Panicking -- High $$ of home birth

[N2theWoods]

Am trying so hard not to destroy my last month of pregnancy peace-of-mind by dwelling on this, but I am freaking out at how expensive our home birth is.

Our midwife's practice charges us $4000 for everything, flat rate. I think this is high, but because I'm having a baby in December, I didn't have much choice - had a helluva time finding anyone who would take me at all during the holidays. I started with them late, too -- was about 28 weeks before I came on board with them. So, you'd think I'd get somewhat of a price break since I didn't require as many prenatal visits, but nope. At the end of the pregnancy, they will bill insurance (BCBS of MA) and I am PRAYING that they pay so that I can get the $$ back from the midwives. I chose a CNM specifically because our plan says that the services of a CNM are covered. Nowhere in the plan can I find any wording specifically prohibiting home birth - am hoping they'll see the bill and think it's a birth center or something.

FINALLY found a backup OB so that I can preregister at the hospital in case I need to transfer, and he charges me a flat $500 under the table fee to do backup. If I need to transfer, then they'll bill insurance and the $500 will go toward my deductible and I can get up to $250 of it back in that case. I liked the doc, and really feel much more comfortable knowing I have someone to call "just in case" that I've met and whom I like rather than having to transfer as an emergency.

But, eeesh! This brings the grand total to $4500 -- money that basically is taking our hard-saved savings to practically NOTHING.

I'm terrified of the financial impact of our family -- and stunned that simply giving birth at my own house should cost me so MUCH. It's my first baby and I'm completely uncomfortable with the unattended home birth option, though I support those who are comfortable with it. My incredible DH keeps telling me that money is for the important things and that having the birth we want is exactly what the $$ is for and not to let myself be stressed out about it. He's right, I know -- but gadzooks it is scaring me.

Please, please, please let BCBS pay, that's all I can say.

Thanks for listening.....

Off now to listen to relaxation tapes and try very hard not to think about money...

[anothermama]

well....

I'm homebirthing my second in May and to *me* the cost is SOOOOOOOOOOO worth it.

Think of how many women you've heard of with REALLY unhappy hospital experiences. You just can't imagine what it's like till you're THERE but it SUCKS having even the littlest thing screw with you.

Think of the statistics....birthing at home for low risk women is SOOOO much safer....it's usually a ton easier and a ton shorter. And YOU'LL BE HOME!! No roommates...no nurses poking you every freakin 5 minutes....no one hovering over your shoulder when you try to nurse (GAWD is that ANNOYING and HARD!). Just YOU and your DH and the baby.

Think of the haven of your own bed....... Thats whats really doing it for me. I COULD NOT sleep in the birth center I had my dd at. COULD NOT. And it was hell, because you are EFFING TIRED!!!!

And, I know that insurance would cover a butt load if you birthed in a hospital, BUT it's money wise still a lot cheaper, especially if you consider all the not needed things done (and spent on!) at a hospital birth.

The one thing that stuck out to me about your post was the back up doc. I can understand needed that peace of mind as a first time mama. BUT.....I don't understand what you're paying for, especially if it's under the table.

Here's the thing with me: My midwives have had to trasport about 10 or so women in the past 5 or 6 years. One is also an RN here in town. And they know the hospitals, they know who is "midwife friendly", and they know where I'll get good care, they know where I'll get the kind of care I want. Why not just have a back up hospital that your midwive recomends? I mean, if you have to be transported they'll HAVE to see you and HAVE to treat you and if it were me, I'd want to go somewhere where my midwife (who KNOWS me and my history) could be present and participate, if only as a birth assistant. I don't really care what hospital I go to as long as my midwives think it's good and they will be allowed to be there and my birth plan will be respected. And I haven't been to as many births as they have...I don't know that better than them. I'm going to get a recomendation from them as to where, near me, they think I should go, and then I'll tour the facilities. I think that'll be all I'll need.

Anyways.....enough about that.....

We are going through REALLY rough money times right now and our midwives are costing us $3000 total, and I wouldn't in a million years give that money a second thought. I would NEVER have another hospital birth if I didn't have to. Sure, there's a ton more that we could be doing with that money...and the thought has crossed my mind that we could just go OB and Hospital...and I think about how unhappy I would be and how scared I'd be of all the intervention....and the money doesn't even phase me.

Good luck.

[georgia]

I know this doesn't address the very real anxiety you're feeling about the money.....

With my first, I went into the hospital, informed, but naive. When all the interventions were done, my stay cost around $8,000. My ds's iatrogenic NICU stay was over $25,000. The money aspect was a huge burden, but the time we lost and the pain we both endured is almost incomprehensible. The sadness I feel about my birth is enormous, and something I will have for the rest of my life. If only...if only....with HB, you're in control of the if only. HB was the best thing I've ever done. Can't put a price tag on that.

With your birth, while the cost feels *high*--the prospect of getting the birth you deserve is worth every penny. Even if you decided the day you went into labor you were hiring a midwife---still worth every penny, IMO, to be at home. Most of us would beg, borrow or whatever to give birth on our terms.

As far as a pep talk goes, at least you have some savings Many of us don't! You're doing exactly what you're supposed to be doing---you're working through your issues. Yeah! Get them out...talk about it. Can you determine what you're needing right now? Talk with your dh---sounds like he's in the know ---how many births will you have in a lifetime??? Y'all deserve it.

For the greatest good,

Amy

[N2theWoods]

Just to clarify -- I'm not thinking about changing my plans at this point. This is the birth I want and it's what I'm going to do. Everything you said is SO right on, and I'm happy that I am making this choice my first time 'cause I KNOW how freaked out I get by hospitals and needles and doctors (O My! ) I am just freaked out at having my savings dwindle SO much further than I expected. It's scary to me to have no money to fall back on, which is the situation we'll be in if insurance doesn't reimburse us. I'm just stressed about it. I am confident that I am doing the right thing for me and for my baby. Just worried about things like paying the morgage...

And the backup OB is for several reasons. My midwife does have an OB relationship, but he is located in San Francisco proper which would mean driving across the Bay Bridge in case we need to transfer (what if it's rush hour? It could literally take me over an hour and a half to drive the 10 miles.) Don't want to do that. The hospital he works out of does not have the best reputation, let's just put it that politely. The OB I chose is low-intervention minded and works out of a hospital 10 minutes from me that has an excellent record in terms of low intervention, and allowing moms to have the birth they want. I don't want to transfer as an emergency - if I have to transfer I want to be pre-registered. That's just way too stressful for me for a couple of reasons -I don't want my insurance getting billed for an ER visit for the birth -- if they do it will flag them that I was planning a homebirth and they might then refuse to pay the midwife's claim. I also then have NO idea what OB I will see, what his/her reputation is or his/her attitude toward women who choose to birth at home. This way, I have this cool OB's cellphone number and he will meet me there -- even if I transfer I will still have someone working with me that I know and trust. Big time worth the extra $500 just for peace of mind on that score. (And he will allow my midwife to be there and continue to act as birth support. He backs up several midwives and is comfortable with them.) So, basically I guess I'm paying for that reassurance, plus 5 office visits if I want to use them. Which, I guess I already have used 1 because he met with me to examine me and assess my chances of having the birth I want - which he proclaimed excellent

But, I still find the $$ situation stressful. I wish I could just not let it faze me, but... it does

[coriy]

think of it this way, what could you possibly spend that money on that would be worth more? And - better to be in a situation of spending the money you have rather than not having the money to do this.
When I was pregnant w/ my 1st child I felt very anxious about money because I knew that I wouldn't be working for awhile and that for the first time in forever I was completely dependent financially on another, (dh).
I had savings that mostly went to midwife and for covering the missing income when I stopped working while pregnant. And I felt stressed out as I watched these savings dwindle.
It took alot of trust for me to give up control in this area. I had to sit myself down and examine the real source of my stress and when I did I realized I had doubts as to whether dh could support us w/ his income.
W/ my 2nd I did all my own prenatal care and gave birth unasissted - nobody made a dime off that birth.
Now, 8 years later I would do it all again. It was money well spent the 1st time around, I needed the peace of mind.
You will be provided everything you need! Your only job right now is bringing yr babe into the world in the gentle, compassionate way s/he deserves!
Blessings,
Cori

[mattjule]

The price does seem high, but you are in the Bay Area, everything is expensive there. In this case, you really are paying for geography. I had a midwife in Auburn, CA and we paid $900 on top of MediCal. I highly doubt she charged MediCal $3100. I am in Colorado now and the average MW charge is less than $2000! Crazy, huh? If it helps at all, I quit working when I was pg and my mother still pays our rent (not an option for you, I realize) but we also learned to live on less. Our pg was a big surprise so we had no savings and lots of bills.

FYI, my mother firmly believes in SAHM's. She says she is paying us for doing a good thing, that she is ensuring a wonderful childhood for our children. God bless her, she's so generous and, honestly, I would be working if it weren't for her. She likes to pass it off as if it isn't a big deal. Seems to me $12,000 a year is a big deal!

But back to the OP, I agree that you are doing the right thing. My friend lives in Berkeley and chose the hospital b/c they couldn't afford a MW. She had Pitocin b/c her water broke and she didn't go into labor for about 18 hours. They gave her an IV and EFM's. At one point a random nurse she had never seen before came in and cranked up the Pit-she had a contraction that lasted over 2 mintues and was horribly painful. After that, she agreed to the intrauterin monitor and the scalp probe thingy. They told her it was to more accurately assess her contractions to keep the pit levels accurate. I am wondering if they didn't do the crank up on purpose so she'd consent. She labored for 34 hours, but she gave birth vaginally and w/o meds of any kind. After that, they needed to move her to another room and told her her ins. only covered a shared room and they would have to pay out of pocket for a private.

They also took the baby to the nursery at least three times. Each time her dh would insist on coming with them so the last time they just told him nevermind!

That was in a "progressive" hospital in your area. You are definitely doing the right thing.

[rubelin]

Margo, I totally know how you feel. I'm in LA and our HB will likely run us about $3500 and our insurance will NOT cover any of it (though I am still working on that, so maybe...) We have no savings, and are not even sure where the money will come from, probably a high-interest loan and that scares the crap out of me.

But, I DID have the horrific hospital birth the first time, with every intervention they've got, short of a C-sec, and that only because I signed a waver refusing one. That Dr was close to home, and covered by our HMO, so the whole thing ran us just a few hundred dollars in co-pays and a private room fee. Let me tell you, we got what we payed for. I sure as hell expect to get what we pay for this time, even if we have to go into debt to do it, it is absolutely worth it to me.

You know in your heart that it's what's right for you, you just have to trust that the universe is going to take care of you. It's hard to do, but it is very freeing I wish you a glorious birth!

[tinyshoes]

I'm a happy insuanced homebirther!

Long ago, dh called our insurance co. "Will you cover a homebirth?" "Yes," they said, "if the person attending the homebirth is an RN. Did this midwife go to school?"

Yes, my hb mw was once an rn, but she isn't now, and what does that have to do with anything? The point is, our insurance chat was retarded and it all worked out.

My hb cost $3,000 in the Twin Cities, MN. We just got our reimbursement check for $2,000, and my mws are continuing to pursue the remainder. I did nothing but sit around while my mws pursued our reimbursement.

I owe thaks to the hb moms who paved the way for me, making my reimbursement problem-free.

(Oh--and I'm so glad to get any part reimbursed I don't care that the wole fee wasn't covered, plus, my hbmw was 'out of network' for sure, so that affects any and all insurance reimbursements for everyone, not just homebirthers.)

[applejuice]

YOu get what you pay for, always remember that .

I paid out of pocket for my four homebirths. My DS, born in 1983, was insured 80/20 by Traveler's Insurance.

All of it was worth it.

What happens if you go to the hospital for the $10 birth and the doctor decides to do a Caesarean Section. Later on in your life things happen and you are not insured for the next baby?

How are you going to pay for that?

Always keep it simple.

[applejuice]

Originally posted by tinyshoes


I owe thaks to the hb moms who paved the way for me, making my reimbursement problem-free.

You are welcome, Tinytoes.

[AnnMarie]

Re: Panicking -- High $$ of home birth

Originally posted by N2theWoods

Please, please, please let BCBS pay, that's all I can say.

Did you call them and ask? I hate to say this but, I know that when I was pregnant with my last they didn't cover homebirths.

[muse]

I had a homebirth in oakland with 2 wonderful independent midwives. it cost us $3000 in 2001 and they were extremely flexible about the amount and us paying in installments. Have you looked into other midwives and their rates? (oh, duh, just saw you have a month to go!) I think your insurance company should pay at least part of the cost since they're CNM's, but maybe not the birth itself unless you transfer to hospital.
for me it was the best use of $$$ EVER in my life. We took a big financial step backwards because of it but I wouldn't change a thing. We re-assessed our lives a lot and ended up leaving the bay area for a year and a half to live somewhere cheaper and spend time with our son.
Now we are starting afresh and in a financial mess, but crazily enough have decided to move back to the bay area and have another baby since our wonderful midwives and community are there. And we will go the exact same route, and do whatever it takes to find the $$ to afford it.
Since I don't have any health insurance right now I'm going to get a PPO with a high deductible/low monthly fee just as an emergency back up if i do wind up in hospital (I had a miscarriage there uninsured and got bills for $16,000....luckily med-ical paid it).
*BTW, if anyone knows of a PPO that will cover independent midives please let me know!!*
It sounds like you have the same backup dr we had. You are very wise to set that up, it turned out to be so important for me. he was excellent and when I had to be transferred after the birth for cloe to 4 degree tears he was an excellent seamstress (!) and we weren't treated like "crazy homebirth nutters".
So, anyway, I think you have made the right choices for yourself but I would see if there is someway to change your lifestyle to save some money for the birth.....

[N2theWoods]

Thanks everyone -- I am feeling better lately. My amazing DH is being very reassuring and positive about the whole thing, financial burden included. I know that we will be okay and we are cutting back a lot in other areas (I think I've gotten every speck of baby clothes from the local thrift stores,) and I know that we'll be OK. This IS the birth the way I want it -- and there is no price tag one can put on that.

Just trying to relax and know that I'm doing the best thing for this little wiggly bumblebean in my belly!