Affording a homebirth--questions

[Quella]

I have some questions.
I'm 10 weeks along with our fourth child. I'm so ecstatic! And so sick. ugh.

I would really really love to have a homebirth. I've had the others in the hospital without any drugs or complications. I'm ready for my homebirth!!

We have Kaiser insurance (which covers nothing related to homebirth.) It only costs us $400 for all prenatal and hospital fees to deliver with Kaiser.

We just got out of debt and are working on saving an emergency fund (anyone Dave Ramsey-ites?). DH says he cannot justify spending $2500+ for a homebirth when the hospital birth is only $400, when we are working so hard, staying in our budget and saving. I consider homebirth something that justifies using our savings. He is so loving and supportive, and wants me to be happy. I know he would do it if I said there was no other way for me, but I do not want to demand this. I do see his point very clearly.

Here is one idea that may make it more affordable-- What if we used our Kaiser insurance until all the labs and, say, half of the prentals, then switched to a midwife in month 6 or 7?
Is that ethical? Would we save money? What is the cost breakdown for midwives? Is the actual birth what costs the most?
I am meeting with some midwives next week and plan to ask them this same thing. I'd be upfront with them of course.

What are your thoughts on this?

Thanks so much!

[mnkygrl79]

that's actually what I did (except mine would only be $200 for the prenatals, birth, labs, etc....) but the midwives are charging me the same amount - they wouldn't prorate it at all :-( BUT, I did get my U/S and most of the labs out of the way before I transferred care at 25 weeks.

To me, it's totally worth the money, and luckily DH is backing me up on it. I've got enough saved up for the HB and hopefully enough for me to stay home at least 16 weeks after the delivery before I go back to work.

Many midwives can work out some sort of payment plan.

I hope that you can find some way to get the birth that you really want/need!

[Peony]

Many MW's charge the same fee regardless of when you start seeing them.

I switched to mine at 30 weeks and still had to pay the entire $3,500. fee.

[SublimeBirthGirl]

I'd find a way to budget in the midwife. Payments, whatever. It's worth it to have a homebirth, I promise (though my HB was free ).

[iamama]

A hb is worth way more than the money it cost. I would pay to stay out of a hospital and managed care.

[Rockies5]

Interview the MWs in your town to see who is willing to work with you on your budget. No, it isn't unethical to switch and it makes no sence why one would charge 100% of her fee, for only doing 3 prenatals and the birth attendance.

Another option is shadow care with the dr, and catching the baby yourself at home.

[heket]

Wow, you know how much a Kaiser birth costs? When I had Kaiser (and I know costs vary by employer), it was nothing for us, but we were told it was about $20,000 for the insurer (being my employer... : )

When ds came around, I didn't want another Kaiser birth. So I saw them for u/s, prenatal to get the tests done, but I had a homebirth MW. She charged me (about 2.5 yo ago now) $3600. All I had with Kaiser were copays, some of which were covered since it was prenatal care (so there was no cost to me for office visits.) Her coverage was prenatal plus 6 weeks after birth. She was always more informative than Kaiser, and dd learned a lot about the "baby" during our times with her...

[rad]

Definitely try to find a way to budget alittle towards a homebirth. It is worth every penny. Now that we've had all 4 kids at home, my Dh is on board. He knows we could have a hospital birth for about $100-200. But it's just not worth the trouble of dealing with managed care and hospital policies when we can stay home in the comfort of our house and have our babies.

[birthgreeter]

As a midwife, for the most part I do not lower my fees just because you come to care late in pregnancy. If someone in your situation would contact me in ther early months, then I would consider a lower fee since you are getting prenatal care.
Ask the midwives you meet with-as they might too. Sometimes we take trade- ( I have taken trade of Hay for our animals; quilts; home canned goods etc). Most midwives will allow payments too. It is worth asking.

[Peppamint]

Originally Posted by Quella

Here is one idea that may make it more affordable-- What if we used our Kaiser insurance until all the labs and, say, half of the prentals, then switched to a midwife in month 6 or 7?
Is that ethical? Would we save money? What is the cost breakdown for midwives? Is the actual birth what costs the most?
I am meeting with some midwives next week and plan to ask them this same thing. I'd be upfront with them of course.

What are your thoughts on this?

Thanks so much!

We are snowballing our debt too. We have 23 months before all our CC and vehicle debt will be paid off. Yes, I'm counting.

Switching mid-pregnancy will save you a bit of money, but not enough to make it worth it IMO. A good portion of the fee is to cover the birth and postpartum care and you can't really put a price on getting to know the MW and her getting to know you and your dh. Again, that's JMO.

The actual price and breakdown varies from state to state, here I pay $1500 for a homebirth and it's worth every penny although it has kept us from getting out of debt as quickly. If I could, I'd go back and change my spending habits but I would not change our decision to pay for HBs out of pocket. We were actually able to pay our midwife in full within a month of the birth because we paid her with part of our tax return... another advantage to a spring birth.

Dave Ramsey doesn't have to give birth- you do. If it's important enough for you, tweak your budget to make it happen.

[MidwifeErika]

There are just some things in life that are worth the debt and worth the money. This isn't you deciding between the name brand or generic antibiotics, but about deciding who and where and how about your child's birthday! That is exciting and wonderful! I have had a homebirth that cost us money out of pocket and a totally free hospital birth.... and the homebirth was more worth its cost to me. There is no doubt in my mind that I would sell my wedding ring if I needed to in order to have another homebirth the next time around.

Ok, so enough about me

Most midwives will not discount your fee based just on you coming into care late so I would just go ahead and start with the midwife.

[Quella]

Thank you

You dear women have given me some great things to think about. I appreciate it a lot.
And thank you for answering my questions!
I think we will begin with a midwife.

Thanks!!

[DoomaYula]

I'm glad you've already made a decision, I just want to add -- I think you will be happier going with a MW for the entire pregnancy. Getting to know your midwife and having continuity of care is worth something.

(We're doing Dave Ramsay too! Last cc payment will be in August! Then we move on to paying off my car, we're going to sell it in December and buy something outright. Then we move on to our home equity loan. And then the house! Whee!)

[jlwagner]

Originally Posted by Quella

You dear women have given me some great things to think about. I appreciate it a lot.
And thank you for answering my questions!
I think we will begin with a midwife.

Thanks!!

Yay!!!

I just wanted to add that we follow Dave Ramsey's ideas as well but having had a homebirth with my first I would go into debt in a heartbeat to have a homebirth again. (And I am having another homebirth in about 5 months! )

[Baby Hopes]

We're paying for this homebirth out of pocket. I'll admit that it hasn't been easy parting with the money. Especially knowing that my hospital birth would be near free... But then I go to a visit and I talk to my midwife and I leave feeling sooo reassured that we're making the right choice.

We used tax return money to pay off most of it and will be making payments on the remaining amount.

[Quella]

It is great to talk with midwives

I called the midwife office (they work out of the Andaluz waterbirth center here) with just a few questions so I'd be more prepared at the consultation.
I don't know, I think I expected them to be quick and condescending ONLY because of my experiences with Kaiser. I didn't expect them (the midwives) to be unfriendly at all--I am just not used to such love and concern and care!
It was great! And I was just asking about prices and if they would let me hear the heartbeat at the consultation. I expected them to say "no" because we hadn't signed any papers or anything.
She immediately said, "sure we can try to fit that in!"

Just in this little exchange I felt so different, and so grateful for them.

[J-Bean]

I had a similar (but different) experience and am with Kaiser. We finally decided as a couple that birth will be the story of this child's life and it will be with all of those who surround you (i.e. your other kids, any other family). So, it's worth the price (though hella expensive for us).
What we did to make it managable was find a midwife who firstly was able to discount the total price (to $3000 from $4000 here in the Bay Area, CA) since we didn't have any insurance coverage (and therefore less work for her in dealing with insurance carrier too). And, she allows us to pay in increments.
The lovely thing is, I don't go to Kaiser for anything at all. I am only working with my midwife and that avoidance of hassle (no trips to Kaiser, no probing questions, no extra tests, no looking for parking or a babysitter for my daughter, no odd comments by doctors that make you constantly question this or that) is totally well worth the price! Sanity!
In addition, while I was looking, it sounded pretty standard that midwives don't reduce the price for starting with them later. They will have to hire an assistant (if they do that) for your birth (my midwife says that's around $500 out of pocket for her just for hte birth), and cover all of their other costs associated with visits (time, time, and more precious but beautiful time to get to know you and your family).
I wish you luck on your search for a solution...and if you want additinoal info., feel free to pm me.

[AugustLia23]

The midwife I used for my first birth charged a birth fee and seperate fees for each prenatal visit, but I know of others that charge 1 global fee, which won't be cheaper if you start on later. Find out what the fees are for midwives in your area, it may work out.

I totally think the homebirth is worth the cost(when with a midwife), but I'm going UC, which is free.

Congrats

[musemor]

I went to Kaiser for prenatals and tests until week 33, when I switched to midwife care. Up until that point I was being "practical" and opting for the free (yeah, not even copays) birth. But as the birth neared I realized how important it was to me to be in charge of what happened during labor, and a midwife was the only way I could be sure that would happen. I got a small discount from the midwife (about $500 off of $4500) but I would have paid twice that to have the birth experience that I got. We had to pay totally out of pocket, of course, and it depleted our savings...but it was SO SO SO worth it!

[mrskennedy]

ITA with hotwings640! And if you don't demand this from your DH, you risk resenting him and yourself later b/c he didn't give you a homebirth and you were too polite to ask for one. Pay for it! If that's what you need, it will be horrible for you to have a hospital birth--not necessarily physically, though that could be true, but definitely emotionally. You owe it to yourself and your baby to try a homebirth. If you need to transfer, that's out of your control in some cases. But if you don't try at all, that's your fault entirely. So go for it! Your savings can be built up again! And you'd be surprised how not-so-bad it is to live on little--I speak from experience here---you can become very creative with things and your spending.