Cost of 3 prenatals?

[RJones1204]

I am 10wks pregnant with baby #4. We are moving when I am 23wks or so. I haven't started any prenatals with a MW yet. I just found one, that is seems like we will mesh. We live in Denver and the COL is higher out here. So it didn't shock me when a homebirth is $3-4K. That includes prenatals, the birth, and the postpartum care. So I expected to pay a nice chunk of change for the 3months of prenatals I will need until we move back to Ohio. The MW that seems like a perfect fit for me, charges $350 non refundable deposit and $150 for each prenatal. Due upfront. I understand her fees and why she has it set up the way she does, especially since I will only be temperary. But I did the math and that would $800 for 3 prenatals. I can't wrap my brain around that. In Ohio I paid $1,500 for all the care and services my MW provided. Does that seem like a lot for 3 prenatal visits?

Would you consider doing your own prenatal care for the few months until you moved (ie eating excellent, keeping records for weight, blood pressure, baby's heartrate with a rented doppler, your heart weight, and using urine strips for protein/ sugar)? I think the services a MW can provide are very valuable.....but I am asking myself if I might just be capable of keeping my body and health in check and if I can recognize any danger signs....

[joycnm]

I'm a home birth midwife and I struggle with this issue.  It doesn't seem fair to charge a large amount for a healthy woman for a few prenatal visits.  But, what I have come to terms with is that you are not paying by the hour.  You are paying for the expertise and knowledge that might be able to see a problem before it becomes a major problem.  All this being said, if I was pregnant and going to change care providers before the age of viability (26-27 weeks) I probably would do the prenatal care myself as you describe.  Prior to the age of viability, nothing can really be done to "save" your baby by intervening in some way. If you are expecting a home birth, you probably already have the mindset that pregnancy and birth is a normal function of nature and having a healthy lifestyle will do more for your baby than a midwife listening to a heartbeat and taking your blood pressure.  What I say to my patients is, "If the worst happens, you have a stillborn baby, which choice do you feel most comfortable with?"  If you are the type of person that feels that every ultrasound, every dopple fetal heart beat, every test will ensure a healthy baby, you need to get yourself to a midwife soon.  If you are of the mindset that nature will do what is needed and there is no test to ensure a healthy baby, you can do this yourself.  But, as a midwife, I would make sure you start prenatal care by the time you are 26 weeks. 

[LindyGirl]

Mine charges $350 for the initial visit, and $100 for each prenatal, but that fee also includes all the initial appointment blood work and labs.

$800 does seem like a lot... do you have insurance that would cover seeing your PCP or and OB for a few visits before you find a MW in your new location? One other thing to consider is that a MW in your new location may be hesitant to take on a patient who has had no "formal" prenatal care. Some might not, but what if the MW you really love doesn't feel comfortable with that?

Another idea... trying to locate and correspond with a MW in your new area, and seek their advice about what they'd recommend.

[RJones1204]

Joy, thanks for your midwife perspective! To me I would love to use the resource of having a midwife for the emotional/ spiritual/ and nutrition support. That hefty price tag scares me away though. I could pull off my own prenatal care (as far as record keeping and the like) with good nutrition. I just really value the advice and wisdom a midwife has to offer. I have a lot to consider.

Lindy, the same midwife that assisted with my last two babies will be with me this time too. I have talked to her and she is supportive of when I choose to/ am able to start prenatal care. She is used to her Amish mamas not starting care until 20wks.  As far as insurance, I have an extremely high deductable that needs to be be met before they cover us as 100% (or at all for that matter). It makes more sense for now to budget and pay out of pocket. We would never meet the deductable before moving anyhow and the services of a MW won't be covered in Ohio.