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Mothering › Groups › July 2013 Due Date Club › Discussions › Losing my chance to have a homebirth?

Losing my chance to have a homebirth?

post #1 of 16
Thread Starter 

I am feeling so low today. I received a letter from my health insurance company (who up until recently DID cover home birth with my midwife) saying that not only would they not cover my homebirth but they also would not cover any "charges related to complications arising from a non-covered homebirth." So I assume this means that in the event of a transfer to the hospital we would be responsible for all the costs? I don't know how to interpret that and I certainly don't know what to do here. We knew that we might have to pay for the homebirth out of pocket but we had no idea that we might also have to pay hospital fees if we had to transfer!

 

I am 38 weeks pregnant and looking at the possibility of having to transfer to a OB/GYN practice this late in the game...I know it would be the practice that backs up my midwife but I don't know their policies on anything (induction dates, delayed cord clamping, not having IV's in labor, etc.) I guess I should have done my homework beforehand so I would know what to expect in the case of a transfer but I just assumed that if I was transferring it would be an emergency and none of those things would matter as much.

 

Part of me is okay about having to give birth in the hospital. My mom is here to help after the baby is born but she often needs to be taken care of herself so I was worried about how we were going to work that. The hospital is pretty natural birth friendly, but like I said, I know very very little about the practice and it would be up to fate as to who would be there for my delivery. Ugh.

post #2 of 16

That really sucks. Can't you keep your midwife though, to deliver your baby in the hospital or do you HAVE to switch to an OB that you aren't familiar with? At least if you had your midwife you wouldn't have to redo all your research into a changing practice and just stay with her, if she already knows everything you are down with for the birth. I have a midwife and a doula but I will give birth in the hospital (because I live on a small island and certified midwives don't deliver here because we are too far from the hospital) Anyways, is that possible for you?

post #3 of 16
I am so sorry talldarkeyes! What a bummer to hear of this so late in the game! So someone gave bad info to your family the first time you inquired? That is just SO frustrating.

If it makes you feel any better, chances are that a physician who's chosen to partner with a midwife is keenly aware of the concerns of natural-minded moms.

When we had to transfer to OB care, I was so worried, but ultimately really reassured by our hospital tour, and what local doulas had to say about the midwifery practice's back up, who we ultimately went with.

I'd suggest making an appointment to talk birth plans ASAP, and if you can poke around in the local doula community, find out about your possible new caregiver, and maybe even ask your midwife to be your doula if she doesn't have hospital privileges.

Either way--- my heart goes out to you!!
post #4 of 16
Thread Starter 
Homebirth midwives here do not have hospital privileges,unfortunately. One of my midwives is my friend so dh and I were planning on asking her to doula for us in the event that we do need to transfer care. Unfortunately she is German and totally unfamiliar with US hospitals and their procedures. I have my next appointment with my midwife on Monday, though, and then see what she has to say.

Cynthiamoon, my midwife is an in network provider with my health insurance and has been fully reimbursed for homebirths from my insurance company before. It is only recently, when my midwife tried to get paperwork from the company for my homebirth that they have backpedalled and decided to no longer cover home birth. My midwife even talked to a supervisor who said "yes, we cover it. We just need to review." But evidently not.
post #5 of 16
Now that seems even worse! Can they even do that? I don't know much about how a provider gets in network, but it seems like there should be contracts of some sort.
post #6 of 16
I'm just so frustrated at our medical system. We are shopping around for a new insurance plan this month and I am so fed up with it all. This is just one more injustice to add to the list!
post #7 of 16

Oh, talldarkeyes, I'm so sorry. That sucks so much to have to change gears this late in the game. I'm angry at the insurance company on your behalf! 

post #8 of 16
How infuriating, this is not the kind of stress you need right now. Personally I think, unless you are at some sort of risk like placenta previa, gd, etc a home birth should be perfectly safe. With healthy pregnancies there are few misshaps when birthing at home. That rhetoric was made to scare and intimidate you. With that said, if you need to look into a hospital birth, it is truly better to know and be safer than sorry. Remember you are the patient and have the right to refuse any undesired procedures. I desperately wanted a birth at the birthing center nearby but couldn't get clearance for one because of gd so I have to go to the hospital but I've written my birth plan and will have it enforced. Nobody is going to bully me!
post #9 of 16
Thread Starter 
I had a really traumatic hospital birth with my dd and I knew that by having a homebirth I could avoid many of the terrible things that happened. I know my husband is a big advocate now, whereas before the nurses and midwives scared him shitless. Even so, I was looking forward to not having to fight and it seems like this whole pregnancy has been nothing but, except this time it has been a fight with our insurance company, not a hospital. Why is it so hard to get a peaceful birth on my own terms?!
post #10 of 16

If it were me, I'd still birth at home. Chances of needing a transfer are pretty low. Sucks that the insurance company did all that though!

post #11 of 16
Thread Starter 

Dayiscoming, do you know the statistics on that? I really would love some information so I can make the best choice. I am leaning more towards the homebirth too.

post #12 of 16

I think it varies from midwife to midwife. I know overall it is low. I would recommend asking your midwife's transfer rate. 

 

Interesting thread I stumbled on http://www.mothering.com/community/t/565839/what-is-a-good-transfer-rate-midwives-homebirth

 

I know my midwife's transfer rate is low. She only transfers for real emergencies or if the mom would insist on it for pain relief, which I know I would not. HTH

post #13 of 16

It sounds like the insurance company is trying to make a risk-based decision--which is what you're trying to do too (and we all have to do at some level or another). It sucks to get this info so late in the game, but better now than after the fact.

 

Personally, my financial risk tolerance is pretty low, so I'd be working the dual path right now (fighting with the insurance company, while simultaneously planning to transfer to the OB practice--and maybe planning to hire the MW as a doula, if she'll do that). My major concern is that they'd deny coverage to both you (if you needed a hospital transfer) AND the baby, if he/she needed one. Good luck, I hope it works out for the best!!

post #14 of 16

good advice, Ruheling!
 

post #15 of 16
Thread Starter 
It looks like we are going forward with the home birth. In the case I had to transfer it would be extremely hard to prove that it was due to the fact that I was attempting a homebirth. My midwife thinks it is illegal for them to deny reimbursement in the case of a transfer and she is calling the state insurance board.

Rhueling, that probably wouldn't be a good choice because it puts my midwifes backup OB in an awkward position. I guess if the OB agreed beforehand it would be fine, but like I said, I don't have much time.
post #16 of 16

Hopefully, it all happens smoothly. I think it's odd that they could deny paying your care if you need to transfer too. Makes very little sense. So, hopefully your midwife gets that figured out.

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