Question from expectant mother

[catholic74]

I thought this might be the best place to ask my question.

My husband and I are expecting our 4th child.  We are very excited and want to have our baby at home like we did with the last one.  Unfortunately, the reality is that we can't afford a midwife.  We are barely making ends meet as it is.   I considered have an unassisted  birth and while I still haven't ruled out that choice, I'm not very enthusiatic about it either.  My husband is military and so the birth would be covered completely by the military, of course, but we sure don't want to give birth in a hospital.  Still, I had a idea.  Is is possible for a midwife to reduce her fee if I hired her just for the birth and not for the pre-natal visits?  I could easily get my pre-natal care at the local miltary hospital for free and keep my midwife up to date and perhaps we could afford to have her come for the birth and perhaps after care?  Has anyone every done this?  Is this scenario completely out of the ordinary?   Any advice would help.

Oh and I haven't found a local midwife yet....I'm still hunting...we have since moved or I'd just ask my former midwife. It's still very early in my pregnancy and I have time to figure it all out, but I like to get a head start on these things.  I just want to get a feel for whether my idea is even a realistic possiblility.

Thanks for any help you can give me! 

[RubyOrganique]

I am not a midwife, but am becoming a childbirth educator.I had a homebirth and would say from my own personal experience that the prenatals with my midwife were equally as important to me as the birth. Along with managing the clinical aspect, it was the time she and I got to know each other. My respect for her grew as we spent time together and she got to know me: my limits, my desires, my commitment, my fears, etc. My birth was quite long and I often attribute what I consider a very successful and satisfying birth experience to her knowing how best to motivate me, keep me focused and prop me up when I started to doubt myself (along with having superb clinical skill, of course.)  I'm not discounting your idea at all and I totally get the financial part of it. If I did it that way, I would make sure that time was spent with the care provider to develop trust and knowledge of each other prior to the big day.

Have a blessed and transformative birth experience no matter where you end up.

[love4bob]

 

Where are you stationed? Is there any chance you could find a CNM who would do a home birth? Here I have found a CNM who does home births, and Tricare has told me that she would be covered. I will have to switch to Standard and pay the copay since she is not in network, but it is better than the full fee at least. I know many midwives will do payment plans if you can't pay the full amount. Some also do a sliding scale sometimes based on your income. Also, I recognize your SN from AWW.  Congrats on your pregnancy!

[catholic74]

Thanks for the congrats!  I am stationed at Fort Benning. I've inquired and from what I've learned, there just aren't any CNM's that do homebirths.  I intend to ask Tricare if they will cover a homebirth for me, but I don't hold out any hopes. 

I understand that having a trusted relationship with your midwife is special and can be important to the birth, and ideally, I would prefer that, but if we can't afford it, we can't afford it, ya know?   I'm blessed with very quick births. In fact, my last midwife didn't make it for the actual birth and my husband and I caught the baby ourselves. My midwife showed up about 30 minutes later and took care of the cord, clean up, paper work, etc.....I liked having her take over all the "afterwards" stuff.   It's a tough situation to be in and it makes me frustrated with Tricare. I feel like I don't have any birthing choices. I feel like the military has one cookie cutter way of birthing and all us military wives are supposed to line up and follow directions......sorry if I'm ranting a little.....it's the frustration! 

[Crispie]

As a former pregnant woman and mama...I can relate to your situation on many levels. I've totally been there financially! Cutting out 6-8 months of prenatals for just the birth at the end of the pregnancy seems so logical. Let insurance foot the bill for prenatals and just have a midwife for the birth that's over in a day. (usually). But, as a student midwife, I know firsthand the real work is in the birth and afterwards, and the mothers that have come on board later can often be more work than those that started care early on. Prenatals are all geared toward maintaining a pregnancy optimal for birth. We are much more diligent in making sure nutrition is balanced, all the supplies needed for birth are at hand...we also look at body work which can help optimize birth...details often not seen or taken care of by other health care professionals...we usually have to see late oncoming clients more than we would other clients, to help build and establish relationship with them, the unborn and them with us as well. Things that they may blow off as non important, or less important, may be very important to us, and the way we may handle certain lab results etc may be a totally different protocol than they would, resulting in an imminent birth that has not been "set up" over 6-8 months of care the way we would normally care for our pregnant mamas and prepare them for a birth with our practice. And...the liability and responsibility we carry is ultimately the same, as well as time, supplies etc. That being said, we also are willing to accept payments and work with mothers on the financial aspect of pregnancy and birth.

I know this isn't the same for everyone everywhere, just thought I would add a different perspective on the situation and hopefully help you feel encouraged to call around and ask! I used to feel the same way you do, and it's taken me being a student to fully understand how it all works. The midwife I am a student under was (of course) my own midwife once, long before I became her student. I believe her words to me during my first contact phone call were "I'd hate to see you not have a homebirth because of your insurance not covering, let's get together and see what we can work out..." Perhaps you can find someone willing to do the same, or offer a military discount, even bartering is not unheard of! I just want to encourage you to not give up, keep asking around and be open!

I am one who also believes it is possible to have a nice hospital birth if that truly is your only option. I hope you don't have to go that route, only because you really want a home birth..but know that nice hospital births do happen too!

I hope you are able to find the path to a birth that makes your heart sing with joy! Best wishes mama!

[JessicaE]

I would find a midwife in your area, then contact her to talk through the possibilities. What skills do you (or your husband) have that you could barter? Since you're newly pregnant, could you pay a small amount each paycheck from now until your delivery? There are lots of options, the midwife should be able to help you figure something out. As a doula and CBE, I am always open to barter but I find many people are just not that interested in putting in the effort.

[la mamita]

I did this for a different situation: due to school in a different state & time abroad, I was only in the same area as my midwife for the birth and maybe one or two prenatal visits, although we did stay in contact during my pregnancy. I used regular hospital OB/midwives for prenatal care, which was covered by my insurance. The midwives' fee was the same, even though the midwives were basically just there for the birth and post-partum visits. You can ask, but don't count on it being any cheaper.

[catholic74]

Thanks for all the answers. I can't imagine what my husband and I would have to barter!  It's got me thinking....hmmmm......well, I homeschool.....I could tutor or teach a class....my husband is amazing with computers, perhaps we might be lucky enough to get a midwife who needs her computer fixed!  :)   If I do find a local midwife, I'll ask her and see what she says.....I suppose you never know.

[Crispie]

We LOVE mamas willing to do normal housework, laundry, wash windows, sweeping, vacuuming...all those types of jobs for our home office. Sometimes there are fliers to type up, filing and other such chores. I'd venture to say, even cleaning out the car and vacuuming it would be a welcome offer! And all/most of those would be kid/baby friendly. It just depends on what you are comfortable offering. It never hurts to ask!

[catholic74]

Now, I can do housework really well and I was a receptionist for a major electric company before I married so filing and organizing are second nature to me as well...........:)