Another thing to cry about...

[Lucy&Jude'sMama]

Jeez am I ever going to get a break!

So I've been coming to terms with having a hospital birth for my second. I really wanted a home birth but can't afford it and am not comfortable UCing.

What I've wanted is simple. I mainly want to be left alone to do my thing. I know they have to do fetal monitoring and I've said that I'm totally fine with the Doppler method, but I don't want to be strapped down when I get to the point where contractions are painful. I gave birth un-medicated in a hospital the 1st time and honestly being strapped up to a monitor was the worst part of it. I didn't have to be continuously strapped, but for example... I would be laboring in a tub and getting into a zone with the contractions then a nurse would come in and demand that I get out of the tub and sit on a ball for 15 minutes to be strapped to a monitor. It was horrible! Eventually I did get a nice nurse who could see that I was really trying for an un-medicated birth experience and she went and got a Doppler to use on me instead.... sadly she wasn't with me the whole time.

I think part of the problem with being strapped down is not being able to move about during contractions for those 15 minutes that go on forever, but also because I have a lot of loose skin on my tummy even when I'm fully expanded (hahaha) and so it really irritates me. I think most of us know that all those little irritations can really escalate when your in labor.

Soooo I've been told that I have to be strapped when I first come in and if THEY deem it to be safe then THEY will give me permission to have the Doppler instead of the straps but only if THEY say its ok.. Oh and if it’s not busy and not a hassle for THEM. Mmmmm.... Well I've been coming to terms with this and have been planning to go to the hospital as late as possible. Hopefully I'll be able to gage it right. With my daughter I made the mistake of going right after my water broke and was in the hospital for 20 hours + 24 hours postpartum. I thought babies just sort of fall out after your water breaks! LOL! HA! At 5 centimeters is when I started to feel the contractions and at 7 centimeters is when I got to the point where I realized "Mmmm so this is why women get drugs! "... That took 3 hours from 5-7... I'm hoping that this is around the time I'll get to the hospital. Hoping.. not counting on since I know you can't really count on anything when it comes to babies.

Ok ok so I already know I don't have to have an IV, I can walk around, I'll sneak in my own food (no food policy for laboring women), go in as late as possible, and my next plan was to leave with in 6 hours post-partum... the sooner the better. I'm even making plans on telling people not to visit me in the hospital so I can leave sooner.

Yesterday my midwife (nurse midwife who works for the hospital) tells me that the minimum stay is 12 hours. I said no biggy I'll just go against doctors orders like my mom did. Then she hits me with... Medi-cal wont pay for my birth if I go against doctors orders! WHAT?!?!? She is the midwife who delivered my daughter and I really like her. She knows what I want and wasn't trying to scare me, but was more like... "hey you need to know that this can happen."

I'm just ready to start banging my head against a wall. I started crying. I just don't understand why it has to be so hard. I feel like I'm not demanding much. I want an un-medicated birth. I want to be left alone so that I can labor in peace and get into the grove. I want the Doppler. I want to leave the hospital so I can go home and enjoy my new buddle and introduce him to his sister. I feel like I'm being back into a corner and I'm dreading this birth! I keep having horrible nightmares about it. I'm getting more and more depressed about that whole thing and I can't even celebrate this kid because I just hate that I'm being forced into things I don't want due to being poor. Of course I know that I can refuse and say no to anything and everything... but this new thing that medi-cal wont pay if I do start refusing things... I don't have the money to afford it. I would be totally screwed if medi-cal didn't pay. I've worked very hard for what I have and well... there is a reason I'm on medi-cal. I'm in California by the way. So I truly am back into a corner. I mean yes I could still potentially UC, but that's not what I want to do either so either way I look I feel like a trapped animal. The thing is I don't feel like I'm being crazy about my wants and needs? I mean I really don't think I am. I think I'm a fairly rational person and I'm willing to compromise on things.

Birth is such a huge experience. This is my last child and originally the plan was for my partner and I to wait until we had saved up enough money to afford a home birth with a midwife... well...Mmmm those plans got screwed up and now I'm where I'm at. I know I need to just suck it up and think about the overall reward of having my baby boy in my arms. I'm a person who really hates being told what to do and feeling out of control. I've always been a fighter especially when I think something isn't fair. Amazingly I don't feel out of control when I'm in labor. I only start to feel that way when people start messing with me or telling me to do something I'm not comfortable with.

Ok this is super long. If you got this far... pat on the back. I'm ready for a gigantic glass of wine! ha ha!

[MegBoz]

Originally Posted by Lucy&Jude'sMama

Then she hits me with... Medi-cal wont pay for my birth if I go against doctors orders! WHAT?!?!?

Lie lie lie! This has come up before on this board & I posted a thread on it. It seems very many HCPs believe it - so they're not deliberately lying to you, they really think it's true. But people who provide care aren't really involved in billing, so they don't know it's just a pervasive myth.

The bit of truth behind it is that if a problem arises with you or your DC, then insurance may not pay for future treatment that could have potentially been resolved if you'd followed doc's orders in the first place. But they cannot deny pmt for the birth itself because you leave AMA.

& the whole 12 hours thing may be their "policy" but we all know that lots of HCPs go against policy all the time, so maybe with enough badgering, nagging & logic you could get them agree to a compromise of maybe 9 hours?

I was GBS+ & had no time for ABTs so they wanted to monitor baby 48 hours minimum. I decided not to argue, but it really wasn't all that bad. Of course I didn't have other babies at home at the time.

Originally Posted by Lucy&Jude'sMama

I'm a person who really hates being told what to do and feeling out of control.

I'm the exact same way. I had a lot of the same stresses & feelings as you prior to my DS' birth as well. Hopefully the knowledge that the whole "go against doc's orders = insurance won't pay" is a myth will be a big load off your shoulders.

& when it comes to the monitoring, is your MW supportive of doppler? All you need is for her to back you up with the nurses. Is your partner supportive? You can have him run interference & ask for doppler & argue with the nurse if she wants EFM instead so he protects & insulates you from the argument.

At least you still have some time to come to terms with all of this. You're right - it sucks to have to fight for what we want. It sucks that a substantially more expensive hospital birth will be covered in full & HB not at all. I find that really idiotic & ridiculous. BUT - at least you have a MW you like & trust & it sounds like the hospital is fairly good comparatively (i.e. OK with no IV, they have a tub for you to labor in.)

It seems to me at this point you have to just work towards envisioning this birth as a positive experience - even if you may have some EFM (or your DP may have to do some fighting on your behalf.) That's how I felt when I found out I was GBS+ - I was devastated!!! I had spent so much time envisioning doing most of my laboring at home. I had trouble envisioning laboring peacefully in the hospital. But I realized that's what I had to do - I had to get my head around that idea & accept it as my reality.

I'm confident you'll still have a fantastic birth!

[Lucy&Jude'sMama]

Originally Posted by MegBoz

Lie lie lie! This has come up before on this board & I posted a thread on it. It seems very many HCPs believe it - so they're not deliberately lying to you, they really think it's true. But people who provide care aren't really involved in billing, so they don't know it's just a pervasive myth.

Phew! Thank you! Yeah that does take a load off. I mean I was all ready to fight and get my partner prepped to fight, but my weakness is when people start waving $ in my face. I think she truly believes what she told me. Is there anywhere that I can look this up? Just to have peace of mind that its 100% true (no offense to you of course ). I just need reassurance. Like I said $ is my weak spot and if they start talking $ to me then I'm not going to win any battles. If this truly is a lie and not something to do with CA goverment or something crazy then I'm good to go! lol! Mmmm maybe I should bring boxing gloves with me. LOL! I have a pair... Mmmmm...

[southernmommie]

[MegBoz]

Originally Posted by Lucy&Jude'sMama

Is there anywhere that I can look this up? Just to have peace of mind that its 100% true (no offense to you of course ).

Ha - totally understand, I would verify as well! Here's a thread I started on it where someone posted a link:
http://www.mothering.com/discussions...545&highlight=

Originally Posted by Lucy&Jude'sMama

Mmmm maybe I should bring boxing gloves with me. LOL! I have a pair... Mmmmm...

Ha - that reminds me of something I read. Some mama actually came with a "birth plan" written an index card that said nothing more than, "Don't F*** with me." short & simple.

[Lucy&Jude'sMama]

Ok I called Medi-Cal. They don't refuse payment because you leave AMA. That is not up to them. The provider sends a bill to Medi-Cal and they pay the bill... nothing about AMA in there. If the provider doesn't send the bill then Medi-Cal wont pay. Simple as that. But seriously why would a provider not send the bill?

The woman I spoke with suggested I ask my provider where they are getting their information and from what manual. HA!

[Lucy&Jude'sMama]

Originally Posted by MegBoz

Ha - that reminds me of something I read. Some mama actually came with a "birth plan" written an index card that said nothing more than, "Don't F*** with me." short & simple.

OMG! I love it! HA! I should do that!

[Greenlea]

Oh boy I feel for you. My 1st was in a hospital, by choice though. I went in 6 hours after my water broke and had to lie in bed for 20 minutes while they did the fetal monitoring when I first got there. Fortunately they then let me just do the doppler, but they were coming to check me every 1/2 hour! It was getting ridiculous. I'd be having a contraction, in the shower, and the nurse would want to check the heartrate for 5 minutes with the doppler.

Eventually they wanted to do another 20 minute fetal monitoring and laying in bed, not being about to move around during contractions was the worst. I hated being in bed.

I'm surprised that even though you have a CNM, they still want to do the monitoring. Usually CNM's are all for the doppler. I say just let them do the initial monitoring, like I did, and when things look good they'll be more apt to just do the doppler.

My hospital stay had to be 24 hours, not 12 or 6. But right at 24 hours we were outta there. It was the worst - nurses coming in wanting to check me and the baby while we're sleeping, telling me I couldn't sleep while holding the baby, etc. I hardly ate there cuz I am a vegetarian and there weren't many options from the cafeteria.

Needless to say we are doing a homebirth this time, I don't have insurance, so we're paying out of pocket for our midwife this time around.

[nmelanson]

I didn't know this until the end of my pregnancy, but 2nd babies often come A LOT faster than firsts... my midwives told me lots of stories during my 3 days in hospital (in a tiny, loud cramped semi-private room where roommate had constant stream of guests, so i felt like i couln't have a bm in the washroom that was on her side! Also, the room was the end of the plumbing line on our floor, so we didn't get hot water... and water came out of the shower head like little needles - how awful on engorged, tender breasts!)

[rparker]

You can refuse to do the EFM. The hospital still has to provide you with care. You have the right to refuse consent (regardless of your payment method). If it would make you feel more confident you can bring copies of ACOG guidelines for intermittent auscultation, but you have the right to refuse ANYTHING whether or not ACOG, or the hospital, or the nurse on duty, or your hcp give their blessing. You are in no way obligated (legally or morally) to accept medical treatment for you or your baby that you do not desire.

And, yeah, I totally agree with you about the EFM being painful. I had a mix of EFM and doppler with my first birth which is why I've already told my doctor that I do not consent to EFM. He's being a nice guy about it, but I'd still refuse it even if he were a jerk

Oh, and fwiw, my husband used to work as a medicaid physician in CA and his patients were constantly refusing treatment and/or leaving AMA and the state always paid for their treatment.