Midwives, what would you want?

[bygones75]

So I am in the position of really wanting a homebirth, but my insurance won't cover it. It's 6K (according to the homebirth midwife I spoke with.) I just don't have that kind of money. I so want a homebirth, but I don't want to insult her either. So I was wondering if y'all could read what I was going to suggest to her, tell me if it's ok... and also tell me: what would you want in a barter situation? I've just learned of it, and honestly, I have no idea what I have to give! I'm a drama teacher, so unless she wants acting lessons, I'm useless.

Ok, here is what I was going to ask and suggest after telling her the financial situation.

1) I have a $1000 saved, and my dad is giving me $2000. I could probably save up another $500 or so before the baby is born. Is there any discount for paying cash upfront before the birth?

2) Is there any discount for coming into her practice later? Say, 35 weeks?

3) My husband works for the airlines and we can get standby tickets cheaply. Could we send her and a friend on a trip somewhere she's been wanting to go?

That's all I can think of. If I'm being silly or ignorant, let me know. I've never had to ask someone to come down in their fee and I'm embarassed.

Thank you for your help.

[mwherbs]

if you come late costs the same-- infact people who come late I want to charge more because they are always always more work-- talk to the mw- talk to her about your finances-

[snugglebug14]

all of the midwives I spoke to basically said "pay what you are able to pay" if you are upfront about your financial situation most seem to be really understanding. One I spoke to said we could barter for things like housework, odd projects around her house, dump runs with my busbands truck things like that. just have an open conversation and I'm sure you'll be able to work something out. Also, maybe it's just the area you live in but 6k seems really high to me. hb around here are typically 2800.

[bygones75]

Yeah, you're right. I just have to be honest, but I feel like a beggar.

I live north of NYC, so just about everything is more expensive here, unfortunately.

Good idea about housework and projects, etc. I didn't think of that.

[momto l&a]

Originally Posted by mwherbs

if you come late costs the same-- infact people who come late I want to charge more because they are always always more work-- talk to the mw- talk to her about your finances-

My mw charged me less because I hired her so late. Took me forever to find a mw who would do a hb for us.

[JunipersMom]

It never hurts to ask... Personally - I really like it when families make it a priority to figure out their finances, abilities etc.. to offer for the birth they are hoping for. I think you have great ideas and they sound like a great trade. Another thing I like to hear is when families do have a barter system in place - they pay more if they can and they make a point of starting to save for their next birth right away so they can pay full price

[DoomaYula]

I think there's a difference between deciding late -- after getting prenatal care at a doc or something -- that you want a hb and finding a mw, and knowingly not hiring a mw til late to save money. Ya know?

My motto is: it never hurts to ask. Good luck!

[bygones75]

Originally Posted by YumaDoula

I think there's a difference between deciding late -- after getting prenatal care at a doc or something -- that you want a hb and finding a mw, and knowingly not hiring a mw til late to save money. Ya know?

My motto is: it never hurts to ask. Good luck!

I wouldn't be doing it late to "save money". It's money I don't have. That's the problem. I just want to give her as little work as possible for a reduced fee.

[memiles]

Realistically, though, she has to do all the same work no matter when you start care with her. It's actually more work for her to have to scramble for all the information she needs, not to mention the relationship building aspect of prenatal care.

I think the offer of bartering with plane tickets, with the rest paid in installments would be your most fair option.

[mwherbs]

yep-- can be more work and another provider may be not so careful or give the best information-- for example something that is typically missed and an intervention I just see way too much of locally- for the glucose screening they do not warn mom to carb load for a week ahead of time- it is how the standard test was made up and most docs don't think about diet and just think that the majority of women eat more than enough carbs so no need to tell them to carb load-- then the glucose test is off because she has been eating carefully and now she thinks she is GD- doc recommends weekly ultrasounds or some do non-stress test and start talking potential c-section to protect against loss or damage because of a potential big baby... see this mess happens all the time- how much work is it to prove to a woman that the test was done wrong to begin with and then try to exorcise the fears that have now settled into her and her partner and other family members-- and even the doc who now thinks that I have irresponsibly stole a diabetic client! sorry more than you asked for but it happens so often and there are other senarios-- remember doctors in this country have 1/3 of the women afraid that they uniquely have something wrong and cannot have a baby anyother way than surgery.
talk to the midwive and I know you have already said you would- it isn't the same as begging it is being truthful about your situation- more often than not a midwife finds a way to help or makes a referral to someone who can-

[bygones75]

Originally Posted by memiles

Realistically, though, she has to do all the same work no matter when you start care with her. It's actually more work for her to have to scramble for all the information she needs, not to mention the relationship building aspect of prenatal care.

If that's the case, then that's fine. I don't want to give her more work. I just resent the implication in the previous post that I would do that to "save money". This isn't a case of being cheap. Just a case of being really strapped for money. I'm already ashamed of it.

I've decided not to ask, but rather start researching UC. If I can't afford a midwife, then perhaps I can learn to birth the baby myself. After all, lots of women on MDC do it beautifully. Hopefully I can learn from their experiences.

[nurnur]

you CAN have the birth you want! I know how discouraging the $ issue can be. If this mw doesn't want to take what you have to offer, keep looking, there has to be a mw around that will work with you on a sliding fee. Good luck and happy birthing vibes to you!

[nurnur]

oh gees, I should have read you last post more closely, since when I was writing mine I was thinking "you COULD always UC!!!" but I didn't want to be radical just in case the thought of that freaked you out! You could surely find a doula or lay midwife to come and help for a fraction of the cost, and this Im saying as physical/emotional help not necesarily medical. The sky is the limit really, and when you look at it that way you will manifest the right scenario for you and your birth. Start asking around and getting a feel for who the birthworkers are in your area.

[SublimeBirthGirl]

$6000? Jeeeeez. Even for women whose insurance won't pay? That's twice what the most expensive midwives charge where I live. I loved my UC

[bygones75]

Thanks, Carrie! You made me feel a lot better. I have a doula already... I'll talk to her about UC. And I never even thought of a lay midwife. Good idea!!

[Defenestrator]

I have found in my state that the CNMs fees are higher than the CPMs on average. I think that NY is a litte more hostile to non-nurse midwives than Michigan (where I am) is so it might be different.

I have a sliding scale for people who don't have insurance and my lowest posted fee is about $1000 less than my highest posted fee. I must admit that I am totally random when it comes to giving bigger discounts than that. It has a lot to do with how overtaxed I feel at the moment and how my family is doing financially. I did a birth this spring for $500 and was happy as a clam about the whole experience and felt like I got compensated well -- it was a fantastic family and I felt sympathy for their story and reasons for transferring to a homebirth at the last minute, but I have refused to help others who call and ask for fees lower than my posted fee, usually because they are too far away and I feel like my effort would be too high for my compensation or because I felt like they didn't value my services.

I hate to see you make a different choice than you would have otherwise because of money. So, if you were calling me and wanting some flexibility on payment, here is how you could be more successful:

When you call midwives, don't make the first question about money. I am much more willing to give a discount to someone who spends time with me on the phone and wants to know about me and about the services I provide. It may be silly, but it makes it seem like they really want me because we are a good fit, not just because I might be the cheapest. When people call me and ask about money right away, something inside of me gets a little defensive and I feel less generous.

Ask about extended payment plans as an option. If you can give a lump sum up front, many midwives would be willing to take payment for the rest in installments.

Ask them in a roundabout way about joining care later or getting less care in exchange for a smaller fee: Say, "Is there any way that I can make my care with you simpler for you so that you might feel that a lower fee is fair compensation for your work?" I guess that I am not like other midwives in that it really doesn't bother me if someone joins me at, say, 32 weeks, especially if we have been in contact before then and I have some sense of how her pregnancy is going. Getting some of the labwork that I usually provide as part of my fee from another provider helps lower costs. If someone has a doula at a birth I might not bring as many assistants -- that lowers my costs or effort.


If none of this works and you still want to have a midwife-attended birth, you could consider hiring a travelling midwife. Hey, if you are due in November or December I might be able to help you! (I'm mostly kidding, but sitting in a hotel room knitting and watching TLC while waiting for you to go into labor does sound pretty good right now). I think that you could probably get a fine midwife for the amount of money that you could raise before the birth.

Good luck!

[Defenestrator]

Oh, I see you are due in early October. Bummer for me. I am swamped then. But the travelling midwife is still an option. There are a lot of them out there.

Good luck!

[Defenestrator]

Oh, one more thing -- you mentioned bartering plane tickets. If you could get them on a specific date, say, around a midwifery conference that I wanted to go to, that would be hugely attractive to me as a barter. I always want to go to conferences but can rarely afford the travel costs.

[heartandhandsdoula]

HB in NYC is super pricey, mine was 5500.00 The city that I lived before it was max 1500.00.

Who are you using? Most of the MW's are really great and will do what they can. It is so worth the $ though, I only had to pay 2000.00 out of pocket but I would have paid much more for the experience that I had. Good luck!

[bygones75]

Defenestrator, thanks for taking the time and giving me your suggestions. That's kind of you. After much thought though, I just don't feel comfortable asking someone to lower their price. I'm going to find some birth-friendly pals and ask them to help me at home. I know it'll be scary but I'm sure I'll do ok. It makes me feel better that lots of women do. And I'll still look into the lay midwife option, though it's proving to be more difficult than I thought.