Shadow care- quite an investment!

[jeminijad]

So if you are planning a home birth with a midwife, and you are doing shadow care, are you finding it expensive?

I have 80/20 insurance, after a $500 deductible. My daughter, an uncomplicated vaginal birth, cost me $2k OOP after insurance, between hospital, doc & misc fees. To add this to a $3 - $5k midwife's fee seems really unmanageable... or at least, makes me question the worth.

Now, I realize a birth that goes smoothly will not have the hospital bill a the end. So I could deduct 1k of the 2k. But if it does go badly, and I transfer, I am now likely paying the hospital for more services, maybe surgery, plus every penny I've prepaid the midwife.

I rarely see this mentioned. Am I missing something?

[tracymom1]

I shadowed care with a hospital based midwife group while also receiving care from my home birth midwife (who had no OB backup). I would say that if your home birth midwife has OB backup then you really don't need to shadow care - unless you have had complications in the past that would make you of a higher risk (as I was).

We paid our $1,720 deductible - yes, that's right $1,750 and then something towards the ultrasound. It was expensive, but worth it to me because I had a life-threatening condition with my first pregnancy and wanted to make sure everything was in place in case it recurred.

[St. Margaret]

I'm doing shadow care, but it's because I have an HMO that covers everything except a $5 copay at visits. I wanted to be established with the docs (OBs and CNM) in case of transfer, too, because I darn well want the insurance to cover all of that if it happens (I would owe $50 for emergency room, something like that.... I think they even waive it if you're admitted...). So it's saving me money because insurance paid for all my labs and stuff. I have to get the Rhogam shot and I definitely wanted certain things checked in my blood work. It also helped when I had terrible sciatica and needed someone through insurance for some meds, although I used my PCP mostly.

I think if I had to pay more I'd skip it. The whole point was just to save money and pay the insurance and medical system's game, to be sure they paid me what I deserved and was paying my insurance for. Right now I'm trying to decide how to end the whole thing... to tell them I'm transferring care, to just stop making and showing up to appts... I figure they might want to know where I am... or maybe they would just forget about me? I wish. I just had to keep it far enough to keep up my labs and be sure they couldn't drop me (I wasn't sure what that would mean, as they are the only providers in my medical group-- I suppose I could have tried that and seenif the HMO would then cover the midwife! But this way they have to take me if I do have to show up at the hospital). I'm going to at least one more appt, I guess, because then I'll be within the window where they can't drop me, and I know I'll be covered if I have to show up (I lucked out and one OB is going on vacation and so I made my appt for after--- a good month instead of two weeks, lol). Hopefully I can go to that one and then forget all about them! We're paying $3500 plus supplies and a couple tests for the midwife, but we've only paid maybe $50 or so for the shadow care.

[misskira]

This is why I'm working so hard at getting my insurance company to count a midwife. I can afford the deductible and copay, or the midwife fee, but not both. And since I'm a vbac, I have a higher chance of transferring. sigh.

[MamaMonica]

Moved to Homebirth

[turnquia]

I am doing shadow care with a group of OB's and seeing homebirth midwives on the side.

We chose to do shadow care because I"m having twins. I also have a history of preterm labor and contractions. So we needed to keep an eye on thing, since twins can be a bit troublesome at times.

The double appointments can be a bit obnoxsious as with twins you already start going more often....but if we do a homebirth and transfer, then we'll work out the money somehow. It'll be worth it. Either way shadow care or not if you transfer you will have the additional fees.

[camprunner]

My midwife has a supervising OB but not OB back up. I am not planning to have shadow care this go around because I'm hoping she can bring my records if we have to transfer and they might be a little kinder rather than treat me as if I had no prenatal care. I also have no maternity insurance. Last time my midwife was not legal and I still did not do shadow even though I did have maternity insurance. That particular insurance did not state that it required me to have a relationship with a doctor inorder to be covered.

[lunarlady]

I did shadow care, and it did end up being more. My pre-natal care was one $50 co-pay for the OB, and I paid my MW $2900. But then I had a retianed placenta with PPH. My emergency transfer and subsequent hospital fee are at $1700 and counting. If I had done a hospital birth, I would have had a $1000 co-pay. So my homebirth has cost me $3600 (and counting!) more than a hospital birth would have cost. Now the insurance is going to pay part of the homebirth fee, so I should be getting a little back, but all told it is going to cost me quite a bit. If I hadn't had an emergency, it only would have cost me $50 more (the one time co-pay amount). I am SO GLAD I did the shadow care, however, because when I transfered I was very loopy due to extreme blood loss, but the hospital had a record for me including my blood type, due date, weight, insurance, etc. that made the transfer go as smoothly as possible.

I don't regret it. Even if I had known ahead of time that my birth was going to cost $5000 or more, I would say that my long-term health, my baby's long-term health, and the memories/experience for my family, including my older DD, are priceless. But I do wish I had done a higher pre-tax medical with-holding! Hindsight is 20-20.