Sliding scale question - Mothering Forums

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#1 of 9 Old 02-19-2006, 02:01 PM - Thread Starter
 
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I am hoping for opinions from some of you midwives.

I am 28 weeks and am seeing a homebirth practice.

My DH just lost his job two weeks ago and now it seems like not only will I not be able to afford the nice dipes and the birthing tub I wanted we won't even be able to easily afford a couple dozen prefolds and the birth kit and the herbs I will want/need.

I'm really scared going into this with *no* money.

Our midwives do a sliding scale type fee. They have three tiers, each one $400 less than the other (2800/2400/2000). We scrimped and cut corners and counted ahead of ourselves to pay our $2400 ahead of time--we gave them teh last check at my last appt.

Now we have basically zero income other than *we hope* unemployment which is aobut half of the threshold amount for the 2400 fee.

How would you feel if a client of yours asked to be bumped to a lower tier fee bc of a huge change in income like this--effectively to get a refund for that part of the fee? We were barely in the 2400 range before and as I say we really struggled to come up with it, but we did. Now our determination to pay it early has left us facing a major crisis with no reserves at all.

I thought about/am thinking about going to a hospital just bc I feel like I can no longer afford a homebirth, but I also feel like I can not afford to *not* have a homebirth. For various medical and psychological reasons, a hospital birth would be *really* bad (I'm just shy of what the CDC thinks is obese, although I don't look it or feel it; my family has a history of big babies; I have PTSD issues already about hospitals. They'd find soem stupid reason to label me high risk no matter what and then I'd freak out).

I feel really cheap even asking for a refund of the $400 difference and money spent is, well, money already spent. But that $400 would also mean I could get the supplies I need.
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#2 of 9 Old 02-20-2006, 01:21 AM
 
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I think you can do no harm by asking! I think that there's a good chance of your midwives understanding and even if they don't you'll be no worse off. Besides I would definitely mention that the money you get back will most likely go to pay for your birthing supplies.

Most of the midwives I know are very dedicated to helping each woman have the birth she wants regardless of her financial situation.

Good luck and I'm sorry you're in such a hard situation!!! I hope things get better
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#3 of 9 Old 02-20-2006, 05:05 AM
 
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I would ask. It can't hurt, but a hospital birth would be a far worse option IMO...see what can be done= maybe the mw could help bring the birth supplies she would normally ask you to get....do you have anyone with a Rubbermaid horse trough? They make good birth tubs. Or one of those $20 fishy pools from walmart, they work too....I wouldn't give up on a home birth, since in the long run, it is the less expensive option...
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#4 of 9 Old 02-20-2006, 10:15 AM
 
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well, if my option as a practitioner were to refund your full amount (or most of it, less the fees for the visits you've had) , so you can go to a hospital,or four hundred dollars of it, so you can afford to a) continue to utilize my services and b) not have to be bullied in a hospital, I would certainly go with refunding the $400! I agree with the pp that it certainly can't hurt to ask!

That said, tie-dyed, if you end up having to go to the hospital, please let me know. I would certainly doula for you free of charge to help you stay as natural as you possibly can...are you cobra-ing insurance? I could recommend a really great practice of CNM's, as well. PM me, and we'll talk, if that's the route you end up having to go.

I am sorry that your dh lost his job. This isn't a stress that is good at any time in your life, but during pregnancy it's CERTAINLY not a good thing. Please, be sure to do some yoga or get some exercise...relax in a tub. I know it's hard, but it'll help to keep you low risk to keep your stress levels down!

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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#5 of 9 Old 02-21-2006, 11:27 AM
 
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I have a spare birthkit in Ann Arbor. I would be happy to give it to you if you can come and pick it up. I just got it last week from a client who had to have a pre-labor transfer of care. It might be slightly different from your midwives, but if you pm me a list from them I can see if I have some extras in my birth bag to make up for any differences.

PM me and I will give you directions.

Stacia

Stacia -- intrepid mama, midwife, and doula. Changing the world one 'zine at a time.
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#6 of 9 Old 02-21-2006, 11:28 AM
 
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Oh, and I have some herbs, too. Let me know what you were trying to buy.

Stacia

Stacia -- intrepid mama, midwife, and doula. Changing the world one 'zine at a time.
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#7 of 9 Old 02-21-2006, 03:11 PM
 
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Defenestrator to the rescue. But too another woman in your situation, I would both ask for the partial refund and see if the midwife could help cobble together a birth kit from other clients' extra stuff (chux, etc.).
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#8 of 9 Old 02-22-2006, 02:03 AM - Thread Starter
 
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Thanks so much for your replies. Courtenay, thanks so much for the offer of doula-ing. If we do end up going hospital (doesn't look like we'll need atm, although it also depends on FIA) I already have a relationship established with Metro Partners out of Providence and we'll definitely take you up on your offer. I saw your post on the local thread about looking for births and I thought about inviting you to the homebirth. I'm stilnot sure how many people I'm gonna want around (midwife is bringing an apprentice, plus MIL plus possibly my cousin), but that is also a possiblity if you are interested and willing and if we can keep our homebirth. I've heard some good things--or about as good as a hospital practice gets. I dunno if medicaid would cover the ABC though

Defenstrator--thanks so much for the offer of supplies! I will put together a pm with my midwives' list. I will be in A2 some time next week, but not sure when yet since I have to change my next appt time. Thanks so much! I'm overwhelmed!

As for the original question it seems the concensus is that it would probably be ok to ask aobut the adjustment. Now it's just a matter of finding the fortitude to ask for another handout. It's *so* hard! DH is coming with me to next appt though seeing as how no job, so it will be easier with him there.

Thanks all.
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#9 of 9 Old 02-23-2006, 11:28 PM
 
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hey--either way, just let me know, and I'll do my best to be there. I will be out of town from May 4th late in the evening until the following monday evening. Otherwise, I'll be there with bells on!! Send me a message if you feel like it, and we can talk. You'd be my first homebirth, or my second at Providence.

And you know what? I've been poor for most of my life. In this economy in Michigan, I promise PROMISE that you're not the only ones with difficulty paying. No, it doesn't make it any less painful to have to ask, but at least know that you're not alone. AND that, to be homebirth midwives to start with, they have a certain level of compassion greater than the average bear. Just some thoughts.

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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