Which birth option..so overwhelmed..

[micah_mae_]

My first two kids were born at a free standing birth center and at home, respectively. Now I am expecting number 3 and I am stressing out about my birth options. We are a single income military family so finances are tight.

There is no midwife or birth center around that takes Tricare. I can pay everything up front and then bill Tricare myself but a) I don’t want to deal with that stress and b) probably wouldn’t get anything from them.

So my options are as follows.

Option 1: Birth at the military hospital. Dear God I hate this option. It would be free but could I even do it? Being in a hospital makes me so anxious as it is and I don’t want to fight people while I’m in labor. This is my last option.

Option 2: Get prenatal care at the hospital, have an “oops” birth at home unassisted. This would be cheapest. Bad part is I would have to go in afterwards and deal with the hospital anyway, also I have a history of heavy bleeding after birth but I don’t know if that had to do with placenta issues.

Option 3: Get prenatal care at the hospital, then see if I can pay a midwife *just* for the birth part. I don’t know if any would be willing.

Option 4: Go to the birth center, pay out of pocket. It’s cheaper than home birth, but still expensive and have to leave home.

Option 5: Have a home birth, pay out of pocket. Best birth option, worst financial option.

[porcelina]

I would definitely contact all the midwives you can find in the area that do home births and be frank with them about the financial situation and what the options are. They might be willing to work with you, offer you a payment plan, have other ideas, or who knows. I would not be comfortable with unassisted with a history of heavy bleeding after birth.

I'm sure you will get more good advice here too!

[GoBecGo]

Could you arrive pushing?  I'm able to VE myself in labour and could easily wait until i was at 8 and grunting through peaks before making a move (depending on how far it is to drive) so that i arrive, give birth (hopefully in triage) and then go home a few hours later.  That would mean you had help for the post natal hours when you might bleed but it'd be free...?

I do sympathise.  We're going without pretty much anything nice this year to afford our independent midwife homebirth (i'm in the UK but the NHS option round here isn't what i need for a great birth).  It's expensive and there's no chance of having anything rebated.  But for us it's worth the cost, and we can *just* do it.  I do have a list of things like furniture, holiday, new clothes for the kids, new vehicle, various home improvements.... all of which will have to wait until next year when the birth has been paid for...

[micah_mae_]

Originally Posted by porcelina 

I would definitely contact all the midwives you can find in the area that do home births and be frank with them about the financial situation and what the options are. They might be willing to work with you, offer you a payment plan, have other ideas, or who knows. I would not be comfortable with unassisted with a history of heavy bleeding after birth.


I'm sure you will get more good advice here too!

Good idea, I just need to sit down and find all the mws in my area..

Originally Posted by GoBecGo 

Could you arrive pushing?  I'm able to VE myself in labour and could easily wait until i was at 8 and grunting through peaks before making a move (depending on how far it is to drive) so that i arrive, give birth (hopefully in triage) and then go home a few hours later.  That would mean you had help for the post natal hours when you might bleed but it'd be free...?

I do sympathise.  We're going without pretty much anything nice this year to afford our independent midwife homebirth (i'm in the UK but the NHS option round here isn't what i need for a great birth).  It's expensive and there's no chance of having anything rebated.  But for us it's worth the cost, and we can *just* do it.  I do have a list of things like furniture, holiday, new clothes for the kids, new vehicle, various home improvements.... all of which will have to wait until next year when the birth has been paid for...

Showing up pushing was an idea but with how fast my babies are born, I might not even make it. 70,000 soldiers stationed here. Getting on post takes forever any time the guys are going to work, lunch or home.

I think I will have to just talk to mws and start saving like mad..

[GoBecGo]

Ha lol, i sympathise with THAT too - 1hr24 with #1, 61mins with #2.  I NEED to be able to do my VE's because i have lots of prelabour then BANG the baby comes, and i need to know when to call the MW or she won't make it!

[fayebond]

*HUGS*

Loads of sympathy for you here.  Our insurance won't tell us if they cover HB or not, still trying to find out from them.  But I gave birth in the hospital for DD  via CS and it was only a one time $20 co-pay. I considered trying the co-care thing but couldn't find anyone who a) cared or b) listened or c) answered my questions.  So its kinda pointless for me to create that paper trail, since it gives me no information or support whatsoever.  Seriously, talk to the midwives.  Most midwives and even birth centers will meet with you for a free consult and can work with their fee structure.  And some midwives cost less than others.  We just found out the potential bill and are still reeling, but its your health and your baby's health (and in my case with VBAC the future babies health too)... its important enough to spend good money on if you can work it.  Also, billing your insurance yourself will be a pain, but even a small amount to them (we *might* get them to chip in as much as $1,000 by G_d's grace) can be big to you.  At least, $1,000 is big to me. :) Talk to selected people on base about your problem, it might be more common than you think.  Oooh, or the find your tribe section of this site!  Maybe someone there knows.

[themothership]

honestly, I'm going into my homebirth knowing that my insurance won't pay a dime. All my prenatal tests are covered, but the midwife fees are not. I could have my birth covered in a hospital, but I don't want to do a hospital birth again. We are a family of 4 living on $26,000 a year and we are just sucking up the cost because it is important to me.

[Mamabeakley]

Our midwife's fee is on a credit card.  We don't have any other 'bad' debt (we do owe for our car and house) and other than about $75 initial balance transfer fee, we figured out how to do it interest free through about March next year.  I'm pretty sure some of it will be covered by a tax refund (although we had more income in the first half of the year, the second half of the year we're a family of 5 then 6 assuming baby is born before Jan 1 which it will be, I go early, living on about 25K/year) and anything that isn't we will pay off as we can.  Hospital birth would probably be free for us, too, and this is my 4th baby and I'm a doula and I might even be able to pull off a decent hospital birth.  But it's not worth it to me or DH.  The risks of a hospital birth are too high, and with a history of PPH, I, too, am not really willing to go UC.

[broodymama]

I have similar options myself, and there's no way I want to birth at the local military hospital unless it's absolutely necessary.  We've saved like crazy and paid out of pocket for my last 3 births and will be doing it this time around as well.  I would definitely talk to the midwives in your area, see if there are any that will do a reduced fee for a reduced number of visits if you get a few of your prenatal visits at the military hospital.  I've done this before and just stood firm with the docs at the hospital, no taking my pants off and no tests.  

[madis81]

Ugh... I feel your pain. My Dh and I keep going back and forth between the military hospital or homebirth. We considered UC, but my DH isn't comfortable with that option. The CNM's here are actually great, but the hospital policies are terrible. The one OB that I've met was very supportive of natural birth, but did caution us and told us to wait as long as we could before going to the hospital. That doesn't work for us, since I also have very fast labors and this is #4. We did find a great midwife whose husband is retired military and offers a military discount. I'm not sure which Tricare region you are in, but the midwives here have been very successful at seeing a 50% reimbursement rate through TriWest. It's all about the coding. Homebirth is fairly popular where we are too, so they have a lot of experience working with military families and TriCare. And I'm willing to bet you will find a midwife that is willing to work with you. The midwife we hope to use said most of her military clients get their prenatal care at the clinic on post up to 28 weeks. This allows for her to get at least 5 appts. in before birth, which allows her to bill globally. This was a common theme with most midwives in our area.

[Renaissance31]

If it was me (and it may be soonish, we are TTC #3), I'd be doing whatever possible to afford the homebirth. It is very much worth it to DH and I. We started out at a freestanding birth center with our DS and ended up transferring to a hospital (off post) 30 hours in. Worst decision we ever made. Of course not knowing then what I know now, it seemed as though we didn't have a choice at the time. I was experiencing severe sciatica and didn't know the techniques I know now for better positioning to avoid it. For DD, we opted for a midwife at a hospital off post here in El Paso. Love her and her practice, but reeeeeeeally didn't want the hospital birth but financially we were pretty much stuck with it. But as fate would have it, we didn't make it to the hospital. Contractions we 4-5 mins apart.... DH was loading the car and I was getting ready to go and boom... Transition time. I hopped in the tub and resisted pushing for long enough for DH and my mom (who was there to take care of DS) to get towels, trash bags, clean scissors and 550 cord to tie off the umbilical cord.... Then two pushes and there she was. Called our midwife and after going over the details with her, she didn't even have us come in. Just told us to follow up with our pediatrician by the next day. Now, getting the birth certificate turned out to be really fun, lol, but other than that it changed us forever. We plan to homebirth the rest, with a midwife present. Only in the absolute most dire emergency would I go to the military hospital. But the kids and I don't use tricare prime, we use standard and extra. So it isn't an issue cause the military hospital wouldn't see us unless it was a dire emergency anyway

[madis81]

Originally Posted by Renaissance31 

If it was me (and it may be soonish, we are TTC #3), I'd be doing whatever possible to afford the homebirth. It is very much worth it to DH and I. We started out at a freestanding birth center with our DS and ended up transferring to a hospital (off post) 30 hours in. Worst decision we ever made. Of course not knowing then what I know now, it seemed as though we didn't have a choice at the time. I was experiencing severe sciatica and didn't know the techniques I know now for better positioning to avoid it. For DD, we opted for a midwife at a hospital off post here in El Paso. Love her and her practice, but reeeeeeeally didn't want the hospital birth but financially we were pretty much stuck with it. But as fate would have it, we didn't make it to the hospital. Contractions we 4-5 mins apart.... DH was loading the car and I was getting ready to go and boom... Transition time. I hopped in the tub and resisted pushing for long enough for DH and my mom (who was there to take care of DS) to get towels, trash bags, clean scissors and 550 cord to tie off the umbilical cord.... Then two pushes and there she was. Called our midwife and after going over the details with her, she didn't even have us come in. Just told us to follow up with our pediatrician by the next day. Now, getting the birth certificate turned out to be really fun, lol, but other than that it changed us forever. We plan to homebirth the rest, with a midwife present. Only in the absolute most dire emergency would I go to the military hospital. But the kids and I don't use tricare prime, we use standard and extra. So it isn't an issue cause the military hospital wouldn't see us unless it was a dire emergency anyway

Did you see a midwife at Texas Tech? I was considering switching to them, but they don't allow kids to visit at UMC during flu season.

[mama k nj]

((hugs))

We had to pay for our last HB out of pocket and are doing the same for our third.  Though with our crappy insurance a hospital birth wouldn't be completely free either.  My midwife is working with me and allowing me to pay as I can.  I have been paying her throughout the pregnancy and will continue to do so until I pay off my bill.  She was pretty cool about it last time thankfully.  

There are no birth centers here.  Period. 

Neither DH or I am comfortable with UC and I don't see that as an option for us.

[Renaissance31]

Originally Posted by madis81 

Did you see a midwife at Texas Tech? I was considering switching to them, but they don't allow kids to visit at UMC during flu season.

Yes we did. Her name is Betsy Portugal. She was great. There was another midwife I liked a lot... I'm guessing she is a midwife. She may have been a student midwife or even an OB or OB student... I never got her name. I only had one conversation with her while I was there waiting for my rhogam shot a couple days after the birth, but that was enough to know I liked her haha. I really wish I had gotten her name. She was pregnant herself at the time and planning a homebirth which I thought was pretty great. Anyway, when we were there we were told they don't allow kids to visit at any time. We didn't like the policy, but our son was only 14 months old so we planned to have my mom keep him anyway so it wasn't a deal breaker for us. This was in the old facility. I imagine they have moved into the new building by now, so I'm sure things have changed in many ways.

Who is this midwife you are seeing whose husband is retired military? I dont think I ever found her in my searching. I'd be interested in meeting her as we will be needing to find someone soon (as long as we conceive soonish that is, haha). Ideally I'd love to find someone who is very hands off... We really want to do things on our own and just have a midwife here for support as needed and for those what if scenarios. I know there arent many around who operate that way but it isnt beyond the realm of possibility. Oh, and so that getting a birth certificate doesn't require an act of congress. Hahaha

[madis81]

Originally Posted by Renaissance31 


Yes we did. Her name is Betsy Portugal. She was great. There was another midwife I liked a lot... I'm guessing she is a midwife. She may have been a student midwife or even an OB or OB student... I never got her name. I only had one conversation with her while I was there waiting for my rhogam shot a couple days after the birth, but that was enough to know I liked her haha. I really wish I had gotten her name. She was pregnant herself at the time and planning a homebirth which I thought was pretty great. Anyway, when we were there we were told they don't allow kids to visit at any time. We didn't like the policy, but our son was only 14 months old so we planned to have my mom keep him anyway so it wasn't a deal breaker for us. This was in the old facility. I imagine they have moved into the new building by now, so I'm sure things have changed in many ways.
Who is this midwife you are seeing whose husband is retired military? I dont think I ever found her in my searching. I'd be interested in meeting her as we will be needing to find someone soon (as long as we conceive soonish that is, haha). Ideally I'd love to find someone who is very hands off... We really want to do things on our own and just have a midwife here for support as needed and for those what if scenarios. I know there arent many around who operate that way but it isnt beyond the realm of possibility. Oh, and so that getting a birth certificate doesn't require an act of congress. Hahaha

She is the same CNM I was considering. The CPM we want to hire mentioned her, and she seems very friendly towards homebirth! If UMC allowed kids to visit I would pursue that route, but I'm afraid not allowing the kids (especially my youngest who is very attached) to visit would make for a rough transition at home. Not to mention that we don't know anyone we trust enough with our kids for that long!

I'll pm you the info for that midwife. She advertises by word of mouth, so you won't find a website or anything for her.