Frustrated! I have few options!

[hunnybumm]

Ok, this is going to be more of a vent than asking a quest or getting support. I found out that my ins (Tricare) covers a CNM for hbs. The ONLY CNM in my area is 2 hours away and won't travel that far. So I start looking into birth centers, for me it would be a better option than a hospital, but not as good as home (but cheaper if my Ins would cover it). Plus I wanted to have a couple options incase I didn't get the support from my DH or I decided I would prefer the BC over a HB. Well after spending 2 hours searching the net, calling 'birth centers' (which are actually L&D floors), then calling my Ins company to get numbers from them (which are L&D floors), then calling the numbers, then calling my Ins company again. Just to find out there are no BCs in my area which are connected to a hospital. AND my Ins won't cover free standing BCs.

Now, I don't really blame my Ins co because they do cover HBs as long as you use a CNM... but my area doesn't have any. They do cover BCs.... but there aren't any in my area. I am so frustrated! I HATE were we are living, it's in the booneys, back hills, nowhere. *sigh* I am just so frustrated right now that I have so many options... but none of them work because I live in a hospital orientated area.

[homebirthing]

And you don't want to pay for a homebirth? You should make a list of your priorities so that you know in what direction you want to move forward with. Good luck!

[hunnybumm]

At this point I only have one option. A homebirth. I am just frustrated because I could have the majority of it paid for (except $600 for the assistant, $35 for the steril tray + whatever water birth stuff I want) if there was a CNM who would come to my area. But there isn't one. I would also have liked to have the option for a birth center, but there is no way I am paying for that out of pocket, I would rather pay for the hb out of pocket. So that's not an option.

I'm just frustrated because I should have more options... but I don't because of were I live. I don't even know if I am really making sence... I am just so... frustrated at this minute in time. LOL

[Baby Hopes]

Originally Posted by hunnybumm

AND my Ins won't cover free standing BCs.

Make sure to double check that. The one Birthing Center that is actually covered by Tricare Prime in the area I'll be birthing is freestanding. This is a good link to check out.

I do hear you on the frustration, though. I just spent a good chunk of my afternoon on the phone with Tricare trying to locate an in network homebirth midwife. So far, much in line with what I suspected, there aren't any. THEN I spent the other half of the afternoon trying to get a lead on a homebirth friendly OB who would refer me out to homebirth midwife.

I am feeling just plain drained.

And dh doesn't really get it. I mean, he's supportive, but supportive also in the fact that he's like, "If it's this much hassle just go to the hospital!" :

[wombat]

Oh that sucks. I know how hard it is to find a CNM who'll attend a HB. I consider myself extremely lucky to have found one, as I'll be a having HBAC as well. I live in an over populated area though.

If this CNM won't travel 2 hours, then how far will she travel? How about a motel or using someone's house that's, say 1 hour away? Hey, I wouldn't be above asking the midwife if she had a spare room in her house It's not ideal but if you've got to travel to a hospital, then why not travel to the midwife?

I don't know anything about birth centers and Tricare - none of the ones in my area will do VBACs so I didn't even look into it. But my basic rule when dealing with kinda stuff is never believe anything I'm told unless I hear the same thing from at least 3 different people.

[hunnybumm]

Well, I called Tricare and they directed me to Health Net. Health Net told me they don't cover free standing birth centers and they only cover birth centers that are in network, but attached to a hospital. They also said I couldn't go out of network unless there was nowhere within 40 miles of my house where I could deliver ie a hospital. Which there are 2 within 40 miles, maybe more.

Baby Hopes - Thanks for that link I will call Tricare (who will probably transfer me to Health Net) and give them the information on that document. I asked for an in network birth center and they said theren't weren't any. So I will have to call again tommorrow and harrass them. I mean, I would still love a hb, but that will come out of our pocket 100%, plus I would love a back up. And, I could always go to the CNM and plan to go to the BC, but I could change my mind at anytime and do a hb with the CPM. I already plan on using one of the lay midwifes as a doula even if I have a BC birth.

As for birthing in a hotel. I just really don't want to do that. LOL I know how gross those places could be, and I highly doubt my DH is going to want to pay for a really nice one. Though it would be cheaper... but it just wouldn't feel right to me, I don't think. Besides I would probably feel like I have to be quiet and I want to have the freedom to act how I want.

[Stugroupie]

I feel your frustration! I have just begun my search for a midwife and have found only three in my area. The CNM I had planned to use lives nearby but is closing her practice ONE MONTH before my due date! UGH! Not upset with her, of course, but with the lack of choices available for a homebirth in this area.

I agree with you about not going to a hotel for a birth. I used to work in a hotel and I can tell you that even the expensive ones are not clean! I would have to check in a week early just so I could disinfect the room!

Good luck in your search!

[wombat]

hunnybumm, when you say you're speaking to Tricare, do you mean your local Tricare office at the MTF, the health benefit advisors? Because I found them to be useless where I am. They gave me a lot of misinformation. Mainly along the lines of 'this is what I know/have experienced with others so this is how it must be' without investigating or checking things for you. The old 'no one else has done it that I know of' so you can't either and I'm too busy to bother with it. I got very frustrated with those people.

Healthnet is Tricare in our area. Speak directly to the regional Healthnet office - either the Authorisations/Referral dept or better yet get them to put you through to the Medical Management dept. Those people know their stuff. I was very impressed with them especially compared to dealing with the general Tricare people at the MTF and base. They are the ones that actually authorise it so they can give you the final word.

[hunnybumm]

Everytime I have contacted Tricare (the 877 number) they transfer me to the Health Net people, I am not sure exactly what deparment, but I have talked to the same woman both times they have transfered me. I will see if I can speak to someone in Heath Managment deparment. Also do you have the direct number to Health Net? I didn't even think about asking, I just kept calling Tricare.

But I am on my way to the chiro then when I get back I am going to call Tricare again and speak to Health Net again, and give them the information I got about BCs a few posts ago. I also ended up contacting a free standing birth center last night and they have had one Tricare patient who was covered there. The lady didn't know if she was Prime or Standard, and if she had to pay out of pocket. So I am going to call them back this afternoon and talk to the lady who will know, as well as a couple other BCs in my area to see if they have had experience with Tricare. It doesn't hurt to tell Health Net "Well, I talked to X birth center and they have had a Tricare patient covered within the past 5 months." etc.

Shame on me for trusting what these people have said. Especially since they were VERY adimiat about not covering free standing birth centers. *sigh*

[hunnybumm]

Well, just for future reference for anyone who may be interested in this thread. I called Tricare who transfered me to Medical Managment. It turns out that BOTH free standing birth centers in my area are covered as an out of network provider, as well as the CNMs which include all the pre and post natal stuff. I would still love a hb but it's something DH and I have to decide on. As of right now my options are (a) homebirth - $2200 + water birth supplies, or (b) Birth Center - Free + doula cost of $500. So we will see how it goes from here. I plan on visiting the BC which is closest to me and seeing how I feel about the CNMs and the center. I have a meeting set up with the hb midwifes for the 25th, and a visit to the BC on July 1st. So I guess I am just going to wait and see who it all pans out.

[camprunner]

Is there away you could get your prenatals through the CNM's or even someone in network and then have a homebirth at a discounted price? I know a midwife on the other side of the state that does this. She has actually been quoted as giving a quote for both. I think the one for just the birth at one point was likek $600 and both was double that.

[gonnabeamom]

This might seem crazy, but you mentionned going to Hotels at one point, and it reminded me of all the women in Ina May's book who one reason or another had had to travel to get the birth they wanted. I wondered if you'd investigated going to The Farm for the birth. If you'd be at all interested here is their website

The Farm midwifery center

I hope you find an option your happy with. I just wish it wasn't so hard for so many women to get the options they want.

[hunnybumm]

I never really considered doing my prenatals with the CNMs, then having the CPMs be at the delivery. However, I really want to have a close relationship with whoever is going to be assisting my delivery. With the OBs I didn't really know any of them, but this is a lot different, especially for a hb. I really want to feel like I have spent plenty of time with both of them, KWIM? I might bring that up though, they know that cost is going to be an issue since we have great insurance coverage. And they also have great classes they offer for free (if you are a doula or hb client) that I might miss out of if I go that route.. definitly something to talk to them about though.

That ranch sounds really nice but definitly won't work for us. DH is ALREADY complaining because the birth center I am looking at is about an hour and a half away. To me that is nothing, I use to drive that everday on my way to school, but since he will be driving it he is complaing... but he isn't even 'ok' with a BC at all *sigh* but that's a whole nother post. My plan if we choose the BC is as soon as I start labor get everything packed up and ready to go. Shortly after that we will make the hour and a half drive. I will probably go to the BC and if they think I should wait a little longer then rent a hotel room and return to the BC later. This is something I will talk to them about when we go for a tour / orientation. I know I am not the first or only woman to drive a distance to use the BC since there are only 2 in my state.

[camprunner]

Originally Posted by hunnybumm

I never really considered doing my prenatals with the CNMs, then having the CPMs be at the delivery. However, I really want to have a close relationship with whoever is going to be assisting my delivery. With the OBs I didn't really know any of them, but this is a lot different, especially for a hb. I really want to feel like I have spent plenty of time with both of them, KWIM? I might bring that up though, they know that cost is going to be an issue since we have great insurance coverage. And they also have great classes they offer for free (if you are a doula or hb client) that I might miss out of if I go that route.. definitly something to talk to them about though.

one girl I know that basically did this was going to go UC if she couldn't find someone. She felt that just using the midwives for the birth was her best option.

You could get to know the midwives better through homebirth meetup if they'll agree to just do the birth.