim, hoping a hb midwife will be available later in the pregnancy and that the insurance will go through? Or would you try to get the hb midwife from the beginning, paying the minimum out of pocket til we can figure out the ins? Because the longer we wait, the less likely it might be to get an hb mw here.

If we pay all that $ out of pocket and then do a UC, I'm going to feel really ripped off. I don't think that a lot of the prenatal care is necessary and really just want someone "on call" at the very end.

I'm just concerned that if I start with the reg mw, then I'll be more likely to be pushed into unnecessary tests, lying about our intention to hospital birth or have no backup except hospital transfer in the final moments.

Sigh. Any feedback?
post #2 of 6
Can't you at least meet with the hospital midwives and see if there's a mesh personality / philosophy-wise with one of them? They give free consults, right?

You never know until you meet people what they're really going to be like. You may find someone truly wonderful for prenatal care that insurance will cover, and then accidentally not make it in time to the hospital for your birth. Might not even be an accident--maybe your delivery will go quickly! And if you do have to xfer to hospital, at least you'd have a relationship with someone there. I dunno if that's a solution, but I'd keep my options open in your situation. You should probably consult with the hb midwives as well...you may not like either of them!

ETA: and you can always say no to tests. HB midwives sometimes like to push tests as well--you just never know--so you might have to say no to them as well.
post #3 of 6
Does Medicaid cover a licensed midwife doing HB or is your state still illegal for midwifery? Here, Medicaid will cover a HB MW, but she has to be licensed and you have to apply for an open card for the 3rd trimester, but the MW still does prenatals all throughout. I am a Christian and student Midwife and would never hold anything against a family. I would meet with them to just get the feel if you mesh or have the same ideals for how you want your hands-off delivery. You are free to labor/deliver how you want.

Personally, I wouldn't want to switch providers at the end because then you just may have inhibitions from of not developing a relationship with the MW. Just my take on it. Good luck mama!
post #4 of 6
Yeah, I'm with everyone else in the interview stance. You never know who you may meet and know you want at your birth. I interviewed 9 different midwives and one I looked at her website and didn't get a "good feel", and she looked very inexperienced, and kinda "out there", so I scratched her off the list. Then, she was recommended to me to interview her, I did, and she ended up being the one I chose. It's hard not to prejudge a person based on looks, religion, facility, etc...but you never know who you are going to connect with.

I would be going and getting prenatal care, just because I would want to hear the baby, you can always switch caregivers if you find a hb mw.

Also, with us, if we were to have a hospital birth, with insurance, it would still cost us around 4K total after insurance pays their part. A HB would only be around 2.5K, with no insurance coverage, so it's still cheaper to go to them.

Another option, I don't know what state you live in, but if it is small, maybe consider crossing the state border to birth? I know this happens a lot especially in states where HB is not legal. I'm in Texas, so it's kinda out of the question for us, the nearest state border is about 5 hr away, and that's to LA. Happy Birthing!
post #5 of 6
You should probably find out exactly what DP's insurance will cover/when/etc before you try to make this decision as it seems the finances are a big factor for you.

As I just read in another thread dealing with HB and insurance there are HBMW's who bill insurance without notating that it was done at home. So medicaid may cover it but the bearucrat whom you spoke with doesn't really understand the system. Now finding a midwife in your area that takes medicaid could be vert difficult. It is impossible in my area. If DS's insurance will cover you at some point you need to know what point and speak with a midwife about how she could work with insurance in this case.

My first midwife is a JESUS LOVER, and I am Jewish, but we didn't have any issues over religion. Like above posters have said there is a personal/trust relationship built with a midwife.
post #6 of 6
Thread Starter 
Quote:
Originally Posted by Lilyoftheincas13 View Post
Can't you at least meet with the hospital midwives and see if there's a mesh personality / philosophy-wise with one of them? They give free consults, right?

You never know until you meet people what they're really going to be like. You may find someone truly wonderful for prenatal care that insurance will cover, and then accidentally not make it in time to the hospital for your birth. Might not even be an accident--maybe your delivery will go quickly! And if you do have to xfer to hospital, at least you'd have a relationship with someone there. I dunno if that's a solution, but I'd keep my options open in your situation. You should probably consult with the hb midwives as well...you may not like either of them!

ETA: and you can always say no to tests. HB midwives sometimes like to push tests as well--you just never know--so you might have to say no to them as well.
Well, for dd I had care with a local hospital birthing midwife center, and I really liked all the midwives, particularly my primary who was there just in time to catch my super fast baby at the hossy. I just wish that same gal could come to my house! Looking back now, I realize they were a bit medical, but I guess it's easy to get desensitized after 3000 babies.

I know I'd feel fine going back to those ladies for prenatals. I think I may just give them a call and see if I can drop in to hear the heartbeat but be very upfront about wanting a homebirth and see if there's anyone they can recommend or if they'll even be supportive of us laboring here til whoops! We are literally a block from the hospital--I don't know what the laws are, but maybe they'd be willing to be on call or just meet me at the hospital if I needed stitches or something.

Sorry if I seemed snobby about the difference in religion thing, I just was imagining myself holding back from nudity or breast stimulation or whatnot because of feeling like I might be immodest or whatever! Like that mattered to me the first time; I didn't even care that I was naked around all these people I didn't know.
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