HBAC, Insurance, and Indecision

[Panthira]

I'm 25 weeks pregnant and this will be my last pregnancy as long as everything goes alright. I had one c-section 14 years ago, and a VBAC 2 years ago in a hospital with a doula. The VBAC went alright but it was also a struggle with the doctors and hospital. I had to battle my way through it to get a natural, unmedicated birth. In the end, I did agree to have my baby monitored on his scalp in-utero which they said wouldn't hurt at all but left him with a scab and scar there - it had to have hurt. I also had an episiotomy, but I wasn't asked, they just said we had to cut you so the baby could come out after they already did it. Hmmpf. The thing I hated most was the way they took my baby away right after delivery (he was healthy with no issues) and put goop in his eyes, and took him to the nursery to get cleaned up and all that. My husband was with him but they were in control of him and at least 30 other babies. I get a bit of seperation anxiety after waiting 2 hours for my baby to be brought back.

This time around I can't seem to get it together. We've moved to a new area and I do have OB care with supposedly VBAC friendly doctors. They seem alright but they also seem like typical doctors to me. I'm really scared of delivering in a hospital. I tried to find a birth center here but I found out California made it illegal for VBACs.

My other option is a HBAC and while there are plenty of MWs here, I called my insurance company (Aetna PPO) and they deem homebirths to be "medically unneccesary" and will not pay for them. We live paycheck to paycheck. How can we afford a homebirth, which I'm scared of doing as well? My husband is very scared of homebirth too, he wants both the baby and me to be safe, of course. He also wonders about the mess involved and we are 1/2 hour to the nearest hospital in case of an emergency.

If I have to deliver in a hospital I'd want a doula but we can't even afford one. My doctors (there are 3 women and I have to see all of them) question my desire for a doula because they say I've had a VBAC before so why do I need a doula? UGH.

Sorry for the long, rambling post. My confusion obviously shows.

[alegna]

Just have a sec, so forgive the short post.

Homebirth is safer than hospital birth. It's really that simple.

Do some reading here and some searches for links.

I would do ANYTHING to have a homebirth. Hospitals are for sick and injured people. A woman in labor is neither. A newborn baby is neither. Hospitals are cesspools of nastiness- you are much more likely to get a deadly infection in a hopsital than at home, not to mention the rate at which people die from dr. error.

Paying for it- ask around- a lot of people have luck getting their insurance to cover homebirth at a pretty good rate. How about tax refund money? Or a good credit card offer with 0% interest for awhile? Find a midwife and talk to her- some have sliding scales or will barter.

good luck!

-Angela

[crunchymomof2]

I agree with pp. Ask around one will probably work with you. As far as the mess. I never had to clean any of that the mw picked everything up. I was also 30 mins away from the hospital. But you just call and tell them your emergency and get there asap. They could have things ready for you.

[Barcino]

An Aetna HMO is paying for my homeVBAC. I found that my midwife's administrator knew how to handle it better than we would have. What she went after is the fact that they had no midwifes in their approved list so they did a out of network exception type of a thing that covers the midwife and the birth. So you might want to talk to midwifes to see if they can get around the insurance companies.

Good luck with everything just wanted to make sure to let you know that what the insurance says is not always the way it has to be. Also, we were planning on no matter what homebirthing even if we had to borrow money. We also live month to month but I did not want to go through another csection or bad hospital experience and regret it later. Totally worth the sacrifice in my opinion. My husband said he would work at home depot or anywhere nights if he had to to pay for it. He was the one saying no way to anything but homebirth.

[orangebird]

Yep yep yep. I would do whatever it takes. I am a NICU nurse and attend lots of births in L&D. I would do whatever it takes to have a homebirth, it is that much safer.

[Panthira]

Hmmn.. well I did call Aetna again, and they will cover a CNM (certified midwife), so maybe that's the way around it?
Confusing.
My husband says he really doesn't like the idea of a homebirth though. He's terrified something will go wrong, like a lady we know. She has a very severely disabled child because of a full-term homebirth and not getting to a hospital in time. I also have a severely disabled child - from a hospital preterm birth.
He wants the safety of a medical team if something goes wrong.

[alegna]

I bet there's more of the story of your friend with a disabled child. If your husband would be swayed by talking to a pro-homebirth guy feel free to pm me- my husband thinks homebirth is the only way to go.

-Angela

[wombat]

I'm going the HBAC route with a CNM and my insurance is covering it. No birth center will take me. I don't trust hospital VBACs either. In an emergency, I'm 10min drive from a Level 3 NICU - I'm comfortable with that.

I wouldn't normally be a homebirthin kinda mom but after my last hospital experience, I don't dare go back. I just don't feel any safer in a hospital. Have you checked out the ICAN list? They have great info on relative risks of VBAC/HBAC.

CNM's also do their own risk assessment and if they don't think you're a good candidate by 36w, they'll risk you out and you'll have to go to an OB anyhow. I find that quite reassuring.

You could try talking to a few CNMs. Warning - it can be hard to find a CNM to do a HBAC as their malpractice insurance is a big issue. I think my CNM doesn't have any. But I'd rather a CNM I trust without malpractice insurance than a OB/hospital I don't trust with malpractice insurance.

Good luck, it's a hard decision to make.