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What would you do?

post #1 of 11
Thread Starter 

Drive 1.5hrs for prenatal care and pay a couple thousand dollars out of pocket for a homebirth or drive 10min and pay maybe a couple hundred dollars out of pocket for a great birth center (and I work at the birth center and know and love all the midwives), but you have your heart set on another homebirth?

I'm so torn

post #2 of 11

How far is the homebirth midwife from you?  Would it take her 1.5 hours to get to you while you are in labor?  How long were your previous labors?  Have you met the homebirth midwife(ves) yet?  Do you love her(them), too?  How long are you required to stay at the birth center after the birth before going home?  Are there any birth center procedures for the labor/delivery that you are not fond of? (antibiotics, excessive monitoring, etc.) What about procedures for baby that you aren't happy about? (vaccinations, eye ointment, Vit K, etc.)

 

I need the answers to those questions and then I'd be able to tell you what I'd do! :)

post #3 of 11

maybe if you could answer a couple more questions to help us help you :)

 

does your HBMW use an insurance billing company and is there any way you could get some reimbursed through insurance?  

do you have a healthcare flex spend account that you can add more funds to come annual election time in the fall?

Do you have care to watch your children if you were to do the 3hr round trip?

At what point would the midwife come to you? would you be driving 3 hr round trips 39 weeks preggo?

Does your financial situation mean that a HB would be a financial burden or no? for some a few thousand isn't a big deal, for some its huge

Would the birth center let you go home the same day as birth, provided no complications?

post #4 of 11

That is such a tough question. I'm assuming that none of the midwives you work with at the birth center will do a homebirth (I know that it's a conflict of interest due to liability sometimes) or know of someone closer who would? Or, would one of them possibly consider working in the role of a monitrice to be with you an monitor you during labor until the midwife can get there? Seeing you're in midwifery school and are working in a birth center, my guess is that you are hyper-aware of some of the concerns (such a negative word) to be looking out for during labor and might be able to prepare yourself for a UC if needed. 

 

If it was me, I just wouldn't want to take the chance on the midwife not getting there (or drive for prenatals -- goodness, I don't want to drive 40 minutes for one midwife I've interviewed). But then again, I've only had 1 child, and not at home either. Your experience and training will probably serve you well for this pregnancy and birth. I wonder, seeing you're in training, if the homebirth mw would work with you to, especially later in the pregnancy when you have to be seen more, to let you do some of the prenatal exams on your own via telephone or something. And, if you continue working at the birth center, then you have instant access to knowledge if something is concerning for you.

 

OK, one final question & then I'll shush. Are you hoping to work at the birth center (or in that setting) when you're done at Frontier?? If so, it might be beneficial for you to experience a birth in a birth center. Although I know there is a lot of similarities between the two, there is something about experiencing riding in a car during 2nd stage labor to get to a birthing place that could help you relate to future patience. One of the reasons that I'm hoping for a homebirth is to avoid that drive, but also because I hope to focus my doula practice to homebirths & birth centers, and might consider midwifery in the future. I want to have a birth in both settings to help me relate to the families that I will be working with. 

 

Phew. Sorry for the novel. Hope some of that info helps. I look forward to hearing what you choose.

post #5 of 11
Thread Starter 

I am pretty sure it would take the homebirth midwife 1.5hrs to get to me in labor. my first labor was 40 hrs and my second was 12hrs (homebirth) so I dont really think time would be an issue but who knows.  I would have to drive the 3hr round trip for all prenatal visits and would prob have to bring my other kids with me to several of them.

I have not met the homebirth midwife yet and have set up an appt to meet her is a couple weeks.

The birth center is pretty low intervention and they are pretty open to refusal of most things.  They recommend you stay 4-6hrs after the birth (if gbs neg) but if I wanted I could prob leave earlier if I wasnt bleeding too much and everything else was ok since they know I know what Im doing.

 

With the home birth it is $4000, $500 up front then the rest by 36 weeks.  Then they said that they file to the insurance after and usually get reimbursed $1,500 to 2,500 back.  We definately do not have $4000 just sitting around and would have to come up with it some how, coming up with that much money up front could be difficult.

 

With the birth center it is $6,000, $500 up front, but with my insurance I would likely not have to pay anymore than the $500 out of pocket.

 

My biggest hang up with going to the birth center is I just dont feel it is necessary to go anywhere and really like staying at home with my last one.  And since I had a homebirth previously I dont really want people to think that I had a problem with it or couldnt handle it and that is why I am going somewhere else this time (I dont know why I care what other people think though)

post #6 of 11
Thread Starter 
Quote:
Originally Posted by maydaymom10 View Post

That is such a tough question. I'm assuming that none of the midwives you work with at the birth center will do a homebirth (I know that it's a conflict of interest due to liability sometimes) or know of someone closer who would? Or, would one of them possibly consider working in the role of a monitrice to be with you an monitor you during labor until the midwife can get there? Seeing you're in midwifery school and are working in a birth center, my guess is that you are hyper-aware of some of the concerns (such a negative word) to be looking out for during labor and might be able to prepare yourself for a UC if needed. 

 

If it was me, I just wouldn't want to take the chance on the midwife not getting there (or drive for prenatals -- goodness, I don't want to drive 40 minutes for one midwife I've interviewed). But then again, I've only had 1 child, and not at home either. Your experience and training will probably serve you well for this pregnancy and birth. I wonder, seeing you're in training, if the homebirth mw would work with you to, especially later in the pregnancy when you have to be seen more, to let you do some of the prenatal exams on your own via telephone or something. And, if you continue working at the birth center, then you have instant access to knowledge if something is concerning for you.

 

OK, one final question & then I'll shush. Are you hoping to work at the birth center (or in that setting) when you're done at Frontier?? If so, it might be beneficial for you to experience a birth in a birth center. Although I know there is a lot of similarities between the two, there is something about experiencing riding in a car during 2nd stage labor to get to a birthing place that could help you relate to future patience. One of the reasons that I'm hoping for a homebirth is to avoid that drive, but also because I hope to focus my doula practice to homebirths & birth centers, and might consider midwifery in the future. I want to have a birth in both settings to help me relate to the families that I will be working with. 

 

Phew. Sorry for the novel. Hope some of that info helps. I look forward to hearing what you choose.

I have actually just recently finished my  training at frontier (I cant figure out how to change my signature) and am working at the birth center as a nurse right now, hoping to transistion as a midwife soon. So I don't what to do anything that would affect me working there in the future or my relationship with them, if you know what I mean.

post #7 of 11

For me, hands down, I would do the birth center. But that is simply because I had a 45 minute start to finish, including placenta for my second baby. You just never know how fast or slow these births can happen, though I get that is out of the norm for most. I wouldn't be able to wait 1.5 hours for my midwife to arrive, nor would I want to be that far away from home in the event that labour started and I was at an appointment 1.5 hous away with my kids...or worse in the car!

 

I too have a background in midwifery and can understand the reservations you may have at giving birth within your community, especially with co-workers. Is this something playing in your mind? I've had both a hospital birth attended by very hands off midwives and a home birth, and although it's my preference to be at home, I know that in a peaceful setting, it really does not matter in the end so long as the birth can happen unhindered. For me, the stress of the distance would be a major hindrance. But you need to evaluate for yourself which of the two scenarios has fewer conflicts for you personally. The finances are whole other story!
 

post #8 of 11

i say birth center given your answers.  Its the happy medium without jeopardizing finances or you b/c the MW is so far.  

post #9 of 11

Well, I'm in a similar situation, except there's no birth center and my insurance doesn't cover midwives at all. I've opted to pay out of pocket for a midwife-attended homebirth and do the driving.

post #10 of 11
Thread Starter 
Quote:
Originally Posted by revolting View Post

Well, I'm in a similar situation, except there's no birth center and my insurance doesn't cover midwives at all. I've opted to pay out of pocket for a midwife-attended homebirth and do the driving.

 Yeah, if my only other option was going to the hospital then hands down I would pay out of pocket and drive the distance for a homebirth.

post #11 of 11

The driving 1.5hrs for prenatal care would probably make me do the birth center.

I can't imagine driving 1/2 hr for those once per week visits, let alone 1.5

I have my heart set on homebirth, but if I was in your situation, judging by the info you gave, I would go birth center.

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