Getting nervous of risking out. What will happen if I have no health insurance.

[4 in 2005]

I am currently planning a homebirth.   Since about 35 weeks (and I will be 40 weeks on Thursday) I have been making my Midwife nervous.   Since 36 weeks she has said, maybe you will go into labor before the next appointment so we don't have to worry.  (My youngest was born at 35 weeks and 100% ready so she was not worried about him not being ready if he came on his own at 36-37 weeks.  

Every week my blood pressure is borderline.  I have had a trace of protein in my urine at 35 weeks only since then there is no hint of protein.   Now I am having severe swelling.   I am gaining/losing 4-10lbs a DAY!   That is making my already nervous midwife even more nervous.  The good thing is my blood pressure is actually coming DOWN instead of going up.   It has been 130-135 over 87-90.   Now it has been as low as 110/70!   However averaging 125/80 for the last week.   I even went to 2 stores to check my blood pressure today because I was worried maybe my blood pressure cuff was not working right.   I got similar results at both stores as I was getting at home.   So I feel like what I have been getting at home is accurate.  

The main issue is that my midwife wants me to go to the ER if I get a headache.  Well I have had one all day today.   I haven't gone in because my blood pressure is fine and my swelling is actually gone today.  My thought is that last time I was pregnant and had symptoms worse than this and the ER brushed me off and I had insurance.  That time I had a severe headache, I was severely swollen and my blood pressure was up.   I forget how high but it was really high.  Also I was having blurred vision.   They told me it wasn't pregnancy related and gave me morphine and was going to send me home even though my homebirth midwife sent me in.   However while they were writing up my discharge papers I went into labor and was sent to Labor and Delivery.  I was only 35 weeks along that time so going home to deliver was not an option even though my blood pressure had dropped.  

So what happens if my midwife says go in because of the headache or swelling.   I live in a state where homebirth midwives are not recognized so they can't send the records over with me.  I know that if I transfer during labor they have to deal with me, because of federal law but what if I go in not in labor but needing treatment or induced?  

I am getting so nervous.   I am also hoping that if I go to the University Hospital (which my Midwife says is a good place to transfer to) I can ask for and get an attending that was my favorite OB.   I never dreamed of having a homebirth when I had her as an OB because she was so wonderful.  However after she went from my local hospital to the University hospital I was told I could see her but they didn't take my insurance and I would have to pay 100% out of pocket at my first appointment to see her.   So that was why I had a CNMW for the next birth.  When I was told I couldn't have the CNMW for the next baby because I refused to let her induce at 37 weeks (like her supervising OB wanted) I switched to homebirth.  

I figure I am wanting to much to have my favorite OB.   However because they insisted for 100% payment up front I was wondering what they will do if I come in as a transfer. 

I know this is a novel and I am thankful you took the time to read my post.  I am just so worried about this and I know that worrying about it will only increase the chance I will risk out.   Of course I have worried about risking out of homebirth this entire pregnancy and yet here I am almost 40 weeks.  I qualify for medicaid but they have denied me 3 times for BS reasons.   Like first my proof of pregnancy was from a clinic not an OB.  So then I got a proof of pregnancy from an OB (at cost to me), then they said I didn't supply proof of assets.  They wanted proof of my private health insurance that I DON'T Have and denied me because I didn't have proof of something that doesn't exist.  This time they denied me because my proof of pregnancy is too old.   So I am just out of luck.   If I end up at the ER I can try to apply a 4th time but I still show up as having no insurance when I go in and no assurance I will be approved for medicaid when I try again.

[XanaduMama]

Well, first of all I think you should just stop worrying about the what-ifs. I'm sure it's not helping your BP, and nothing productive can come of it anyway, kwim? If you have to go in, you have to go, and you'll deal with the results afterward.

But the second thing I would say is that, if I were you (and obviously this is your decision to make), I would start trying to get things moving. Pre-e is nothing to mess with, and you already know that it's (also) in your interest to be in labor if you need to show up at the ER. Plus a nervous MW is not conducive to a calm mama or a peaceful birth. What do you thInk about trying some things ( membrane stripping, maybe castor oil or cohosh, certainly loading up on EPO and dtd as much as you can, nipple stimulation, acupuncture, etc)? Now I'm usually one to say wait until your body/baby is ready--I'm averse to all attempts to force things--but in your situation it's something to consider.

[4 in 2005]

Yeah actually asking the question allowed me to mostly let it go.   I am trying not to worry because I know that only makes things worse.  I told my midwife my blood pressure tends to be higher in her office because I think I am worried about her saying I have protein or something else.  

The midwife is always calm, and has a relaxing tone, but I can tell she is nervous.   She says things like well maybe we will just have a baby this week so we don't have to worry about things changing.   Then she has me weighing in 2x a day and taking my blood pressure 3x a day.  That alone is enough to make me worry.  

I know pre-e is nothing to play with.  That was why I went in with my last child.   I wasn't taking any chances.  

I have tried accupressure, nipple stimulation, walking and sex.   Midwife doesn't want to sweep my membranes yet but I am going to ask her about that Thursday, which is my EDD.   I don't want to try Castor oil or cohash until at least 40 weeks.  I haven't done EPO because it is my understand that just helps to prepare your cervix and I have been known to walk around at 4cm and 85% effaced for up to 4 weeks before.   However I might have to think about that.  

I am not a big fan of rushing baby so I like methods that only work if baby is ready, like walking and sex.   However I added the accupressure and nipple stimulation this week. 

Thanks for the reply.   I did decide today and this one choice makes feel like I have a little choice back, that if I do have to risk out to go to the University hospital.  (Cause if it is an extremely urgent transfer I will go to the nearest hospital.)   The reason is the midwife said that is where she has seen is best for natural childbirth even for her clients that risk out.  Also I will try to get my former OB but if not oh well.  I am thinking she is the reason they have gotten so great for natural childbirth.  She was awesome in terms of supporting natural child birth and got my local hospital to make great strides in being natural childbirth friendly but since she has left that has started to change. So going to the hospital she is at I think will be a good thing. Also being the university hospital they will likely have a sliding scale.

[lookingforaname]

Be very careful, Mama - you sound like you do have a lot of symptoms, and you don't want to risk your health or baby's health just because of insurance or paperwork.  I'd trust my midwife, and call her about how you're doing, rather than trusting people on the internet!

[4 in 2005]

She knows.... She hasn't suggested I go in yet.   However she is really watching me.   Like I said she has me weighing myself to monitor the weight gain/loss from water retention.  (Which for a second day I have no swelling YAY!!)   I was just wondering if anyone had any clue how I might get treated having no insurance.  My biggest fear is her saying I need to go and an ER turning me away because of no insurance.   

That terrifies me.   Because I do trust my midwife.  I trust if she says I need to go that I need to go no matter what an OB thinks.  Does that make sense.  Because she is the one that has been seeing me. 

[CorpusMom]

I don't know where you are but, as far as I know an ER cannot turn you away for lack of insurance.

[4 in 2005]

Corpus Mom--- Thanks I needed to hear that.   Around here there are signs that say if you are in labor they can't turn you away but I thought they couldn't turn anyone that needed emergency care away. 

[lilikoi]

My sister is a L&D nurse  and she said there is no way they can turn you away. If you are in labor, they have to take you in. I also wanted to tell you that I had to apply for medicaid and they denied me 3 times with a bunch of BS reasons. I got really mad and wrote them a certified letter with all the dates and copies of all documents they sent me. I told they they were endangering my health and my unborn child's health by denying me care. About 4 days later I received an envelope in the mail with medicaid cards. I ended up having a HB and did not need to use it, but I wanted to have it in case of a transfer. Hope you are doing well. 

[4 in 2005]

Thanks for the reply.  It was a non issue.  I had a fast but complication free (although intense) waterbirth last night.  I am so glad to have that weight taken off my shoulders.  My DF has insurance for the baby so no worries about insurance for him. THANKFULLY!

[XanaduMama]

Yay, congrats mama! So glad to hear it went well!

[lilikoi]

That's wonderful news!

[lookingforaname]

Congrats!  Enjoy your sweet baby!