Would you UC in this situation?

[Mama2mc]

Hello!

I'm new to the UC forum. This can be considered a vent with questions, I don't know, I'm upset... Lately I've found myself seriously considering UC. I originally wanted to give birth in a birthcenter, or at least have a homebirth with a midwife. But I'm having a some problems - we recently moved here, and after several weeks and tons of calls and paperwork, we finally have insurance (from DH's job). The insurance company doesn't have the birthcenter of my choice in their innetwork of providers, but I now have a short list of "approved" midwives for my prenatals and delivery. The problem is when I call to make an appointment, they ask for information I don't have yet, and don't know if I'll have. Among other things, I don't have a SSN, nor an "established address" since we're staying in a hotel due to the move being temporary (we're looking for a house, though); also, while I have some sort of medical records I don't think they'll consider them "complete", and they won't even add me to their system if I don't have the info mentioned above!

At home, I have a great doctor, and to make any type of appointment I simply need to give my name and maybe phone number, that's it! Why is it so complicated over here? I'm already halfway through my pregnancy, and I'm getting frustrated. Definitely not the best reasons, but that's why I'm considering UCing, thing is I'm afraid something might go wrong, and then? If I end up in the hospital, will they call cps or get in trouble when they learn I had little to no prenatal care? No OBGYN? or for trying to UC? On top of that, I don't want to be separated from my newborn (or my other DS), don't want unnecessary procedures or vaccines, etc. The last person I talked to called her manager several times to see if they could accept me without that info, and wasn't able to do anything for me... Is it like this with every midwife/dr? I just want to be sure my pregnancy is progressing correctly and have someone trustworthy to call if I have any problem . I had considered UC (but not UP) before all this happened, but if I do, I don't want it to be because I had to choose between UC and going to the ER at the last minute. What would you do?

Edited by Mama2mc - 5/31/11 at 11:34am

[labortrials]

Homebirth with a midwife might be an option for you.  Typically homebirthers hire Certified Professional Midwives (CPM) or Direct Entry Midwives (DEM).  Some Certified Nurse Midwives (CNM) attend home deliveries and usually have an established relationship with a physician.

I'm sorry the move is causing so many complications!  Your DH's employer should have someone on staff who can help you (somewhat) with this, especially if he's with a large firm/organization/university.  I would also contact your previous doctor ASAP and have them send you a copy of your medical file/record.  You should have this information anyway, and I'm certain any care provider will ask you for records.

I think you still have time to get a lot of this institutional crap worked out before you have your baby.  You shouldn't have to resort to UC.

[MittensKittens]

After quite a few international moves, I can say from experience that it is often possible to "blame" a lack of paperwork on the move or the previous country you lived in. Not having US papers is not the same as not having any relevant papers - it doesn't show you to be irresponsible if you just got to the country. If you can explain that you WILL have the papers, you might be able to get a midwife more easily?

Would I UC in your situation? I'd only do it if I really wanted to or was at least totally comfortable with it as a second choice. Not if I didn't want to but was doing it only for practical reasons.

Hope you figure out how to make whatever birth setting you want happen for you!

[Lynann]

I just wanted to say, for what its worth, that I moved to the US almost 3 years ago, and I did bring a copy of my medical records with me. I've never EVER been asked for them by any care provider.

I have had to repeatedly give my medical history through questionnaires with every new care provider. You can apply for a SSN if you want to which might make some of the paperwork easier, but again I've never had a issue when I don't provide it. The thing most providers want to know is that you have insurance etc.

Is it not possible to use the address of the hotel where you are currently staying until you find something more permanent.

When making an appointment by telephone I do make sure I have my insurance card (&SSN) next to me as I always get asked for the insurance info etc, then frustratingly have to give the same info all over again when I go to the actual appointment. I grew up with the NHS (UK) where all I had to do was give my name and confirm my phone number, so I can understand your frustrations. There is so much more paperwork involved here, but having complete medical records just to get prenatal care seems over the top compared to my own experiences as an Ex-Pat.

Hope you find a reasonable care provider soon.

[Mama2mc]

Thank you, labortrials! Apparently my insurance will only cover CNMs, and those I've called do seem to be in a practice along with other physicians, but I have no idea if they'll attend home deliveries, I can't seem to get past the "we need more information". Regarding my medical records, how detalied do they have to be? I asked for mine before coming here, and a couple of days before we left home, I was given a very short summary, it's kinda basic information I easily know and can give, so I'm not sure that's enough. Maybe I can try giving that and if they want more, ask what exactly they want... we were so caught up with the move I didn't pay that much attention to what they contained. I still have the SSN and address to deal with, though...

Thanks, MittenKittens! I don't know if telling them I'll have the papers later would help, I did explain we had just moved here from another country, but was still cheerfully told to "call again" when I had the information. I love the idea of UP and UC, but there's always the "what if something going wrong?", especially since I can't just pick up the phone and call my doctor, or go to a hospital I know.

Thanks for answering, Lynann. I was surprised I was asked for the medical records upfront, I did have my insurance card with me - that I expected, but not being asked so many questions and not being allowed to make an appointment! I don't know how easy it'll be to get the SSN - acording to the website, if I have no permission to work (I'm a dependant on my DH's visa) here, I can apply for a SSN only if a federal or state law requires me to provide a SSN to get a particular benefit or service. They say I can get health care without having a SSN, but apparently not having it and not having an established address was just not enough for the practices I've called.

Edited by Mama2mc - 5/31/11 at 11:55am

[ElizabethE]

I think for someone to even consider UC, this means they recognize it as a real option, and are therefore potential good candidates for it. Although it may seem like "resorting" to UC, I think that sometimes different paths have us arriving at UC and perhaps this is hers. I mean, like she said-- she had considered UC before this. It was UP she wasn't sure of,

So what would I do? If I had no concerns about my pregnancy, I may continue the remainder as a UP, and then UC. Plenty of women here are pro UPers and could tell you it's really nothing to worry about.

For fear ("something going wrong"), well... that's kind of personal and varies, but reading lots is a great tool for positive affirmation and feeling mentally prepared. Once you understand a certain amount about birth and in particular, UC, confidence can easily be gained (I didn't know I was doing a UC 'til around 6-7 months pregnant, and that was all the time I needed to prepare). Understanding more is really also key to less badness really occurring to you, as well. Calmness facilitates that.

I would not honestly worry about CPS-- especially since you don't yet even have an official address. In all seriousness though, you aren't doing anything illegal. So, unless there is some other reason that validates a CPS visit, the CPS would probably view your situation as a waste of their time. More and more people are giving birth unassisted, and many of those were unintentional. The same goes for women who've had a hard time finding prenatal care and just went without. You will most likely not be persecuted for this, because you're not alone-- there are many of people out there in similar shoes. Just keep to yourself and mind your "Ps and Qs" and you will probably fly under their (and everyone's) radar.

If you don't really want to UP or have further concerns you want to look into for this pregnancy, I am pretty sure that you can get help of some sort! Maybe not your preferred caregivers, but there are people who receive help without giving all the information people had been asking for you. What are they going to do-- not see you? Like Lyn said, use the hotel address if you have to.

I was in a similar position to you in that I unintentionally lost prenatal care when I was in the 30s of weeks pregnant. I was a little fearful of what to do but the more I learned, and grew comfortable, and felt, and waited, the more I realized that I could do the rest of the pregnancy UP. The choice I almost made was to go to a new OB and finish weekly visits there, but that came with its own set of risks and interventions. I was on medicaid at that time. In the end I decided it wouldn't be necessary.

I don't want you to feel panicked at the last minute, either. Making a conscious choice and plan now is the best thing you can do to have the right ease during childbirth-- of body, and of mind. But don't worry! I really think you're going to be okay. This situation is/seems stressful, but as soon as you just look at your options and accept the choices at hand, start making some and do the best you can to have what it is you want and need most.

[newsolarmomma2]

Here's an easy way to figure it out:

If everything went great with your insurance, and you could have a CNM or doc you liked, at least somewhat, would you choose UC?

If you would, then GO FOR IT!

If you just want prenatal care, and UC, but the insurance cannot provide you someone you like, you can always go to Planned Parenthood instead, it's no hassle and low cost. You can also get your prenatal care, then decide to UC later on. I ended up at a practice with a CNM and OB for prenatal with DS, and when my UC didn't turn out as planned, it was good to have them as back up. Just because a CNM works with a doc or in a hospital doesn't mean they aren't good, and doesn't mean they will work against you.

I wouldn't choose UC if the only reason is paperwork hassles. For sure, that stuff is irritating, but if you want a medical attendant, that's what you should have. Its all about choice- don't let insurance make it for you, KWIM? UC is a different experience than birth with a provider of any type, and isn't for everyone.

No matter what you want, you have the right to get it, and whatever you choose, I hope you have a great LnD!

Congrats on your pregnancy. We just moved back to US from Mexico a few weeks ago, so I know all about the hassles you are going through. it gets better!

[Mama2mc]

Thank you so much for your quick replies! It feels great to be able to receive advice and reassurance, especially when we don't have anyone to turn to over here. I'll definitely keep all of this in mind when we decide what to do.

[zoebird]

Also, your passport and visa number should suffice in place of SSN. When you call them again to make an appointment, simply say that you are new to the country due to your DH's job, which is providing your insurance, and that you would be happy to provide them with your visa number and pass port.

In addition, you can tell them that you do not yet have a permenent address in this country -- again due to the move -- and you can use your husband's office as an address.

At least, this is the case in most offices where I've worked and done reception and bookings (for doctors). 

[amberskyfire]

I had a UC and while I didn't lie when I said these things, you can certainly use these as lies to your advantage IF you go with UC for any reason. I had two midwives who did my prenatal care and who came to check on me and the baby the day after the birth.

If you need to go to the hospital, you can say that you were being attended by midwives, but that they are friends of yours working out-of-state so you will not divulge their names. I got no questions when I told healthcare professionals and the health department (when I applied for her SSN and birth certificate) this.

If you refuse vaccinations, first find a pediatrician who is okay with selectively vaccinating and say that you already have a pediatrician in mind at the hospital so they will not vax your baby. You can also say that you and your doctor have already agreed on an appropriate vaccination schedule and you want to have vaccinations done with him/her alone.

The trick is to seem as though you are being completely cooperative with what they want. You don't actually have to do it, just let them believe you completely agree with them and what they want, you just have already made plans elsewhere.