Midwives, what would you want? - Page 2

[angington]

Have you spoken to her about the insurance problem? Maybe there is a way she can bill it that is generic so the insurance company won't necessarily know it's a home birth. Mine (also in NY) covered home birth at an out of network rate, but my mw just coded it as a series of "office visits" anyway.

Also she may be willing to work with you knowing that you have an insurance problem. She probably never gets the entire $6000 anyway. She probably bills high expecting to only get 80% from the insurance company. Maybe she'll drop the price to 80% of the original cost.

Seriously, don't feel embarassed to discuss it with her. Although it is rare for insurance not to cover mw's and home birth in NY, you can't be the first to have issues with your insurance company. Maybe she can work with you to get an appeal or do creative coding or something.

[bygones75]

She typically gets $5500 of the $6000 from insurance, so that's not much help to me. And since my insurance won't cover *anything* that comes from a midwife, creative billing won't help.

They're good ideas though. Thanks for trying.

[wumanh]

Where exactly do you live? I might consider coming down your way. I have a sister that lives in Putnam Valley. You can PM me with questions.

[bygones75]

Hi,

I tried to PM you... but for some reason the option won't come up under your name. Anyway, I live 20 minutes from Putnam Valley!

Would like to talk to you. My email is [e-mail]. Thank you very much.

[feminist~mama]

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!

Originally Posted by bygones75

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 didn't read YumaDoula's post like she thought you were trying to be cheap FWIW. I just thought she was saying that she might charge less if you transfer late because she'll be doing less work.

Not having $6000 lying around isn't anything to be ashamed of as far as I'm concerned! I'm sure that the midwife you spoke with frequently makes payment arrangements with clients- that's a lot of money!

I'd encourage you to talk to her and be honest about your financial situation. It sounds like you're planning to move ahead with a UC though. If that is the case, then good luck to you! I hope you have a lovely birth!

[cottonwood]

Just a case of being really strapped for money. I'm already ashamed of it.

Oh my god, why? Not being rich is not something to be ashamed of, and $6000 is a lot of money. The vast majority of people I know -- heck, the midwives I know -- would not be able to afford that, and we're all white, middle-class, and college educated. There's a kind of homebirth midwifery that is only for people who are very well-off. I'm not saying that midwives shouldn't be able to make enough to support their families, just that it is a fact that homebirth is in some areas very much a class-dependent option, unless you're planning UC. That's not right. It is not you who has something to be ashamed of, or even the midwife, but our culture and the hierarchy of wealth it supports. Women should have all options available to them, and not just if they're wealthy. That you don't isn't something for you to be ashamed of, it's something for us as a society to be ashamed of.

[pamamidwife]

I k now for me as a midwife one of the reasons my fee is set where it is means that I can do some low-cost births for a couple families a year. This is different from my sliding scale - these are births I do for very little money so women can have the birth they want without bringing money into the factor.

I'm always willing to barter, to reduce my fee, etc. All I need from a client is honesty, willingness to pay something and then stick to that plan.

[doctorjen]

Even as a hospital based provider, I discount my rate for folks with no insurance. Please don't let embarrassment stop you from asking. I feel strongly that I'm lucky to be in the financial position I'm in, and part of that is that it gives me the ability to help out some folks who wouldn't be able to hire me otherwise. I don't think less of these clients - and in fact, once the financial aspect is settled, I don't think about it at all. I bet there is a way you can work it out.

Although I support the decision to UC for folks who feel that is the best way for them to birth, I worry about folks who are going to "find some birth-friendly pals and ask them to help me at home." Midwifery care is much different than having someone who's merely interested in birth there. If you want a midwife, please do what it takes to find one who's a good fit for you - don't think you can get the same experience with a good natured friend. (And I realize that many people UC because they DON'T want the same experience as having a midwife - that's just not what I'm hearing you say.) I think it's less safe to be relying on inexperienced untrained help than to be using your own intuition, so worry when people UC merely because they can't have what they really want - a trained, experienced birth attendant.
I apologize if I'm misreading you and you really are leaning philosophically towards UC - just want to encourage you to at least ask before you rule out having a midwife-attended birth if that's what you want.

[pamamidwife]

I agree with DoctorJen - you have to talk to the care provider first. Please don't discount all your options without discussing them.

Seriously, midwives work with families. Don't feel ashamed - I don't think I could afford $6000 for a midwife, either! Talk! Discuss! Ask!

[Maggi315]

Wow, that's alot, and I mean ALOT more than we get around here! I guess it's the cost of living, but no one around here would be able to afford that fee.

I never want women to not come to me because they can't pay. I don't want to be taken advantage of either, but I am willing to negotiate a fee, take payments, barter, exchange office work/childcare, lots of stuff. I have been burned in the past, but overall, both my husband and I have used exchanges and made out very well. We have had several vacations using vacation property owned by couple or someone in their family,(disney, vacation resort, poconos) had a difficult tree cut down, etc. Right now, i am just waiting for one of my amish (or even my "english" or regular) women who quilts to make me a family photo quilt to hang on my wall.

I am in the process of writing an article about how to afford a homebirth, so this thread is of great interest to me. I would love to hear what other midwives want, bartering ideas, etc.

Please don't be afraid to ask. Don't be afraid to come early for prenatal care. Since I bill separately for each prenatal visit, sometimes people can save money there, I can do alot of counseling by phone, but I wouldn't want anyone to try to skimp on prenatal care.

And don't be afraid of us lay midwives!!!!

[nurnur]

Have you gone into your tribal area on here and asked if anyone has info on mw's in your area who will work on a sliding fee.