We are going through the process of trying to get our MW care covered through BCBSMA. While BCBSMA has hundreds of 'in-network' midwives, all of them perform hospital-only births. Those we spoke with also work on a rotating on-call basis, meaning that the person I see for months for prenatals may indeed NOT be the person who delivers our child.
My husband & I feel passionately about a home birth. Fortunately my primary care doctor feels the same way (his wife has had 6 home births with a midwife!!), so he eagerly submitted the referal for me. BCBSMA denied it on grounds that they have midwives already, so I don't need to go "out of network".
Below is the letter I sent to the "grievances" department just yesterday in hopes of turning the tide...
Hope this helps others out there - and hope it works for me!! If anyone has other advice, I'd love to hear it!!
Re: Case #XXXXXX
Dear XXXXXX -
Thank you for providing me with your email address so that I can submit a formal request for my case to be re-reviewed.
As you are aware I am requesting coverage from BCBS for midwife services from a non-participating specialist, namely Deborah Eastman of Home Birth Midwives (http://www.homebirthmidwives.com)
. The single reason for my request is to enable me to deliver our child in the comfort of our home.
My husband and I spent many hours calling, speaking with and (in some cases) visiting all of the midwives listed in the BCBS network for this region. While many of them seemed well qualified as midwives, none of them provide the service we require - namely a home birth.
Deborah Eastman, our midwife of choice, is a midwife who will provide all of my pre-natal care, part of which includes a home visit; attendance at labor and delivery in my home; and finally postpartum care, also in my home. I encourage you to visit Deborah's website (http://www.homebirthmidwives.com
) for her philosophy of care.
My reasons for electing a home birth are as follows:
- I am proceeding with a normal, healthy pregnancy with zero morning sickness and overall excellent health.
- Since pregnancy and birth are natural physiological events, normal birth does not belong in a hospital.
- The natural course of labor is perfect and should be interfered with as little
as possible. At home I will avoid unnecessary medical interventions such as
episiotomy or constant fetal monitoring.
- I expect that with a homebirth, our baby’s birth will proceed gently and
naturally unless a real emergency occurs. If I am transported to a hospital
during my homebirth, statistics indicate that me and our baby are just as likely to have a good outcome as if I had started out in a hospital setting. Many experts believe that our baby and I will have a reduced chance of getting an infection if I am not in a hospital.
- Medical management of pregnancy and birth should be limited to those which are medically complicated. If my pregnancy changes to fall into this category, my midwife will refer me back to my OB/GYN and hospital.
- Unnecessary medical interventions complicate normal labor, creating additional risk and the need for more intervention.
- Comfort and security will help me cope with labor. Comfort and security exist in my home. Women who give birth at home report a greater sense of control over the experience and this sense of control generally contributes to greater overall satisfaction with the birthing experience.
I'd also like to reference a study conducted last year regarding the safety of
home births, based on 5000+ planned home births in North America. You'll find a reference to the study at the Citizens for Midwifery website
) and the actual study at the British Medical Journal's site
. The study found that for low risk women in the United States, planned home births are as safe as hospital births.
In addition, according to a US-based study by Anderson, et. al published in the Journal of Nurse Midwifery, (44(1):30-5 1999 Jan-Feb), "The average
uncomplicated vaginal birth costs 68% less in a home than in a hospital, and
births initiated in the home offer a lower combined rate of intrapartum and
neonatal mortality and a lower incidence of cesarean delivery." See alsohttp://web.centre.edu/david/Home%20B...ub%20Draft.doc
My primary care physician, XXXXXX (Provider # XXXXXX)
wholeheartedly supports my decision for a home birth.
Please honor my desires for a homebirth by allowing coverage of care by Deborah Eastman. Please feel free to contact me at this email address
(XXXXXX) or on my cell XXXXXXat any time. I am now 16+
weeks pregnant with an expected due date of June 9th, 2007.
For your reference, my midwife's contact details are as follows:
Deborah Allen Eastman
83 Inman Street
Cambridge, MA 02139
Thank you for your consideration,
Aiyana, Michael & "baby" XXXXXX