I asked this question in the birth professionals forum and thought I'd toss the question out here too. I posted earlier that we can't afford a midwife, but really want to have this baby at home. I had the idea that perhaps I could ask a midwife is she would consider reducing her fee if I were to hire her only to assist at the actual birth and perhaps some after care. I can get pre-natal care through my insurance so I would still get pre-natal care and would certainly keep my midwife updated on that. I don't mind getting the pre-natal care at the military hospital, I just don't want to give birth there!
Anyone ever pay for a midwife to just attend the actual birth? Do they typically do that?
mine did! i did my own prenatals. i just had my initial blood work done and that was it! midwife came for the birth and post partum care.
No most typically do not do that, but there are some rare ones out there that will. The prenatals with a HB MW are different, you are getting to know them, they are getting to know you, there is much more of a relationship often then with other providers. And then there is the liability issue, many will want to do their own prenatals even if you are receiving them elsewhere.
That being said I did hire a MW just to hang out in my house for my DS's birth. I did no prenatals. I am doing the same for this pg, but this MW is the only one in this entire area that will even consider such a thing and will only do it for certain families. Some MWs still change the entire fee regardless of when or what care they provide. I paid $3,500 for DD2's birth and 3-4 prenatals, no pp care. DS's was just 1K for the birth only, the MW didn't end up making it but of course we still paid her for her time.
I know of a few that do. My HBMW didn't start seeing me until 36 weeks last time. So I saw her a few times before baby came and then she did my pp care as well. My insurance doesn't cover HB and we do not have money to pay out of pocket so my hubby did some woodworking for her in trade. I also know lots of MW that do that. My sister is a MW and someone gave her chickens for one of the births she did. This time our HBMW is going to do pre and post. But again we don't have the money to pay out of pocket so my husband is doing trade work again.
I'm hoping to do that because I feel like prenatal appointments cause me stress (even with the best of midwives). But I'm anticipating using a MW who already knows us and that we'll still be paying the full fees.
Mama to DS (6/07) , DD (6/09) , and DD (07/12) ..
Well, once I find local midwife (we just moved to the area), I will simply ask her what she can do for me. I can't imagine what we would have to offer as barter that would equal the value of her fee! The only thing I can think of really is that my husband is excellent with computers and can fix them, but what are the chances our midwife will need comuter repair?! Well, we'll see what happens........
Actually, I would say the chances are excellent! ;) We've been lucky enough to get free vet services, dog grooming & I even got free laser hair removal from a cosmetic surgeon's office thanks to my DH's computer skills, LOL!
That being said, are you absolutely certain insurance won't cover HB? Sometimes they make exceptions - even the same plans give people different answers! Insurance is so wacky & unpredictable, it's worth looking into to see if you could, at very least, get coverage on an out-of-network level.
Best of luck!
I assume you are military? Are you the spouse or the AD member? Tricare policy is silent on the issue of homebirth. I believe at one point it specifically allowed homebirths, but that requirement has been removed. There is one place in the Tricare policy manual that mentions homebirth in passing that was not removed, but I would have to go back and look to find it. What it does address is the kind of providers they will cover for maternity care services: OBs and CNMs. They will not cover CPMs or lay midwives according to their policy. So, the trick is to find a CNM who attends homebirth and secure her in your maternity referral. If there are no CNMs in your area that do homebirth, then you are out of luck for Tricare coverage.
If there is a CNM that does homebirth and is an in-network provider, you just get your referral changed to her. This may mean that you have to drop to Tricare Standard if you are now on Prime and are required to get care at the MTF.
If there is a CNM who does homebirth but isn't an in-network provider, you will have to talk to your Tricare Service Center folks. If there are no other in-network CNMs within 100 miles of your home of record, then they have to allow you to use the out-of-network CNM. They will probably require you to go through your PCM to get the referral change request, and they will likely have to have a special meeting to discuss it, but it should go through. If there are other CNMs within 100 miles of your home, they don't have to approve the homebirth CNM, even if the other in-network CNMs don't do homebirth. BUT, if you are the spouse (not the ADSM), you can still use your point-of-service option and use the out-of-network homebirth CNM; you'll just have to pay more than you otherwise would.
Good luck! It's annoying but keep calling, keep asking questions, keep digging! And feel free to PM me if you have any questions ... I am not an expert, but I have been jerked around by the red tape and I have a little experience trying to get them to approve a referral.
I haven't commited to a homebirth yet but the Midwife I am planning on using only does the delivery. I am seeing my regular
MD for all my appointments.
Busy Mom raising 5 kiddos, 7, 6, 5, 2 and a brand new bundle!! (5/15/11)
My midwife charged the same amount regardless, and my understanding is that the same is true of most midwives.
It's understandable - most people have insurance that will cover standard prenatal care (especially with the medicaid requirements being looser for pregnant women), so it's a loophole a lot of people would take advantage of. The majority of a midwife's time, energy, and expenses are going to be directly related to the birth - a midwife could easier spend more time at the birth itself than at all the prenatal appointments combined. Plus, she generally wants some time to get to know the family.
I wish it were different. We moved around the beginning of my third trimester, so it wasn't reasonably possible for me to start care with my HB midwife before that point, and all my prenatal care and testing up to that point had already been done (normally included in her fee). But I still understand and support the reasoning.
DS born 6/03, DD1 born 9/06, DD2 born 10/10, DD3 born 4/14.
Well it wasn't my plan to do that.. but it did end up that way last go around.
I ended up through a few misfortunate happenings being dropped by two other midwives.. and barely found a midwife who would take me within a week an half before birth. We had to pay full price, there was no reduction in price due to a late coming, I think honestly especially since mine was sudden/unplanned that it was really only fair since we were not on the 'schedule' .
Something to keep in mind.. if YOU don't know the midwife already (I did not).. it could actually make your labor longer/cause you to stall when she comes.
I was to the point of pushing.. when my midwife arrived last time, and stalled to nothing.. it was about 4 hrs later till the birth happened and that only after a lot of hard work (mostly I had to go off to the shower with DH eventually) to reconnect with my body and get going.
Don't get me wrong she's an awesome midwife (and I have her for the whole pregnancy an birth this time around).. but she was a total stranger.. and having her enter my private space during labor (and touch me).. almost stopped me completely.
ETA: I should mention to that the above was my first home birth (3rd child), I had had two hospital births prior to this.. so it's not like I 'knew' everyone at the hospital in fact I didn't know anybody but DH and the Doula and sort of the doctor. But in a private home environment somehow it's very different.. and knowing them was very important to me.
Rae 27 DH Phillip 32 married 11-22-03
DS1 Nathaniel b. 11-21-04, DS2 Ian b. 9-8-06, DS3 Samuel b. 10-1-08, DS4 Peter b. 5-24-11
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