How do you pay for homebirth?

[Cindi]

I am really interested in home birth but cannot afford it. I can get coverage through the AIM Program (is that specific to CA?)--Access for Infants and Mothers--which offers two HMOs but no insurance that would be accepted by the local Birth Center. I haven't called all the midwives to find out rates, but I got discouraged after my first rate quote. The hospital could be free, with an in-house CNM. How do you manage to pay for homebirth?

[Arduinna]

Our midwife accepted payments and had a sliding scale fom those that couldn't afford her very reasonable rates. Honestly I don't think it's a good idea for insurance to pay for homebirth. With insurance comes control.

[Cindi]

good point

[khrisday]

Cindi,
Even though we had private insurance, we were able to get Medi-Cal for the pregnancy. They paid all but a couple hundred dollar fee for the second midwife (CNM- I think it was $250) I had an excellent CNM in Santa Rosa from Redwood Midwifery on College Ave. He name was Carol Garrett, and if you see her tell her we say hello!

[Cindi]

khrisday, I know the place on College and went there once (last pregnancy) with a friend who had Carol as her midwife. I will talk to them. How do you apply for medi-cal? I have been trying to figure it out through their web site but I see nothing about income brackets or how to apply.

[khrisday]

Cindi,
You may want to call their office and talk to someone about your circumstances. They should be able to answer questions and direct you.

[rainsmom]

My homebirth and prenatal care with midwife was covered almost completely by insurance (aetna). I did end up going to a hospital in the end, which was also completely covered

[cottonwood]

Some midwives do barter, payment plans, and/or sliding scale.

[applejuice]

how do you pay for a homebirth?

Like everything else that is worth it, I paid for my midwife with my own $.

Four times.

You have to get your priorities straight.

[MysticHealerMom]

Re: how do you pay for a homebirth?

Originally posted by applejuice
You have to get your priorities straight.

True. I just thought I'd toss in a little vent.

Insurance isn't "free". I just get a little twisted every time someone says, I'd do homebirth, but hospital birth is free. (or insert your favorite alternative health care here) It's NOT. It's a deferred and hidden. You pay for it through your employer, or your partner's employer, or through taxes, deductables, etc. And they can still itemize your bill and choose what to pay and what not to pay. There are so many hiden ways that insurance, hospitals and the pharmaceutical industry ingrate themselves into our lives and make us dependant. If you pay for medical bills outside of insurance, you can deduct it on your taxes if you itemize. My DH and I have to do this because we elected coverage and paid for things that our insurance didn't cover, and dh's health insurance didn't kick in right away. We budget so that we can pay for things we want, and that includes the kind of health care we choose. And as a consumer, I'd rather have the choice, regardless of what the industry and govt choose for me. If I could, I'd only purchase major medical insurance, which covers accidents and serious illnesses, and pay for all well-patient stuff myself. When I was an independant contractor this is what I did.

One of the things that has caused the cost of health care to sky rocket is the invention of Medicare. And we've all heard about how so many healh care providers have been bilking THAT system, it's disgraceful. Not that I'm saying we shouldn't have it, but now that medical expenses are so out there, we need it. HMO's are another story. They intended to provide well-patient and health education, but discovered after they set up that people didn't want that stuff, they just liked paying $5 to see a doc any old time, and since they never saw the cost of their health care, they didn't care if they saw a doc every week. I know that sounds crazy, but that's what the statistics show. HMO's had to try to recover from this poor business plan, and they just aren't able to.

And to toss in another tangent, alternative medicine is so much more cost effective. It's less invasive, has fewer side effects, if any, people are more actively involved in their healthcare and the basic costs are less for more and better coverage. Most people in the alterantive medicine trade aren't in it to make money. The costs of education are the same, but the return on investment isn't the same as for MD's, etc. It almost doesn't sound like a smart idea business-wise, but it is so much more fulfilling to heal people than to keep whacking them with a medicine stick until they're better or dead.

ARGH. Ok, I feel much better now.

Thanks.

[birthinglau]

Amen and Halleuiah MysticHealerMom! Your vent was exquisite. And I second Applejuice on finding the money to pay for what you think is important.

HB Midwives don't make very much. I know this cause I'm planning to become one, and once you've educated yourself, bought necessary equiptment (O2 tanks, fetoscope,teaching materials) and put in long hours working for another person as an apprentice for little if any pay, then you hang out your shingle, pay your dues to your certifing org. (if you so choose) and still only make $1000-$2500 a birth. Did I mention you provide prenatal appts. that last 1-2 hours instead of 6-12 minutes? You labor sit, sometimes for 24+ hours with a woman (think of what that would average out to if midwives were paid hourly?). You attend national and international conferences and workshops that cost hundreds to thousands of dollars to keep up on skills and research and network with other midwives and drs. You are often the only person on call, not one of 6 in a group. You provide much needed postpartum care, no extra charge.

Maybe the question should be how do HB midwives afford to be midwives? Well, of course the answer is, for most of them, love of what they do and the women and babies they assist.

Sorry if this is OT....

-lau

[kama'aina mama]

Good points all! I recently had a chat with one of our local midwives. He told me that he worked it out once and his average hourly wage on most prenatal care + delivery cases was about $4/hour. And people still act like it "costs too much" to hire him. It is too bad.

[MysticHealerMom]

T

a guy midwife? nifty.

[kama'aina mama]

Yeah. He has an awesome reputation 'round here. I believe he may have been a licensed physician in Holland or somewhere. When he came here he worked as an L&D nurse for a while at the local hospital. (The local Bradley instructors first became aware of him when some of their students came back after their births with stories about this AMAZING male nurse.) After a while he started doing home births. He does all or almost all water births now. Delivered a good friend of mine a few months back and she sings his praises. If I manage to get knocked up again I will almost certainly use him too.

[MysticHealerMom]

and I had this idea that if HMO's placed homeopathic/naturopathic physicians infront of MD's, they'd collect a lot more patient history and prevent a lot of reactions to medications, etc. Plus people would get that education and self-involvement that they should be getting regarding their healthcare.

there's a Kaiser HMO in New Mexico that has more midwives on staff that obs or gyns. Like 10 to 1. And they really lowered their costs and people were a lot happier, etc etc.

[Megs Mom]

lau, thanks for sharing your perspective. My respect for homebirth midwives, while it was already high, has just been raised.

[Cindi]

You know maybe you folks could start a new thread rather than tell me what my question should be, and what my priorities should be. I wanted practical advice about paying for a midwife because I would like a home birth. I am also scared about our very delicate financial situation, and am feeling so vulnerable right now, morning sickness, hormonal, relationship struggles...I would like compassion. It has not felt good to come to this thread, getting so little support.

[khrisday]

Cindi,:better:2

We could never have afforded to pay for our homebirth out of pocket. Our priority was a home (ok rented apt) in which to have the baby

[BusyMommy]

I would imagine you could use a sliding scale and pay them off over time. Would your insurance cover your prenatal visits w/them? My mw charged by a global package, but I'm sure they'd be flexible/creative w/billing for insurance.

We're lucky. My insurance covers everything 100% as soon as I pay $500. out of pocket over the year. And, no, there's no control issue, no approvals, etc.

[birthinglau]

Cindi,

It was never my intention to tell you what your priorities should be, or to make light of your serious question.

My apologies if my post caused you to feel that way.

I should also say that paying for our midwife will be a stretch for us as well, we are barely paying rent and bills between the 2 of us (fiance and I) and I am very lucky to have a very small amount of $ support from my parents.

The solution for us was just to budget some money each week that we can't spend on anything else. At $25 a week, we should make the $1000 needed for the birth by babytime in march. Or hopefully close. Protecting my birth is a really high priority for me, and I fully realize that not everyone can be in the "place" that I am, as other priorties may be equally as important for them, such as kids, partner, housing etc.

-lau