Delivery Dilemma! - Page 3 « Back to Group Discussions

[kitteh]

I haven't contacted the midwife that I really liked yet. I'm kind of trying to process and weigh my options before I reach out to her. Also, part of me feels like I'm going behind mom's back to ask dad instead, because the cranky woman is supposed to deal with the financial aspect. So I guess I feel like maybe I'd be overstepping boundries to bring it up with the other owner? But maybe that is just silly. My emotions are all over the place these days.

But the financial thing isn't just due to this one midwifery practice. I also contacted a midwife whose name I found here on mothering, and explained my situation to her. She said that she accepts one reduced-fee client per term, and that she has not taken one on yet this term so she would be available. But she also said that for $3,000 she would essentially be paying to attend my birth--what with having to travel to me for prenatals, getting a sitter to watch her own child, and the fee she pays her assistant. She told me that the first place I spoke to uses midwifery students as assistants, so they don't have to pay them, but she uses a certified midwife and pays her $1,000. So I understand her financial situation, and was grateful that she was willing to take me on, but I heard a lot of hesitation in her voice and knowing that she would take a financial hit to help me out was just too guilt-inducing.

This whole process has made me realize how many hangups I have regarding money. I place a lot of my self worth in how much money I have in the bank or how much debt I have. I grew up poor as the eldest of 8 children. As soon as I turned 18 I moved half way across the country on my own and supported myself while putting myself through university (and getting deeply into debt in the process!) Part of it was my need for independence and self-reliance, but there was also a side of me that felt almost spiteful or defiant about it. I still haven't figured it out completely, but I know that I have always had problems accepting financial help, even from my own parents. I feel like no one can control or manipulate me when I'm financially independent, but I also feel like I have a sense that I just don't DESERVE help either. Or like, if I receive help then I'm indebted to the one giving it. I have a lot of issues of shame and guilt surrounding money (or rather, lack thereof) that I didn't really realize I had. This process is triggering them, unfortunately.

[sky_and_lavender]

I just wanted to say that, while it's nice the outside midwife takes a lower income client each quarter, it seems wrong of her to say, "I do this out of the goodness of my heart, but I'm going to make you think about my finances and how grateful you need to be if I do this for you." It's like feeding someone a meal and then complaining about the cost and effort of making it. Unfortunately, that seems to be an acceptable way to behave towards people with lower incomes in our culture. I would struggle with the same feelings that you are struggling with if I were in your position (and I have been in similar situations in the past.)

At the same time, it is not sustainable or healthy to go through your whole pregnancy and birth feeling guilty about getting reduced cost midwifery care, or worrying about what your caregivers are thinking of you. Since other people's attitudes are probably not going to change, the question is whether you can personally let go of this issue and not think too much about their opinions and feelings about it. Can you just let go and say, "this is about them" when/if they make barbed remarks? When they are being indirect ("oh, it's going to cost me money to get the babysitter and pay the assistant," etc.), can you say, "Are you saying you would rather not take me on?" If this isn't possible for you right now, I would really consider not taking these options, just because getting emotionally intertwined with their feelings about "low income people" is going to bring you down. You don't need that! You have nothing to be ashamed of--it is not a crime to be poor. In fact, you are doing amazing stuff with the resources you have, and you can be proud of that. 

[kitteh]

You're absolutely right veggieviola. Thank you for your response, and for your kind words. 

I think I could get over the money/guilt issue if I went with the first midwifery practice, mostly because they have a system where the midwife care is somewhat separated from the financial side as that owner isn't currently a midwife (though I heard that she is currently studying to become a midwife herself!) But midwife A, the "nice" co-owner, was really amazing and both DH and I loved her energy. If the other midwives in their practice are anything like her then I could definitely  be able to separate the financial aspect from the care/birth without wondering if they look down on me or resent me for not paying full price. With the independent midwife I spoke to last night, I know that there is no way I can separate the two and I've already basically told her thanks but no thanks.

[FarmerMomma]

This whole process has made me realize how many hangups I have regarding money. I place a lot of my self worth in how much money I have in the bank or how much debt I have. I grew up poor as the eldest of 8 children. As soon as I turned 18 I moved half way across the country on my own and supported myself while putting myself through university (and getting deeply into debt in the process!) Part of it was my need for independence and self-reliance, but there was also a side of me that felt almost spiteful or defiant about it. I still haven't figured it out completely, but I know that I have always had problems accepting financial help, even from my own parents. I feel like no one can control or manipulate me when I'm financially independent, but I also feel like I have a sense that I just don't DESERVE help either. Or like, if I receive help then I'm indebted to the one giving it. I have a lot of issues of shame and guilt surrounding money (or rather, lack thereof) that I didn't really realize I had. This process is triggering them, unfortunately.
[/quote]

Kitteh, I have money hang ups too. Maybe you can do some meditation on paying it forward. I had the opportunity to pay for a guys order at a thrift store after he had 3 credit cards declined. He was so thankful and wanted to repay me but I didn't want that and I didn't want to disempower him so I told him to help someone else out when he could, financially or otherwise.

[kitteh]

That is a good suggestion FarmerMomma. I like it and maybe it could help me let go of my issues a bit.

I have exchanged a few emails with the independent midwife and I figured I'd post them here to see if anyone has any feedback:

Dear (Independent Midwife)

I hope that this email makes it's way to you through cyberspace and doesn't get lost like the last one. :)

I just wanted to thank you for responding to my initial inquiry, and for getting back to me when my email failed to make it to your inbox. I do appreciate that you took time to contact me.

I realize that here in Los Angeles $3,000 is not a lot of money for someone who is running a business, especially considering the economy these days. So I appreciate that you expressed a willingness to accommodate us. Unfortunately, for my family right now, it IS a lot of money. That is slightly more than we make per month, everything we have in liquid savings, and more than a third of our current total "life savings." I guess that's kind of sad, huh.

Ever since I found out that I was pregnant with my now 3 year old, I have dreamed of having a calm, natural, home water-birth attended by caring and compassionate midwives. Unfortunately that has not been available to me because of finances, but I was still able to have my daughter naturally and attended by a midwife (whom I'd never actually met before I went into labor!) back when the UCLA nurse-midwives accepted Medi-Cal. It wasn't exactly the birth experience of my dreams, but I made it through 28 hours of labor without pain meds, and I now have a beautiful, intelligent little girl who is the light of my life. Still,  I was really hoping to have the opportunity to make my home-birth dream a reality this time around, and though we don't have very much money we are much better off financially than we were with our first (at that time we had nothing in savings, 25k in debt, and my husband had just arrived in the US and wasn't authorized to work yet. Our daughter was a little surprise!) But I'm quickly realizing that everything is relative, and "a lot of money" to us just might not be enough to cover my dream birth. I think have to let go of that dream.

Knowing that you would take a financial hit by agreeing to attend our birth is far too guilt-inducing for me to accept. I appreciate that you were willing to meet with us and try to work something out, but I'm sure that my feelings of guilt and unworthiness aren't conducive to my dream birth either.

Thanks
(kitteh)

Wrote that to her last night after I got off the phone with her, and after I finally stopped crying. So perhaps it's a bit melodramatic. But I'm hormonal.

This was her response:

Wow Tashia,  I am sorry if our phone conversation left you feeling that way, I feel you may have misunderstood what I was saying. I would never want you to feel guilty or worthless about money. I was just relying to you the reality of finances in these times. If I didn't think we could work things out, I would not have contacted you back.

So I wrote back:

I certainly didn't intend to place any blame for my feelings on you. However, I could definitely hear the hesitation in your voice last night when we were discussing the fee, and it made total sense when you explained that after paying your assistant, and a babysitter, and transportation costs, you would basically be paying to attend my birth.  I completely understand that you have a business to run and a family to take care of, and the reality is that $3,000 is not a lot of money in LA. I suppose that is why most home birth midwives charge almost twice that figure.

My feelings of guilt for even asking someone to lose money in order to help me get the birth I want, and feelings of being unworthy of the type of care that I envision, are not your fault and I'm not trying to blame you. I grew up poor as the eldest of 8 children, and money has always been a tricky subject for me. I'm really trying to make a better life for my children than the one I had, and sometimes I just feel like I'm failing at that.

So I just wanted you to know that it really has nothing to do with you--I've read many glowing, amazing reviews about the care that you give and would love to have something like that for my next birth. I just know that if I asked you to be my midwife, my hangups and guilt about the money would always be at the back of my mind.

Sorry for dumping all of this on you. I don't have a therapist, so apparently I just unload all of my issues via email to women I have never met before! Pregnancy hormones aren't helping, either.

Kitteh

And her latest email:

Aaaahhhh sweetie! I totally understand and I in no way intended to instill guilt.. You deserve the very very best always. I know HB in LA is sooo expensive. I wouldn't be able to afford it either if I were to get preggo's right now. Times are tight for everyone right now and all we can do is just stay positive and make things work the best we can. That is why I do offer discounts to two ladies a year, because I find it really important to give back to the universe for all the abundance in my life and that is much more than just money.  I was planning on calling a friend of mine to see if she would give me a discount for being my assist. I do believe that there are ways to work things out always. P.S. $3000 is a lot of money. I am happy to see still see you and sit and chat and see if it is a good match.

I haven't responded yet.

I have reached out to one other midwife, whom my Medi-Cal CNM referred me to, and I'm waiting to hear back from her. I also contacted Midwife A (the Nice Co-Owner) but she was with a client, so I am waiting for her to call me back.

In the meantime, I went to the Library to pick up their brand spanking new copy of Mindful Birthing and I'm going to crack into that over a cup of RRL tea, and then hopefully go for a 3-5 mile run later to de-stress.

Thanks for listening mamas.

[sky_and_lavender]

I'm really impressed by how well you're communicating even though you're feeling really upset, and by her clear and compassionate responses! It would be so great if something like this works out, and it sounds like it might! I'm excited for you, kitteh. Good for you for advocating for what you want!
 

[FarmerMomma]

Sounds like this midwife really wants to pay it forward. I think you'd be giving her a gift by accepting it. (If she's ultimately the one you want). Also tokens of gratitude, homemade gifts, etc go a long way in this funny economic world. My midwife and I exchange gifts and it really means a lot.

[kitteh]

Originally Posted by sky_and_lavender 

I'm really impressed by how well you're communicating even though you're feeling really upset, and by her clear and compassionate responses! It would be so great if something like this works out, and it sounds like it might! I'm excited for you, kitteh. Good for you for advocating for what you want!
 

Well I'm happy that you think I'm communicating well, because I mostly just feel like a big blubbering mess these days. Before this whole midwife-search I knew that pregnancy had heightened my emotions, but I didn't realize just how sensitive I'd become. I've cried so much lately I think I'm dehydrated! And it's not just crying out of sadness, it seems like my tears are flowing even more freely for just about anything, happy or sad or moving or whatever. It's kind of draining!

I am really happy that she responded so compassionately, and I'm happy that I chose to take a few deep breaths (between sobs, lol) and took the time to write her back, because my defensive reaction is usually just to say "forget about it, I don't need you, etc" and walk away. All in all, this whole process--having to contact various midwives and ask them to take me on at a greatly reduced fee--has been a very humbling experience. It sometimes feels shameful, and it's not at all easy. My pride usually keeps me from asking anyone for anything, but I'm learning that with "practice" it gets easier reach out and to ask. Not a LOT easier, but easier nonetheless.

Originally Posted by FarmerMomma 

Sounds like this midwife really wants to pay it forward. I think you'd be giving her a gift by accepting it. (If she's ultimately the one you want). Also tokens of gratitude, homemade gifts, etc go a long way in this funny economic world. My midwife and I exchange gifts and it really means a lot.

Since I read your last post about paying it forward I have been thinking more and more about that concept. It's one that I really love. There is a commercial on TV--for some insurance company I think--that talks about doing the right thing when no one is looking. It shows from the perspective of an uninvolved onlooker, people doing little random acts of kindness. Then the person who witnessed the act then goes on to commit their own random act of kindness, and someone else who is watching is moved by it and follows suit, etc etc. I always loved that commercial.

And thank you for the suggestion to remember that tokens of gratitude are an important touch. I'm afraid to say that might not have occurred to me on my own, and I do think it's a very important detail to remember.

[amlikam]

This is up to you but I wondered if this midwife might be able to bring her little one to appointments if needed to help save on child care? Could your little ones play while you are meeting? Just a thought To help defer expenses. I do a lot of community service type work and sometimes I take a hit that is pretty big if the family is invested in the process. Good luck mama!

[dayiscoming2006]

Kitteh, I must say I really like that midwife you got in contact with. I'd definitely consider her if I were you. Actually, my gut reaction would be to have her at the front of my list. :)

I don't ascribe to the whole "universe" thing, but if it makes her happy, none of my business. The pay it forward thing is nice though. You can maybe help someone else out in the future with some little gesture or whatever. I like the idea of giving her other things that was given. As far as the pay it forward thing, I once had someone walk up to me in goodwill and give me a $25 gift card and run off. LOL That was nice of them. I was pretty broke at the time so that was very kind.

Hope you get it all figured out soon. 

[FarmerMomma]

Kitteh,

Any news?

[PartTimeCrunchy]

I'm not sure if this will help, but with my last birth I used a birthing center and my insurance refused to pay for it. I called them back everyday and kept it non-emotional and on their favorite topic - MONEY! I would tell the first person, when they said "no", I asked for their supervisor, and when they said "no", I asked for THEIR supervisor. I kept telling them that it was a Win-Win for both of us as it would be tremendously cheaper to use the birth center. Plus their much lower rate of c-sections, that was going to make a big difference too. It took a couple of months, and I'm not sure what all they did, but they got it covered. If you keep at them, there is a chance that they would find a way, just to rid themselves of your daily, annoying phone calls! ;)

Good Luck!

[kitteh]

If my regular insurance were covering this, I might try that tactic. But Medi-Cal is a whole nother beast, and THEY tend to give YOU the runaround and wear YOU down about stuff.

After a few somewhat uuanticipated expenses arose--which had me feeling even more tense about money--I stepped back and took a good look at our situation and realized that I was being a bit of a "Birthzilla." I was clinging to this image of what my ideal, dream birth would be like (not unlike Bridezillas and their "one perfect day") and I realized that birth--much more so than a wedding--can be so unpredictable that even all of the planning and preparation and money spent out of pocket for a home birth couldn't guarantee I'd get what I was envisioning.

It kind of hit home one night after a run during which I'd been having persistent, very uncomfortable BH contractions (due to dehydration--resolved now.) When I got home I just wanted to take an oatmeal bath and drink some tea and read my book, but DD INSISTED on getting in. Nothing I did or said could dissuade her, so she stripped herself down and started trying to inch her way into the bath, while I tried to explain that mama's bath water is too hot and too deep for her, and that I wanted to read my book without splashing, and that I couldn't stretch out and relax with another body in the tub. We spent 45 minutes like this, with me barely heading her off and her continuing to wear down my defenses. Eventually started begging to nurse as a clever ruse to get herself near enough to just plop entirely into the bathwater. And I realized that my vision of her being able to be present for the home water birth might not be reality, and as cute as it sounded when I joked about her possibly wanting to join me in the birthing tub, in that moment I realized that during labor it would probably feel like the polar opposite of cute. DD is intense and really likes to be the center of attention. I'm not sure that is compatible with her being able to be present at the birth.

Additionally, it occurred to me that if an ACTUAL emergency should arise--not labor related, but in regards to our finances--then we would be kind of screwed for spending a third of our emergency fund on this birth. We recently got out of a lot of debt while on a fairly low income and through bouts of unemployment. We did so by drawing a hard line regarding the differences between a NEED and a WANT, and also being very strict and firm about what constitutes an "emergency" worthy of dipping into the Emergency Fund. It was tough, but when I was truly honest with myself I realized that a planned pregnancy was NOT an emergency, and given the fact that I have the option of a natural, CNM attended waterbirth in the hospital, a home birth is much more of a WANT than a NEED. Also, we are very open to the idea of having a 3rd fairly close to our 2nd (probably start trying as early as 6 months postpartum, if AF is back) so the thought of spending so much on this birth when we might have another right around the corner seemed wasteful.

Finally, a co-worker of mine made a comment that really hit home. She said that when I'd first brought up the idea of a home birth the major reasoning behind it was to reduce my anxiety and stress (about the possibility of getting stuck in rush hour traffic while deeply in active labor, mostly.)  That possibility still exists, who knows when I might go into labor and the trip to the hospital is 20 minutes in absolutely NO traffic. However, the process of finding a HB midwife to take me at such a greatly reduced fee was causing ALL KINDS of extra stress and anxiety, and it kind of defeated the purpose. I'm still not sure what to do about the commute to the hospital. I'd love to labor at home as long as possible and head into the hospital only when I REALLY have to, but I know that in the back of my mind I'm probably going to be worried about giving birth in a car on the freeway. I'm still trying to figure that bit out, as I really REALLY don't want to spend an unnecessarily long time laboring at the hospital (like I did with DD.) We'll see.

So, I am kind of mourning the home birth idea. But I have decided to put my energies into finding the right insurance provider--one that has been shown to fully cover home births--for next time so that I can hopefully fulfil my homebirth wish with baby #3.

Thank you ladies so much for your helpful and valuable insight and opinions, and just for providing me with a space to work through all of the messy emotions that this process elicited.

[amlikam]

A friend of mine labored at a state park near her hospital bc it was over an hour away. Just a thought there.

I am glad you found direction and clarity.

[sky_and_lavender]

kitteh,

What clear thinking and self-insight. Even though I'm sorry you won't get the homebirth, the CNM-attended waterbirth in the hospital sounds like a good option, too. I'm glad you've worked it out for yourself and wish you a more emotionally peaceful remainder of your pregnancy. 
 

[FarmerMomma]

Kitteh,

I feel you about birthzilla. I totally get that image and how you can feel that way.

Hopefully with the birth tub you won't feel like waiting for the last minute for the hospital. I labored a long time at home in the tub and got to the hospital to push. Not that I planned that. I think I just didn't want to get out of the tub. Knowing there was a bigger tub might have been a motivator.

You also make me glad that my DS is 5. Seems a good age for homebirth with him around. I might opt to save the money on #3 with a hospital birth. I feel ya on the LO. You want them to have that experience but not ruin it for you.
I loved watching you process the whole thing and having a tiny part in it.

[Sweet Huck]

Originally Posted by amlikam 

A friend of mine labored at a state park near her hospital bc it was over an hour away. Just a thought there.
 

We're in a similar boat, about an hour from our birth center, so we're trying to come up with a short list of nearby places where we can walk and labor.

[veggieviola]

Originally Posted by Sweet Huck 

We're in a similar boat, about an hour from our birth center, so we're trying to come up with a short list of nearby places where we can walk and labor.

Just out of curiosity, why wouldn't you just check in at the birth center rather than find somewhere else close by to labor?  I always thought the purpose of waiting to go to the hospital until later on was to avoid the chance of unnecessary interventions the longer you are there, but that seems like less of a concern at a birth center.  

[Sweet Huck]

Yes, true! Our reasoning for eyeing 'labor stops' is because if youve not progrssed enough at the time you show up at our birth center....they will send you away. It's a careful balance between not going too early, and also not getting stuck far away in traffic. Id rather labor 15 minutes away than be in 2+ hrs of Friday beach traffic... But who knows how it will all shake down.

[veggieviola]

Ahh, that makes sense!  Of course it makes sense to head that way when things start moving.  I can't imagine sitting in traffic (or worse, getting stuck on the road) when things are intense!  Even though we are only 15 minutes away from our hospital with no traffic, I am hoping that things happen in the dead of night for us and not during rush hour...