best/worst states for homebirth - Mothering Forums

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Old 10-26-2008, 02:34 AM - Thread Starter
 
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DH is graduating soon and we will likely be relocating. As we are planning on have a couple of more kids, ease of homebirth matters a lot. I want to know what it is like in your state (or country, but it isn't likely we will leave the states). I'm wondering about legalities/number of midwives/cost/insurance help/etc. Thanks!

: 10/06 : 10/09
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Old 10-26-2008, 02:49 AM
 
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Oregon's good Costs are fairly reasonable ($2500-$3500 from what I've seen) and Portland at least is a pretty HB friendly area.

I actually started my pregnancy in Salt Lake City. HB MW's have only practiced legally there for a few years now but I didn't notice any major issues...except everyone around me thought I was nuts since it's not exactly a popular option (hospitals in the area have a 95% epidural rate and an 80% induction rate). The MW rates are less expensive though ($1600-$2000).

ETA: In Oregon, can have HB between 35 and 43 weeks, HBAC, breech and twins all okay for HB (as long as the MW is comfortable with it of course).

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Old 10-26-2008, 02:51 AM
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Here's some info on state laws here (I'm sure there's a more complete source than this Wikipedia page, but that was the first thing I could find).
I'm in Illinois, and I would not recommend it for home birth. It's not among the worst, and I'm having a home birth this time, but our options are severely limited. Only CNMs are legally allowed to perform home births, so you have to go with either the (VERY small) pool of CNMs that offer them, or go underground to a direct entry midwife operating illegally. Not the best of circumstances.
I feel like I've heard good things about the home birth situation in Oregon, Washington, California (not surprising, in somewhat "crunchier" states), as well as Texas and Wisconsin, among others. But that's just my impressions, not based on very hard facts.
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Old 10-26-2008, 02:58 AM
 
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I'm in AZ, paid $2800 for my midwife.

HBAC is illegal here, as is homebirth with multiples, and I believe breech as well, provided they know baby is breech. Not sure on that last one. It's not a terrible state for homebirth, but the laws are fairly strict. You also HAVE to be between 36 and 42 weeks.

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Old 10-26-2008, 12:31 PM
 
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I know Florida is very homebirth friendly, Oregon and Washington are too. Where I live there is a big homebirth community and movement, but the medical board here has a lot of clout and puts up a lot of opposition.

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Old 10-26-2008, 12:46 PM
 
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i'm in pa and there are quite a few in the central regions of the state--probably due to the amish population. i paid $2500 for mine and it was covered by blue cross insurance both last time and this time
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Old 10-26-2008, 01:08 PM
 
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I'm in AZ, paid $2800 for my midwife.

HBAC is illegal here, as is homebirth with multiples, and I believe breech as well, provided they know baby is breech. Not sure on that last one. It's not a terrible state for homebirth, but the laws are fairly strict. You also HAVE to be between 36 and 42 weeks.
I am in AZ and I know mws who will attend you even under those circumstances. I myself have gone to or past 42 weeks each time (all 7 times and I had a hb mw each time). You might need to sign a waiver though. Of course other mws are very strict about the law, just need to interview a bunch. Some people aren't comfortable signing a waiver either stating that you know the risks of blah blah blah. If you have a back-up ob too they can sign off on whatever it is (like going post dates, thats what I did once). But again some people aren't comfortable with those choices.

Laws change from time to time too so you might want to check to see what is pending in legislation where ever you decide to move. Sometimes for the good and sometime to the bad.

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Old 10-26-2008, 05:38 PM
 
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Not Illinois!
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Old 10-26-2008, 07:04 PM
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Not Illinois!
: IL is a horrible state from homebirth. It was nearly impossible to find a HB attendant for my last birth. Very few options. I ended up going underground w/ a CM (with whom I was very happy with). The few legal CNM were too far away from me.

 
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Old 10-26-2008, 07:48 PM
 
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Just HB'd in CA after interviewing a handul of midwives the cost in CA is roughly $3,900-5,000 plus it is legal for a HBAC which is what I had. After our homebirth I have experienced lots of wow, congrats which I was not expecting

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Old 10-26-2008, 09:50 PM
 
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NM is a midwifery and homebirth friendly state. the out of pocket cost is about $2500-3000 (plus labs and u/s if you get them), but a lot of insurance will cover it, as well as the medicaid program. there are a large number of homebirth midwives in the albuquerque (abq) area, a few in santa fe and probably quite a few in taos (although i'm not certain on that).
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Old 10-26-2008, 11:17 PM
 
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AL is NOT friendly, although there are midwives working under the radar. The state does actively prosecute midwives.

That said, I'm in north AL, really close to the TN state line, so I just cross the state line and have a happy CPM-attended birth there. There are a few options... birth centers in some places, house rentals in others. I only have to drive 15 minutes to a rental house myself.

So while I've mentioned AL and TN, I guess I should say that TN is a very friendly midwife state, I imagine a large part of that being due to the fact that The Farm is there.

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Old 10-26-2008, 11:29 PM
 
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Another vote for Oregon and Washington. I live in Washington, but my midwives are from Oregon. VBAC, Breech, and Twins are all okay.

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Old 10-27-2008, 12:15 AM
 
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Texas is a great state for midwives. Cost varies by where you live considering it is a very large state. Birth does have to occur between 36 and 42 weeks. There are ways to get around the 42 weeks though.

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Old 10-27-2008, 01:15 AM
 
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mine was 42w5d in Houston, and there was no fear-factor. I think my MW might have a policy about before 36 weeks, though - but that makes sense. it's costing us over $3000 - her costs have gone up a lot in the past 5 years. Our insurance covered 80% last time - don't know what it'll do this time. There is only one OB who is willing to be her back-up - politics! But there are other OB's in Houston who are off-the-record supportive of HB. Lots of MW here, 2-3 birth centers, a large hospital-based MW group. I know people who do UC, too - haven't heard much stigma about it.

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Old 10-27-2008, 01:18 AM
 
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Texas is a great state for midwives. Cost varies by where you live considering it is a very large state. Birth does have to occur between 36 and 42 weeks. There are ways to get around the 42 weeks though.
TX is great.

I went 43 weeks 5 days...

-Angela
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Old 10-27-2008, 01:21 AM
 
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New Mexico is great.

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Old 10-27-2008, 02:29 AM
 
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I don't particularly like Colorado itself, but for homebirths - it's a great place. I live in the Denver area and there are quite a few, very qualified and competent midwives. I've had two homebirths here, and I am currently planning a third. The cost is around $3000.
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Old 10-27-2008, 02:37 AM
 
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Another vote for Texas here. From what research I have done, it is one of the friendliest HB states.
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Old 10-27-2008, 02:45 AM
 
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I'm in Washington, and it's very homebirth friendly. Also, most insurance companies cover it here.
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Old 10-27-2008, 03:04 AM
 
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NH is wonderful!! I've had 2 UC's here and have had nothing but positive reactions, and getting the birth cert was ridiculously easy. AFAIK it's the only state with the right to birth wherever you want, with whomever you choose, in the constitution. We're in the seacoast area (between ME and MA) -- midwifery seems to be well-supported here, and there are several options for women. (Plus a fabulous doula network.)

There are other great reasons I love it here, but on the homebirth issue I think it would get a big from just about anyone.

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Old 10-27-2008, 11:22 AM
 
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I used to think FL was a good state for homebirth...they have a law stating that those offering maternity covereag and are insured in FL must cover midwives. However, I know a lot of cases where they 'get around that' coverage by having self-funded plans and by limiting amount of covereage and out of network benefits. Which here can be very limiting for people.

Midwife fees seem to be around $4,000 on average, midwives cannot attend breech or twin births and births can only be attended from 37-42 weeks here.

I'm amazed that in other regulated states the regulations are not this tough...I wonder why we don't have some uniformity. :

Perpetually breastfeeding or pregnant ENFP mom to a lot of kids...wife to a midwestern nice guy...living in tropical paradise...pink cats and homebirths rock!

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Old 10-27-2008, 12:09 PM
 
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I used to think FL was a good state for homebirth...they have a law stating that those offering maternity covereag and are insured in FL must cover midwives. However, I know a lot of cases where they 'get around that' coverage by having self-funded plans and by limiting amount of covereage and out of network benefits. Which here can be very limiting for people.

Midwife fees seem to be around $4,000 on average, midwives cannot attend breech or twin births and births can only be attended from 37-42 weeks here.

I'm amazed that in other regulated states the regulations are not this tough...I wonder why we don't have some uniformity. :
Also, my understanding was in FL MWs can't attend VBACs and don't they have to be backed by an OB?

-Angela
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Old 10-27-2008, 12:13 PM
 
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MN is good, licensure is offered but not required (so if you get a non-licensed midwife like mine, they aren't bound to all the rules and regulations required for licensure, like being able to attend past 42 weeks and stuff). Relatively cheap, mine only charged $2000 for everything. Birth cert and SS# were easy, she filled everything out and sent it in.

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Old 10-27-2008, 12:35 PM
 
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NY is good. HB is legal, and though all the HB midwives I know of are CNMs (which I like - they are definitely not 'medwives'), there are plenty of them, and I don't know if that's required. OBs, perinatologists, hospitals etc. are comfortable with HB. NY has a law that almost all insurance policies have to cover HB. I believe the cost is officially $6000, but you would only pay that if you didn't have insurance at all, and the midwives are really good at working the insurance companies. Medicaid covers HB here too.
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Old 10-27-2008, 01:05 PM
 
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Right now Idaho is also really good.
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Old 10-27-2008, 02:23 PM
 
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HB is quasi-illegal in GA. Everything is underground, and no CNM's, just CPMs. Average price ~2,500, no insurance coverage. Depending on your MW, you can have a vbac, breech, twin birth.

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Old 10-27-2008, 02:36 PM
 
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I think PA is pretty lousy. Legal issues in flux, and availability isn't great everywhere.
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Old 10-27-2008, 02:46 PM
 
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Stay away from Wyoming...but as ColoradoMama said, Colorado is great.
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Old 10-27-2008, 03:11 PM
 
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NY is good. HB is legal, and though all the HB midwives I know of are CNMs (which I like - they are definitely not 'medwives'), there are plenty of them, and I don't know if that's required. OBs, perinatologists, hospitals etc. are comfortable with HB. NY has a law that almost all insurance policies have to cover HB. I believe the cost is officially $6000, but you would only pay that if you didn't have insurance at all, and the midwives are really good at working the insurance companies. Medicaid covers HB here too.
I have to disagree on NY. While it's *technically* legal, back in 1992 they started passing a lot of legislation that knocked a lot of HB MW's right out of practice financially.

As a result, in central NY where I am, there are exactly 3 legal hb midwives, and none of them are closer than 1 3/4 hours away. I've heard of one underground MW, but that's about it.

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