Okay, I'm 12 weeks along with #2 after a totally fabulous pregnancy and natural delivery of DD. Healthy me, no risk factors, saw all CNMs with #1, etc. I hired a doula before I even called CNM or OBs! Want a natural birth, prefer the local birth center but I had understood that they didn't take my insurance (yesterday ins. said that they pay birth centers and that previous issues must have been due to poor billing codes - yay!) We are on military Tricare insurance which can be a bit...traditional? As in 1960s traditional, not earth mama traditional. DH is supportive of natural everything but wants major proximity to a hospital. Like preferably down the hall. :)
So our doula recommended several local OBs who are on board with natural mamas doing their thing and not interventioning us to death. First appt with one (one of 4 female OBs at the practice, all who are supposedly supportive) was sched. for yesterday. I got the appt. time wrong and we arrive 20 minutes late. The OB only has time to chat for a few minute before she has to get across town to the other hospital. I don't really have any pressing questions; ask for support hose rx, and as we leave, she hands me paperwork for blood work (only had a + urine test at my primary care doc at 5 weeks), including genetic screening (CF and two other ethnic-allied ones) and an ultrasound (I wasn't interested in doppler or an u/s). I tell her that my ins. does not cover 1st trimester ultrasounds and they are all kinda shocked:
"Well, how do they expect us to diagnose pregnancy?"
"Well, with my first, they do a blood test..."
"But that doesn't rule out ectopic pregnancies!"
"...and a vaginal/external exam to confirm physical symptoms"
"Well, we can't treat you (maybe they didn't say treat) without confirming the pregnancy!"
"Uhh, I'll call the insurance to double-check."
We call, and turns out Tricare doesn't cover ANY u/s. Including the 19-20w big one. Which we had the first time around because we were at a military medical center. Fine, we can cross that bridge in a few months when it's time to count heart chambers and compare limb length. I think the 19-20 is pretty freaking important and we'll pay out of pocket if we can't finagle a billing code.
Anyway, so they re-code it as high risk so Tricare will approve it. FIne. But I'm starting to wonder if this is the right place for me. The real appt is resched for Monday (13w), so I'll get a better vibe then and actual answers to my care & birth questions. But I looked up ectopic info, and I have zero symptoms, zero risk factors, and the risk is basically nil after 12w anyway. And I clearly have a nice normal uterine swell. So I'm not feeling so warm and fuzzy there. And I don't really want to "waste" my potential only insurance finagling to get this first u/s which I don't need. Also, insurance definitely doesn't cover genetic screening with no risk factors, which I'm glad I asked them about on the phone.
So are they pushing every $$$ option on me or just being cautious? Am I so skewed from a hands-off military approach that this feels a bit weird? I'm worried because at 13w and with Christmas then a vacation to Hawaii and a business trip taking us until 17w, there isn't much time to try to meet a new doc and see if they're a better fit! The "best" midwife around would need to get approved by insurance, which may or may not happen before I'm due. Input welcome!