Hi. Just wanted to post a few things. From my research, tears are almost always better than episiotomies. It's just easier for the skin to fuse back together along the jagged line (think like a puzzle piece) than a forced cut. I have very few scars from scraping my knee, but a few from being cut by things (not the same thing, but couldnt think of anything else). Plus, one of the things you get for your homebirthing kit is perineal massage oil, so that helps with stretching. The ACOG doesn't even recommend episiotomies anymore because it's not evidenced based medicine. This is from the acog's
site
Quote:
Recent studies show that common indications for episiotomy were based on limited data. Additionally, there was a general underestimation of potential adverse consequences associated with the procedure, including extension to a third- or fourth-degree tear, anal sphincter dysfunction, and painful sex. Data suggest that women who have an episiotomy do not have significantly improved labor, delivery, and recovery compared with those who do not have one. Without sufficient data to develop evidence-based criteria for performing episiotomies, clinical judgment remains the best guide to determine when its use is warranted, according to ACOG. |
Have you read Henci Goer's book "The Thinking Woman's Guide to a Better Birth"? It's really good, and tells alot about the hospital practices that are deemed necessary by doctors, but really don't improve (and often worsen) outcomes. Point out to your hubby that simply by walking into a hospital, you increase your odds of having unwanted (and harmful) interventions, a c-section, and the risk of injury (or worse) to mom and baby. I'd also netflix (or buy) "The Business of Being Born". It's a birth documentary produced by Rikki Lake. It's PHENOMENAL and shows how for a low risk woman, the hospital is REALLY not the place to be giving birth anyways. Another really good book to get is "Ina Mae's Guide to Childbirth" by Ina Mae Gaskins. Not only is it full of positive birth stories that take place out of the hospital, but its full of info on why that's better for most women anyways. Feel free to pm me if you need more info/resources/reading material. And if he still has doubts, you may want to inform him that the US spends the most on our pregnant women than any other country, but is tied for the worst birth outcomes as far as maternal and fetal death. The countries that have the best outcomes have 70% of their pregnancies handled by midwives and a high homebirth rate.
As far as homebirthing and midwives goes: I'm 19 weeks pregnant with twins (my firsts) and planning a homebirth. I actually got my insurance to agree to cover my homebirth midwife, and they say they'll cover any fees for anyone who has to come to my home. What i did was this: I called my insurance company and found out that they cover midwives the same as obgyns (they're covered at 100%). I asked for a listing of midwives in my area. They had NOT ONE. So I called a care cordinator and asked that they give me a "gap exception". That's what they give you when they cover a service, but have no one in network that performs that service. Every insurance company has them, so don't let them tell you they don't. This is how you get them to cover your out of network midwife. Say that you're going to such and such midwife (your hb midwife) for prenatal care because there are none in your network in your area. Granted, you would have to see them for your prenatal care, but you'd have to do that anyways for a homebirth. That's how i got them to cover my hb midwife for my prenatal care. I called back and spoke to a benefits person, and told THAT person (not the care cordinator) that my family has a history of very fast labors, and that i was concerned that i would not be able to make it to the hospital on time and wanted to see what my benefits would cover. It was at that point (AFTER recieving the gap exception) that i was told by benefits that if i had to call someone to my home because i was having a quick labor and/or couldn't make it to the hospital that their fees would be completely covered. Since you've got a history of quick labors, this is on your side. But only do that AFTER you have the gap exception. If you do it before, they may give you the standard "we don't cover homebirths" bs. Another option is to get your insurance company to cover her as an out-of-network provider. They don't cover as much for an out of network provider as they would an in network one, but it's better than nothing. I would only try that after i'd tried for a gap exception a FEW times though. Most insurance companies cover out of network providers at about 60%. Another option is to pay out of pocket and send it in to the insurance company for reimbursement. Some are willing to pay for a homebirth after the fact because it's much cheaper than a hospital birth. But i recommend that only as a last resort, because they could deny it because you didn't have prior approval. Even if they deny you for the gap exception, KEEP TRYING. Some insurance companies will deny you two or three times before they will accept the claim.
It's a common practice. Persistence pays off though! You may have to start seeing ONLY your hb midwife for prenatal care. That seems to make a difference. When i was doing dual care (with my hb midwife and a CNM), i was told they didn't cover homebirths, wouldn't cover my midwife etc etc. Once i stopped dual care and presented them with "this is the only care provider i'm seeing and you say you cover this but have none in network", then all of a sudden they cover them.
BE PERSISTENT!
Also, how far along are you?
ETA: I see it's your dh's first baby. Maybe you should suggest that he research homebirths and why they're much safer for the baby and mom. It really is a slippery slope of interventions just walking into a hospital, even things as "innocent" as an iv and external fetal monitering tend to make birth harder and put you closer to a c-section. Alot of the routine things they do in the hospital the acog has even admitted doesn't improve the maternal/fetal outcomes. You should have him read/research/look into these things. And watch "The Business of Being Born". That may help to get rid of his fears about having a homebirth. Alot of people are scared about homebirths until they realize that for low risk women, it really is the SAFER choice, for moms and babies. Just my .02