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Homebirth compared to birthing center compared to hospital......

post #1 of 15
Thread Starter 
I know how much it costs to have a baby in a hospital. I used to be a mdeical biller for a hospital and had my own in one. Since I worked for them everything was free.

How does a homebirth work. Do you have the baby at home and go to a hospital or do you just stay home? How do you get a birth cert? Is it expensive?

What about a birthing center?

Is a midwife expensive or does it depend on the person? How do you find a GOOD midwife? Some of you gals sound great as OB nurses and such......

I know things shouldn't depend oncost....but sometimes they do.

Wil insurance cover a midwife birthing center or homebirth....

Thanks...anything you can tell me would be terrific!!!
post #2 of 15
How does a homebirth work. Do you have the baby at home and go to a hospital or do you just stay home? How do you get a birth cert? Is it expensive?
I had my first baby at home with a licensed midwife. I believe the total cost was around $1200, but my insurance paid for everything. I'm not exactly sure, but I think because it is legal to have a homebirth attended by a midwife in Florida, insurance companies are required to cover the expenses just as they would for a hospital birth. We just had to order our birth certificate from the health department, I think it cost $10. Technically we were supposed to take our newborn to the pediatrician within 24 hours of the birth, but our pediatrician talked to the midwives and said since everything sounded good we could just wait until Monday (he was born on Friday).

Is a midwife expensive or does it depend on the person? How do you find a GOOD midwife? Some of you gals sound great as OB nurses and such...

We interviewed most of the midwives in our area (4 or 5), and they all had roughly the same costs, it may have varied by $100 or so. As far as choosing a good midwife, we went partly by our instincts, but also by intensive interviews we conducted with each midwife, and recommendations by women we knew who had their babies at home. Most of the midwives we talked to gave us phone numbers of some of the families they had attended. We had a list of questions we compiled from many of the books about homebirth. There are so many things you may want to know, how many births do they plan to attend each month, how they handle certain emergency situations, which hospitals they prefer in case of transfer, how involved or hands off are they during the labor... In Florida midwives go through a 2-year degree program and have to keep current licenses, so we asked about that, also. We chose the midwives who were the most patient and thorough about answering our questions We also liked that they attend every birth together unless two occur simultaneously. They also had much more experience than the other women we interviewed. It took some time to find the right midwives, we actually did our initial interviews while we were just TTC!

I liked Ina May Gaskins book 'Spiritual Midwifery', and also Elizabeth Davis' Heart and Hands, they both give you lots of great info about every aspect of homebirth.

Sorry so long, I just loved my homebirth and enjoy talking about it with other mommies
post #3 of 15
Look for the book Gentle Birth Choices by Barbara Harper. It has some good info about each of these choices, and also has an incredibly wonderful and informative video of births in various locations. Whether insurance will pay for homebirth depends on where you live and what insurance you have. It usually will cover birth center birth. In terms of costs, hospital birth is by far the most expensive option for insurance companies. They'd save a fortune by funding homebirths. Go figure. If you're curious about the research into various birthing options, Henci Goer has two great books about that. I wrote my dissertation about this stuff, and the nutshell is that home or birth-center birth is very safe for women with normal, low-risk pregnancies (ie, most women). There has never been a study which shows it to be less safe than hospital birth, and in many cases it's clearly safer due to the MUCH lower rate of interventions. And as many of us on these boards can tell you, giving birth outside a hospital with a midwife is really a joyous, incredible experience. You can also have a joyous birth in a hospital, but it takes a bit more work to preserve your rights and choices as a laboring mother. If you choose to have a baby in a hospital, it's worth hiring a doula, choosing to have a midwife attend you, etc. to minimize the chances of a needlessly medicalized birth. Hope this is helpful!
post #4 of 15
Hi there,

since I'm in Ohio, I thought I would weigh in (since every state is different, and OH is very different in some ways from what other posters have said applies in FL)

here in OH only Certified Nurse Midwives are "legal". I say that with quotation marks because non-nurse direct entry midwifery isn't illegal, it's allegal, which makes it harder to find a non-nurse midwife, and means that non-nurse midwives are not covered by insurance in our state. Or at least I've not heard of anyone who has been able to get a non-nurse midwife HB covered.

Midwives vary in skills and personality. Certified Nurse midwives are a little easier to pin down, in that they have all completed 4 years of nursing school and then 2 years or so (it varies) completing a masters in midwifery. Direct entry midwives are sometimes also trained as nurses, but opt to not get the CNM title, others are totally experientally trained.

As midwifery becomes more sought after midwives are easier to find. Your childbirth educator might know of one, or if you know a La Leche League leader ask them. Sometimes CNMs advertise in the yellow pages. Interview. Read lots of books on midwifery. Ask lots of questions.

Special Delivery by Rahima Baldwin is a good one, if I am remembering right she talks about choosing a midwife and lists great questions.

My homebirth with a direct entry midwife will cost me a little over $1000. None of it covered by insurance. My other options, a homebirth with a CNM practice, or a birth center birth with a CNM practice would have cost me $1000 and $1500 respectively, out of pocket. No cheaper, but then, CNMs often charge more than a direct entry midwife, so even with insurance, it can balance out. But of course, everyone's insurance is a little different.

If you need some resources in OH, I might be able to help you out with that too.

post #5 of 15
Homebirth is covered by some insurance companies, but not most, I think.

My homebirths were $1500; I've heard of fees ranging from $750-$2500. Remember, many midwives will do sliding scale, payment plans, or bartering! Ask around.
post #6 of 15
My homebirth was in VA. Cost $1600 and I was re-imbursed $1000 by Tricare (military insurance). Whether ins will pay for homebirth depends on a couple things... generally it has to be toatlly legal, your practitioner licensed, etc.. and then you have to have an ins program that pays 'out of program providers'. I suppose there may be a program somewhere that has a home modwife or two as a 'preferred provider' but I haven't heard of one.

So hey, tell us... what does a hospital birth cost?
post #7 of 15
here in TN we have recently added state licensing for direct entry midwives. My midwife is a CPM & uses an insurance billing agent, so even though we will do a home birth, it will really look like a birth center birth thru the insurance biller. Then Cigna is so darn happy @ how much $ they saved not paying the hospital, they just pay it!
All the books mentioned are just tremendously good books. I would say that I have heard of women having very successful & rewarding natural births in all 3 locales: home, birth center, & yes, even hospital. However, I did chose a home birth bcz I think I have the best odds of getting that successful, natural birth here @ home.
best wishes in your journey, Maria
post #8 of 15
I called a homebirth midwife practice in Columbus, and they said you have to pay for the birth up front, and they submit it to the insurance company. I didn't ask how much it costs! But generally it costs between 500- 2500, depending. I think that is much less than a hospital birth. I don't know how much they cost because our insurance paid evrything the first time. I just had to pay 100$ copay for myself and 100$ for the baby, the first time. But, I would pay the extra money for a homebirth. It's a long story why I am still having a hospital birth. I want one, dh isn't into the idea...yet.

For now I will live vicariously through other's stories of their homebirths!
post #9 of 15
Thread Starter 
Cost depends.....on days of stay and type of delivery

a natural birth with a healthy baby costs about 2000 between mom and baby a little more with circumcision

an epidural adds about 300

a c/s costs about 3100 for mom and healthy baby 60 bucks for circumsicion

then it depends on if you need billi lights for baby or they need NICU or drugs

There are a lot of factors...our hospital charged 212.00 a day for a private room and NICU is about 450.00 i think

Plus even if you room in they charge you room for baby

usually you also have to pay for phone and TV

Thats about it...I'm sure there is more..but I havent been working for 6 months!!!
post #10 of 15

deliveries And $

In California

Homebirth w/ a midwife and doctor cost me $875.00 in 1980 and $1200.00 in 1983; my insurance covered the 1983 birth only. I went to a pediatician that was recommended by his practice; this pediatrician would have made a house call (for a price) and had privileges at Children's Hospital and would admit a sick newborn, but was worth it.

In 1985, I paid a midwife $1500.00 for a homebirth.

The cost always included nine months prenatal, six weeks postpartum, and the delivery. Lab work was extra. I went to a pediatrician on my own. My midwife took care of the birth certificate.

In 1992, I paid the same midwife $2,500.00 for another homebirth. I took care of the birth certificate and again went to the pediatrician myself.
post #11 of 15
Well, I thought I'd chime in here since I happen to know exactly how much my ds hospital stay was after my c/section, altho I never got a bill for my stay so I can't help you with any numbers.

My son was with me in the hospital for 4 full days. He roomed in and spent maybe a total of - 20 hours in the nursery, most on the first day after c/s.

His hospital bill was just under $6000. That did not include pediatrician visits either.

Just thought I'd share.
post #12 of 15
This probably sounds crazy, but here's what I'm thinking of doing.

A hospital birth would cost me zilch. Our income level went down 30% this year, so we qualify for Hoosier Healthwise which picks up the tab on what my Anthem doesn't pay.

A birthing center birth would cost me $1900. My $900 deductible, then 10% copay for CNM (covered by insurance) and 30% copay for birthing center (considered out of network). The only reason I'd only pay $1900 is because that is the max out of pocket per person per year whether in or out of network (Hoosier Healthwise will not cover a CNM).

A home birth would cost about $1450.

A friend of mine is going to OBs for prenatal care and delivering at home with a midwife. Because the midwife is only doing the birth and not prenatal care, she's charging her $750.

I'm thinking of trying that out, because if I have to have the hospital birth I would hire a doula which would cost me $400-$600 so it would only be a little more to go the prenatal care with OB route and homebirth with midwife.

Wish me luck and good luck with your decision!

PS- my hospital birth with dd cost over $4000. No epidural, just a shot of Nubane, my Pitocin drip and lots of monitoring.
post #13 of 15
I haven't read the replies you have, but I will tell you my experience. Sorry if it is the same as other's replies.
I had my 1st son at a natural birthing center, my DD at home.
My insurance covered the cost of both births and prenatal care, which was about $4500 with each pregnancy/birth. They weren't going to cover the birth center with my 1st preg, but the director called and explained the fact that it would cost them less than a quarter of what it would cost for an OB and hospital, and they said "okay".
For both my birth center and home births, I had the same group of licensed practical midwives (not nurse midwives). They run their practice from the birth center. Childbirth classes were included in the cost of pre-natal care and so were all tests, etc.
When I had my DS at birth center and my DD at home, the midwives filled out and mailed the paperwork to get their birth certificates. The cert's came in the mail about a month later.
After my birth center birth, we stayed there for 4 hours (required) and then went home. The midwife did a home visit the next day, then again at 3 days. My DS saw his pediatrician after that for the first time. After home birth, midwife stayed for 4 hours, then same home visits, then DD visited pediatrician on day 5. My midwives also do 2 wk and 6 wk post-partum checks.
I was very happy with both births but liked home birthing better. It was wonderful and comfortable and great!
Good luck!
post #14 of 15
I'm seeing naturopaths who do homebirth. They also provide pediatric and GP care. It's $2500 for the birth, payable afterwards, and the insurance company is covering 70%, so we've got some time to save up. The whole thing includes all the prenatal stuff, homebirth, 3 visits after the birth, some/all at home, with pediatric.
post #15 of 15
Busy busy momma- we used to have Anthem- that's how I only paid 100$ copay for myself and the baby But I am sure it cost more than $1450!! I had my own room, but the way it was explained to me was that the room becomes semi-private once you have the baby So you aren't "billed" for a private room. Anthem was good insurance.

Dh's company paid for the insurance...though we still "paid" because if they didn't pay the insurance, we'd be paying it. And since they paid, it was like his "income" -know what I mean?

I hope you get your homebirth, busy busy momma!

I think it's more cost efficient if you do have a homebirth, even if you have to pay out of pocket. Seems like most homebirths are less than 2500$, and most hospital births cost 3000+...usually more. Unless you have special circumstances, like you are military or something.

The only thing I had was pitocin and nubane too...no circumcision, etc. Oh- I had an episiotomy. And of course we had to do all the tests for the baby, and vita k and eye goop. But this time I don't think I will be getting any of that! No pitocin, no epi, no pain meds, no circ, no eye goop!
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