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Delivery Dilemma! - Page 2

post #21 of 60
Thread Starter 

Thanks for the response amlikam. You bring up some good points.

 

Unfortunately the MW have a policy that the full amount be paid before the birth--by 36 weeks, I think. They do offer financing and a payment plan as an option, but that would only apply to their full fee, which would mean paying nearly 7k for this birth! No thanks.

 

I hate that such a relatively small amount of money is playing such a big role in this decision, but the thing is we just barely got out of debt and I'm finally starting to feel secure about finances. We're still a few of grand from our savings goal, and have nothing in retirement or anything like that. Also, I grew up with very little money, and I feel like I want to do things differently with our family. So yeah, financial security is important to me, as silly as that might sound when I'm currently choosing to work a part-time job (and therefore make a lot less than I could be making.) Plus, looking ahead we will have a significant reduction of income over the summer while I'm on maternity leave, and at the same time we're about to incur the added expense of putting DD into preschool. So while a few thousand really isn't a lot in the grand scheme of things, it would make a difference in our finances RIGHT NOW.

 

Someone in the other thread (I forget exactly who right now, sorry!) was trying to decide between paying out of pocket for a homebirth vs going to the hospital covered by insurance, and she made the analogy of paying more and going into student loan debt to attend a private liberal arts school when a perfectly good state school with scholarships is available, and that kind of stuck out to me. I mean, sure the experience of the former would be really great, but it seems like an unnecessary indulgence when you can get a perfectly good education at the state school. And my "state school" offers water births, so I should feel lucky! It's not like I have to choose between a home birth and an OB.

post #22 of 60

All up to you in the end. What birth do you want? Will it be a safe place for you and baby? What options are really on the table for you? Etc. Best wishes in making your decision. I thought they were offering you a reduced rate home birth for 3,000? 

post #23 of 60
Thread Starter 

They are offering a reduced rate of 3k if we pay it all in cash before I hit 36 weeks. If we wanted to go with their payment plan option (which would allow us to spread the payments out after the birth) it would only be available to us for the full-fee amount. Which makes no sense for us to do because we actually have the 3k in savings. I'm just being a bit of a tightwad with it.

post #24 of 60
Quote:
Originally Posted by kitteh View Post

They are offering a reduced rate of 3k if we pay it all in cash before I hit 36 weeks. If we wanted to go with their payment plan option (which would allow us to spread the payments out after the birth) it would only be available to us for the full-fee amount. Which makes no sense for us to do because we actually have the 3k in savings. I'm just being a bit of a tightwad with it.

 

If you want a home birth, 3,000 is quite reasonable. Average is 3-4 grand across the country I believe. I have to pay it all before 36 weeks too. I think that is pretty typical.

post #25 of 60
Thread Starter 
Yeah, I'm really grateful that they are willing to work with us on the fee and bring it down within the range of possiblity for us.

But that doesn't change the fact that having to pay 3k (vs having everything covered with no out-of-pocket expense should we go the CNM/hospital route) is a significant amount with regards to our current financial situation. We do have that amount in savings, but as part of our emergency fund (which isn't even fully-funded yet) and this really doesnt qualify as an emergency, you know? So i think I would have some guilt or whatever about spending it.
post #26 of 60
Thread Starter 
Also, I just wanna say that I know I'm overthinking this, but I can't help it!
post #27 of 60

Kitteh, it sounds like you've got quite a dilemma here and no I don't think you are over thinking it winky.gif

 

I too have great qualms about saving/spending. We live VERY frugally and manage 3 different piddly savings accounts. Overkill? Yes but each one is for different things. One saves for our hay fund (around $4k every summer) the other is for our mortgage in case my husband is unable to work and the third is our emergency fund. That is how crazy organized I am about our financial goals.

 

If I was in your situation I would juggle things around and put limits on other things that are less important to me and come up with whatever it takes for me to have the birth I want. For me this IS considered as important and an emergency.  After having hospital births all the way to unassisted water births I would never consider anything other than home-sweet-home.  We paid close to 2k for a homebirth and that was the unassisted! (they got there 20 minutes too late due to another post-partum appointment before me irked.gif) I think they should have paid my husband for unwrapping the cord from around my sons neck so he could be born safely. So I'd happily pay 3k for a midwife/homebirth I could trust.

 

Being unhappy with your birthing place could lead to extra stress for you and the baby and the outcome could be undesirable. So like other posters said, I would really think hard on just HOW important this is and make YOUR decision from there.  Nothing else (not even the money) should make up your mind since this is your birth and where you want to have the baby should be up to you thumb.gif
Good Luck!

 

All that being said, my midwife (who, attended MY birth when she was just starting out!!) once accepted payment as a pair of goats for a homebirth of a gal in financial stress.   Ah, those were the days.....I got plenty of cows for trade..... Anyone?   orngtongue.gif

post #28 of 60
Kitteh- I understand so much of your concers with finances. (including growing up). Keep talking about it and trust your wisdom.
post #29 of 60

I'm SO in the same position as you are. I've been agonizing over decisions, changing my mind repeatedly - just not sure what to do. $3k is a LOT for us also. I realize that it's a "good" price for what we get, but that doesn't change the fact that it'll create its own set of circumstances we need to deal with.

 

...sigh....I just can't figure it out either. Keep talking, kitteh - your processing actually helps me also!

post #30 of 60
I wanted to mention (not sure this helps) my insurance covers all prenatal care and delivery but they got me with a inpatient care co-pay for me when I gave birth to DD and an inpatient copay for DD because she had some jaundice issues. They then sent us home for one day bc they needed the room and readmitted us which was another copay. Because we had a deductible for inpatient stay we were hit for like $3000 which the hospital deducted a chunk and let us break it up. But it was still $2500. I believe if I had dd at home the jaundice wouldnt have been such an issue. I guess know your plan and make sure what deductibles you will be hit with if any
post #31 of 60
Thread Starter 

In our circumstance the CNM/hospital waterbirth is 100% covered by insurance. With my first DD I think we ended up spending a couple hundred out of pocket for various tests that apparently weren't covered, but that's it. We don't even pay premiums for it, because it's no-cost pregnancy Medi-Cal. For a minute I thought that we had a share-of-cost (basically a deductible) of almost $1,700 but I called Medi-Cal and they told me that the share-of-cost only applies to non-pregnancy-related doctor's visits. So the difference in price between the two choices is fairly stark. Frankly, I was kind of hoping that the $1,700 applied to pregnancy too, so that I could better justify choosing a homebirth! But no dice.

 

However, as it stands right now I think we're still leaning towards the home birth. DH gets a little sparkle in his eye when he talks about having her at home surrounded by our things and with our daughter (possibly) present. My parents are driving out to attend the birth and will be sleeping in our living room on our sleeper sofa, so I kind of assumed that they would prefer a hospital birth so as to not encroach upon their already limited space, but today we skyped and DH told me he could tell my mom is keen on having a home birth. She kept talking about how much safer our neighborhood is than the one the hospital is in, and how it would be much less stressful for me to be able to relax and not have to worry about when to head out for the hospital. She also mentioned that at home it is easier to distract myself with other things during early labor--cleaning or playing with DD or going for a walk--and that getting to the hospital before really active labor hits kind of makes it impossible to focus on anything BUT labor and contractions and TIME. So I was kind of pleasantly surprised. Even when I was growing up she has always been about letting me make my own choices and just supporting me in them no matter what--even to the point where it sometimes frustrated me, like give me some GUIDANCE here lady! But as an adult it is kind of nice. So she has not come straight out and stated her preference, and when we talk about the hospital she does her best to look at the bright side, so I guess she just assumed she was hoping we'd go that route. Anyhow, I'm rambling.

 

As far as money, the 3k is definitely still something that I'm trying to justify and get over spending. It occurred to me on my run today that part of my problem with the expenditure is that on some level I feel like it's incredibly self-indulgent and financially irresponsible of me to make the choice for a home birth when a "perfectly good" free hospital alternative is available. My income will be greatly reduced over the summer months, and we might be incurring some additional costs sending DD to preschool. Also, I still need to complete my credential (over the next 3-5 years, so we have time) But still, it's an upcoming expenditure that we are trying to plan for, and we intend to pay for it in cash as well. So all of these things weigh on my mind when I think of spending the money on a home birth.

 

However, we just recently paid off the last of our debt, which we were spending $250 a month on. So if we just continue to put that amount into savings then we can pay off the home birth within a year without really changing the look of our current budget, and without having to resort to putting it on credit cards, which amlikam helped me realize was a very bad choice given our circumstances. I mean, it's just not necessary, and debt is riskier than having slightly less in savings. So if we go with the home birth we will have to pay $600 up front (which we have in cash, so no dipping into the savings account yet) and then roughly $150/week until June. Looking at it like that feels less daunting that thinking of it as one big lump sum.

 

The decision hasn't been 100% made yet. Tomorrow I plan to call the home birth midwives and chat with them about where my head is at right now, and then Tuesday we tour the hospital. I also have my next prenatal with the CNM/hospital midwife (who actually suggested I look into home birth) and I want to talk to her about it too. I feel like I need to talk it through as much as possible and with as many people as possible in order to make this decision. This is when having a therapist would come in handy! lol.

 

Thanks for listening mamas, it really helps to have a space to get this all out without feeling like I'm talking the ear off of DH or my mom. I feel like I keep going in circles over this!


Edited by kitteh - 2/24/13 at 10:47pm
post #32 of 60

Sounds good. Neat that everyone is supportive around you. 


Edited by dayiscoming2006 - 2/25/13 at 7:30pm
post #33 of 60

Don't forget you'll have another child tax to claim come the end of the year  thumb.gif
 

post #34 of 60
Thread Starter 

Ahaha, yesss. That's going to be sweet. And this year we made just barely too much to qualify for the Earned Income Credit, but we probably won't make as much this year so we will probably get that credit too. I'm hoping for a nice sweet chunk back to stick into savings. I'm not counting my chickens til they hatch, but that is definitely something in the back of my mond, helping me justify the expense.

 

One tiny update though. And I kinda need some perspective here, because I'm hormonal and sensitive these days and I don't know if I'm just being unreasonable here, or what.

 

So I talked to the owner of the home birth company today. She has contacted me twice since we went to meet with them 2 weeks ago, and I haven't returned her call til now. So I apologized for not getting back to her and just explained how we have been in the decision-making process, going back and forth about it and trying to make up our minds. I said that right now we are about 90% in for going the home birth route, but that we have the hospital tour tomorrow and that should be the last deciding factor. I also mentioned that I had one last concern about the home birth, and that has to do with the prenatal visits. They do all of them out of their office, which is about a 30-45 minute bike ride from where we live. (If I go by bus it will have to use 3 different busses, which would take at least an hour to an hour and a half). For now I have absolutely no problem biking out there, in fact I like the extra exercise. But I am concerned about the possibility that I might not be physically capable of climbing onto my bike and hoofing it over there once a week (as the frequency of the visits increases) during my last few weeks of pregnancy. I'm not sure if it is even going to be an issue, maybe I'll be biking around til the day I go in labor. But in case there IS an issue, I asked if there were any other options available for a location to do the prenatals. I mentioned it only because the other midwife (who is the other co-owner) with whom we had consulted told me that a few of the midwives in the practice live right in my neighborhood, so maybe--if absolutely necessary near the end--we could come up with some kind of compromise/solution? The owner's response was that she couldn't have her midwives "driving all over Los Angeles" and that they were already reducing the fee for us, so she wasn't sure they could work with me on this issue. She went on to say that if I was willing to make it work and get there then they'd love to work with us. I told her that it had nothing to do with how WILLING I might be, but whether or not I will be PHYSICALLY CAPABLE of getting there. I mean, I know that the 3 bus thing is an option, but I don't necessarily want to spend 2-3 hours on a bus just getting to and from the checkups if there is any other possible alternative. She said that if we were paying the full fee then they might be able to work something out where we could pay an additional fee for extra home visits. I told her that we would be in touch.

 

I kind of get the impression that when she looks at us she doesn't see The Kitteh Family, she sees The Family That's Only Paying $3,000. One thing I liked about using the UCLA midwives was that I never once felt like I was walking around with a Scarlet M (for MEDI-CAL PATIENT) emblazoned on my lapel. We were treated with the same dignity, compassion, and respect as the other clients with the GOOD insurance. I kind of feel like the co-owner I spoke to today threw the reduced-fee thing back in my face, and I don't want to feel like that sort of thing is going to keep happening if we go with them. I just think her response could have been more considerate or compassionate, even if the ultimate outcome was that we have no other alternative but to get my pregnant ass out there once a week, by hook or by crook. It was her TONE that really bothered me. The good news is that the woman with whom I talked is not one of the midwives who would actually attend my birth, but I'm still not sure I want to deal with her in ANY capacity if this is how she is going to respond to us. But then again, I know that I'm extra emotional and sensitive these days, and maybe I'm overreacting?

post #35 of 60
Thread Starter 

They have mostly glowing reviews on Yelp, but there are a few very low reviews, and this one in particular sounds like it is referring to the woman I spoke with today:

 

 

Quote:
I find it interesting that the owner, who must have read the previous reviews about their discrimination and poor intake processes, still operates in a way that I perceived as rather "off."  I'd explain, but I don't want to be slanderous.  

The center suggests they have a nonprofit on their site.  I believe this is training related.  They also suggest that ALL women deserve a CHOICE in how they give birth,  so while they give the impression they only want to offer that choice to the upper-middle class, I took a chance and asked for their good will.

The lovely accountant attempted to provide me a discount and when I spoke to a  co-owner about it, she treated me as though I was lying about it.  When I was confirmed, she, in my opinion, seemed to force herself to be kind about it.  After speaking to them weekly to make sure they weren't booked, while en route to take them my check, they called to inform me they would not honor the discount fifteen minutes before our appointment.

I was in the orientation with two other women who were completely put off.  One of them I became friends with and she told me that the owner repeatedly changed her personal story and their financing plan so they decided to go.  I would suggest to some of the more caring people at the Sanctuary that they ask this co-owner to be a silent partner.
post #36 of 60
Wow!!! I am shocked. Like really shocked. That is quiet a review and also that conversation definitely would leave me wondering. No wonder you have been so conflicted and your gut hasn't settled into a choice yet. Good luck with the tour today I hope it brings some insight.
From a business stand point this midwife is probably the one to handle the administrative stuff for a reason... I work in administration and well to be honest there is some people who deal with negotiations that I would never want to be.
That being said I am always shocked when people feel/express such "disdain" to those asking for financial support in this way. Maybe my shock is because most of the midwives in my area use some financial assistance to get by themselves. ??
Ugh I'm really hoping today helps to clarify your choice.
What are the odds that the co-owner will be your primary midwife?
post #37 of 60

Hope you get it figured out. Good that that lady wouldn't actually be the one to attend your birth if you go with a home birth.

I had hospital midwives in Montana and one of the midwives was kind of cranky like that and she was one I'd have to see regularly and could be the midwife at my birth so, I dropped their practice and went it alone UP/UC. But, if I could have had the option to just not work with her and work with the other midwives, I would have probably stuck it out. 

post #38 of 60
Thread Starter 
I haven't met the other midwives, but the one who is co-owner was so amazing that I'm really thinking of still going with them despite the negative impression I have of the accountant-owner. I'm kind of thinking of calling and talking to the "good cop" just to see how that conversation goes. I don't know, I guess I just want reassurance that the midwives will be on "our team" if we go with them, and that I won't be made to felt like a second-tier client because of the discount they are giving us.
post #39 of 60
Thread Starter 

Can I just say that this whole process has been the such a stressful, emotional roller-coaster and has really left me feeling terrible about myself and my financial situation. I think I have spent the majority of February crying, and tonight is no exception. The funny thing is, we are so much better off financially than we were just 3 years ago, and yet I have never felt so low (and so low-income.) I hate this.

post #40 of 60

Have you been able to speak with the midwife you liked, and express your concern about the conversation you had with the other woman?  I would specifically bring up the fact that she threw your financial need back in your face.  That kind of attitude is totally inappropriate and really bad for their business!

 

Sending you hugs, kitteh.  I hate that you are feeling this way, and hate that that cranky co-owner got to you.  

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