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#1 of 29 Old 07-24-2009, 10:19 AM - Thread Starter
 
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You said this in another thread...

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I just can't justify the expense of a midwife at home when my insurance pays almost 100% with a hospital and OB.
That's where I am too. I so want to deliver at home knowing things would 100% go my way, but I can't justify paying a couple of grand for a midwife when I live in a structure that provides *everything* for my initial $20 co-pay.

Glad I'm not alone.

Man, I'm too cheap for a midwife...

Angela
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#2 of 29 Old 07-24-2009, 10:44 AM
 
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Me three!

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#3 of 29 Old 07-24-2009, 10:55 AM
 
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I totally understand. Fortunately, my insurance does cover homebirth, but if they didn't I would really have to give this some serious thought. I feel like if you can find a care provider that you're really really comfortable with, then things could go a lot easier. However, I've had a difficult time finding that in my city outside of CPMs, plus none of the hospitals in my area have a c-section rate below 35%, so I would probably cough up the extra funds even if the insurance didn't cover it.
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#4 of 29 Old 07-24-2009, 10:57 AM
 
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Well, I'm a bit biased but I would pay for it anyway. I can't imagine having to have a hospital birth and so a couple grand is worth it to me.

However, I have to add that it would've been tough to convince DH the first time around had a hospital birth been free. BUt now that we've done it already, I think he'd agree with me.

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#5 of 29 Old 07-24-2009, 11:15 AM
 
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I petitoned to have my homebirth covered and won! You should give it a try.

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#6 of 29 Old 07-24-2009, 11:44 AM - Thread Starter
 
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I petitoned to have my homebirth covered and won! You should give it a try.
How?

Angela
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#7 of 29 Old 07-24-2009, 01:12 PM
 
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my insurance is covering it because of an "in-network exception". i guess because none of their providers can give me the service i need (a homebirth) they are going to cover it. :

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#8 of 29 Old 07-24-2009, 01:21 PM
 
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Yep, I got them to cover it as an exception because they don't offer an in-network homebirth option. I spoke with the head of the division and it really helped to clarify what I wanted. I also sent a letter detailing the cost of our previous hospital birth (over 10K) and the cost of our homebirth AND prenatal care (1,800). The money thing really spoke to them I guess.

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#9 of 29 Old 07-24-2009, 01:40 PM
 
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my insurance is covering it because of an "in-network exception". i guess because none of their providers can give me the service i need (a homebirth) they are going to cover it. :
This is actually how I was able to get mine covered as well. However, if the insurance company has an explicit policy again homebirth or CPMs or Lay Midwifes (some do) then this probably wouldn't work. But if there just aren't any listed as providers without an explicit policy (like mine), then there probably is a way to work around the system.
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#10 of 29 Old 07-24-2009, 05:26 PM - Thread Starter
 
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I called today and they don't have any "in network" midwives...so they're sending me the paperwork to petition. Because without the petition it would still end up costing around 2k.

It stinks, though, I really do like my OB and I had a simply divine hospital delivery with my daughter. I was telling my old man that I would love for my OB and the nurses to just not touch me while delivering...let me do everything. They can stay in the room if they're nervous, but I don't want anyone touching, coaching, etc. My husband says they won't do that due to malpractice suits. I think I'm going to ask my OB anyway...he already knows I'm a crunchy freak.

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#11 of 29 Old 07-24-2009, 05:45 PM
 
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Well thankfully midwives are affordable here ($1500) so even though Medicaid will cover everything for free I totally think it's worth it to me. Although I'm going UC with this one.

Unassisted birthing, atheist, poly, bi WOHM to 4 wonderful, smart homeschooling kids Wes (14) Seth (7) Pandora Moonlilly (2) and Nevermore Stargazer (11/2012)  Married to awesome SAH DH.

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#12 of 29 Old 07-24-2009, 06:11 PM
 
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AfricanQueen, who's your OB?

Mama to dd 2/06 and ds 12/09
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#13 of 29 Old 07-24-2009, 07:12 PM
 
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...sorry you ladies have to deal with this.

I'm so blessed to live in Canada. I have a midwife, and could choose to birth at the hospital or at home....and it is all free.
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#14 of 29 Old 07-24-2009, 10:12 PM
 
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Originally Posted by AfricanQueen99 View Post
I called today and they don't have any "in network" midwives...so they're sending me the paperwork to petition. Because without the petition it would still end up costing around 2k.

.
By the time this birth actually happens...we will be out over $4k to birth at home. My insurance doesn't cover anything with a CPM and in January are deductible won't be met since it turns over Jan 1st. Birthing at home & paying out of pocket, for us, is still cheaper than using our insurance. SAD!!

A doula who married a cop & became a mama to 3 boys: G 12/22/00, my rainbow baby B 2/2/07 and L 2/10/10 my CBA2V baby, waiting for my little caboose late February 2013 & always remembering my two angels 2006 & 2012.

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#15 of 29 Old 07-25-2009, 12:01 PM
 
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Originally Posted by geo_girl View Post
...sorry you ladies have to deal with this.

I'm so blessed to live in Canada. I have a midwife, and could choose to birth at the hospital or at home....and it is all free.
Depends where you are in Canada... the only way I could birth at home with a midwife where I live is by paying out of pocket.

OB and hospital would be free but I would only go to the hospital if it was life or death situation.

To have the safest birth, I UC.

 
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#16 of 29 Old 07-25-2009, 12:20 PM - Thread Starter
 
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Originally Posted by guitarmama View Post
AfricanQueen, who's your OB?
PMing you...

Angela
Chatty Girl - 3/2006, Lovey Boy - 1/2010, Delicious Baby Girl - 1/2012
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#17 of 29 Old 07-25-2009, 12:25 PM - Thread Starter
 
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Originally Posted by paxye View Post
OB and hospital would be free but I would only go to the hospital if it was life or death situation.

To have the safest birth, I UC.
I get that. Totally. BUT I'm taking my husband's feelings into account (not saying you're not...just saying that my husband is a "what if" guy by nature and profession so you get where I'm coming from). My husband would get behind a hospital birth with having nobody touch or coach me...if they were in the room in case of emergency. IF my OB won't agree to that (find out next week at my appointment) *then* we'll talk midwife.

I have to say that it's really tough riding the line trying to compromise so we're both happy.

Angela
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#18 of 29 Old 07-25-2009, 12:26 PM - Thread Starter
 
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Originally Posted by Gray's Mommy View Post
By the time this birth actually happens...we will be out over $4k to birth at home. My insurance doesn't cover anything with a CPM and in January are deductible won't be met since it turns over Jan 1st. Birthing at home & paying out of pocket, for us, is still cheaper than using our insurance. SAD!!
Dude, that's disturbing! Our healthcare in this country totally blows.

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#19 of 29 Old 07-25-2009, 09:23 PM
 
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feels good to know I am not alone! And the least expensive (far from cheap) midwife in my area is $3800, NOT including any of the lab work or ultrasounds.

I understand that these wonderful women need to make a living, but I was under the impression that becoming a midwife is something you do because you have a passion for it, you want to help women have the birth they deserve, and you want to provide a service and care that is greatly lacking in the medical community. Also, at least in CA, they don't have to pay the outrageous cost of malpractice insurance, so why do they charge so much and make it such a difficulty for those who really need and want that kind of care to receive it?

I feel like, around here, going to a midwife is so cost inhibitive that it is only for those who either have a bunch of money to pay for PPO insurance that covers it, or for those who just have a bunch of extra money to pay out of pocket, that basically it's just something cool and alternative for people with money to do, but the rest of us have to suffer with the OB and hospital of our HMO's choosing because who can argue with a $100 copay for the hospital delivery and no copay for prenatal visits?

Not that I am not grateful for the good insurance that we have, but if the midwife only charged half of what she currently charges I would gladly pay for it and she would likely be able to help more women and make a better living.

Can any one of you by worrying add a single hour to your life?
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#20 of 29 Old 07-25-2009, 09:35 PM
 
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Originally Posted by nummies View Post
Yep, I got them to cover it as an exception because they don't offer an in-network homebirth option. I spoke with the head of the division and it really helped to clarify what I wanted. I also sent a letter detailing the cost of our previous hospital birth (over 10K) and the cost of our homebirth AND prenatal care (1,800). The money thing really spoke to them I guess.
This sounds like a great approach. The problem with my insurance is I am HMO. I could switch during open enrollment to PPO, which would go into effect in january and end up covering the midwife, but it would cost me around $700 out of pocket for my "out of network" copay, PLUS the extra premium expense of the luxury of PPO monthly for the rest of the 2010 plan year may cost me at the end of the year what the midwife would have cost me up front to begin with. SO, $100 at the hospital with the HMO, or several thousands over the course of the year with a switch to PPO....hmmmmm.:

I will call and ask and ask until I start hearing something I like!! Wish me luck!

Can any one of you by worrying add a single hour to your life?
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#21 of 29 Old 07-25-2009, 10:17 PM
 
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Yeah, give it a try. I am just so amazed that your hospital births are so cheap! We paid well over $2,500 in co-pays with our hospital birth.

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#22 of 29 Old 07-25-2009, 10:24 PM
 
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I get that. Totally. BUT I'm taking my husband's feelings into account (not saying you're not...just saying that my husband is a "what if" guy by nature and profession so you get where I'm coming from). My husband would get behind a hospital birth with having nobody touch or coach me...if they were in the room in case of emergency. IF my OB won't agree to that (find out next week at my appointment) *then* we'll talk midwife.

I have to say that it's really tough riding the line trying to compromise so we're both happy.
I am not saying that it is the right choice for everyone, but my husband was like that also initially, however, he understands that it is ultimately my choice because it is my body and I have to go through it.

Of course, he has also seen first hand what harms can be caused by unnecessary interventions that I have suffered and that could have been avoided by not being in hospital or birthing centre.

But honestly, even if he wasn't on board it is not a compromise that I would be willing to make, it ultimately comes down to the safety of our child and myself.

 
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#23 of 29 Old 07-26-2009, 12:53 AM
 
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I feel like, around here, going to a midwife is so cost inhibitive that it is only for those who either have a bunch of money to pay for PPO insurance that covers it, or for those who just have a bunch of extra money to pay out of pocket, that basically it's just something cool and alternative for people with money to do, but the rest of us have to suffer with the OB and hospital of our HMO's choosing because who can argue with a $100 copay for the hospital delivery and no copay for prenatal visits?

Not that I am not grateful for the good insurance that we have, but if the midwife only charged half of what she currently charges I would gladly pay for it and she would likely be able to help more women and make a better living.
Somehow you hit the nail on the head and are still way off base. You're absolutely right, these women do have to make a living. True, if they charged less they would be able to have more patients, but at the same time, this would compromise the level of care that make them attractive in the first place. Home birth midwifes have to be very particular about how many patients they take. They don't have the luxury that many OBs and hospital attended births do in the area of back up if for whatever reason they can't attend the birth. Also, midwifes don't have the luxuries of nurses and other attendants to assist during labor, so they are present for a significantly higher amount of time during labor (if you want them to be). During my first labor, she was there 11 hours. Also midwife appointments are typically much longer than your typical OB, mine average an hour. I know my midwife doesn't take more than 4 women due in the same month in order to not compromise her level of care and avoid the possibility of more than one woman being in labor at the same time. So, since the cost of living is so varied in different areas, I'm sure in your area $3800 is the price point where midwifes are able to take the limited number of patients they can and still be able to survive. Note, I said 'survive.' I don't know if you know any midwifes personally, but most of them are not even close to living a life of luxury.

So, all of this to say, please don't blame midwifes but put the blame on a fundamentally flawed system that in addition to strategically denying women access to adequate birth choices, also prohibits more women from entering into the field.
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#24 of 29 Old 07-26-2009, 01:18 AM
 
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Depends where you are in Canada... the only way I could birth at home with a midwife where I live is by paying out of pocket.
...perhaps I should be more specific...I feel very blessed to live in British Columbia!

So sorry to hear that you all have to deal with this expense...it is something that never crossed my mind.

cheers,
charlene
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#25 of 29 Old 07-26-2009, 01:25 AM
 
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...perhaps I should be more specific...I feel very blessed to live in British Columbia!

So sorry to hear that you all have to deal with this expense...it is something that never crossed my mind.

cheers,
charlene
yep... I'm from BC... and I miss it everyday...

There are so many things that BC has for women and families that are just not available in many other places in Canada... Here in Quebec we do have MW's that can do births in the place you choose but there are only a few birthing centre's with limited spaces and if you are out of the city then you are out of luck... The OB's are also making it very hard to open new birthing centres... they threaten leaving their posts if a new one opens in their region...

Anyway... a lot of women just don't have the choice here and don't even know about the underground midwives or the choice to UC and are instead forced to have their babies in hospitals...

 
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#26 of 29 Old 07-26-2009, 03:14 AM
 
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Somehow you hit the nail on the head and are still way off base. You're absolutely right, these women do have to make a living. True, if they charged less they would be able to have more patients, but at the same time, this would compromise the level of care that make them attractive in the first place. Home birth midwifes have to be very particular about how many patients they take. They don't have the luxury that many OBs and hospital attended births do in the area of back up if for whatever reason they can't attend the birth. Also, midwifes don't have the luxuries of nurses and other attendants to assist during labor, so they are present for a significantly higher amount of time during labor (if you want them to be). During my first labor, she was there 11 hours. Also midwife appointments are typically much longer than your typical OB, mine average an hour. I know my midwife doesn't take more than 4 women due in the same month in order to not compromise her level of care and avoid the possibility of more than one woman being in labor at the same time. So, since the cost of living is so varied in different areas, I'm sure in your area $3800 is the price point where midwifes are able to take the limited number of patients they can and still be able to survive. Note, I said 'survive.' I don't know if you know any midwifes personally, but most of them are not even close to living a life of luxury.

So, all of this to say, please don't blame midwifes but put the blame on a fundamentally flawed system that in addition to strategically denying women access to adequate birth choices, also prohibits more women from entering into the field.

I agree with you, and perhaps I wasn't clear enough at expressing my frustration with the flawed system; however, it is worth mentioning that the cost of living around here is not what would be considered high. Let's say a midwife takes the average 4-5 women a month at $2,000 per delivery, and she probably has at least one back-up assistant if the unlikely happens. You are still talking about almost $10,000 a month, minus whatever fair compensation she gives her attendant, that is pretty good money almost no matter where you live. Now consider that most of the midwives around here, and I have been in Northern and Southern California, charge more like $3,000-$5,000 per delivery, you have to admit they are hardly scraping by. If you are fortunate enough to live near one who only charges $2,000 consider yourself blessed and I would take that any day. I think they charge so much because just enough people have the insurance that will pay for it anyway so they don't seem to be too concerned with those of us who don't.

I had a midwife and homebirth with my second, and though I was lucky enough to have unusual "out of network" health insurance at the time that made it affordable, her charge was $5,000 and she justified it by figuring that's about the same as what a OB cost in the end and she was doing the same job so she should be compensated the same. I absolutely do NOT deny that she deserved every penny of it, but docs don't get all of that payment straight off the top and they went through med school, have offices and insurance and hospital/admistration fees, and on and on. My midwife lived well, and so do the others I have met. God Bless them for what they do, but if you don't have wads of money or expensive insurance they are not there for every woman. I realize that's not how most midwives are in the rest of the US, but we have so few in CA and this is the circumstances they have created for the rest of us.

Yes, the system is inherently flawed (on both sides); yes, I am a little bitter; but geez, with #5 can't I finally have the birth I desire and deserve?

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#27 of 29 Old 07-26-2009, 05:25 PM
 
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Sharlla, can you give me the names/numbers of a few midwives in the area? We just moved here and I can't get FOMM to reply to any inquiries.

FYI, my dh said that if he could do it over he would find the money for a MW. My delivery with my 3rd was 'free' at the hospital, too. My dh is super cheap so that is saying something!
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#28 of 29 Old 07-31-2009, 03:48 PM
 
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My insurance will cover hospital or birth center but not CPMs. The birth center won't have me with twins. The CPM is $3500. And there are other homebirth costs like doula, tub (maybe), etc. That's alot. On the other hand, with twins, it looks like c-section is the way of things in the hospital. Major surgery is expensive and I think I get to pay 10%. It looks like my options are to suck it up and find about $5k, or have my belly cut open and only come up with about $2k.

I am so frustrated that our medical system leaves me with so few options. (Just think ... if insurance covered CPM, they could still leave me with 10% and it would only be $350!!)
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#29 of 29 Old 07-31-2009, 03:56 PM
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I haven't read the whole thread, but I agree with the sentiment of the OP.
I paid 4K for a midwife for Trixie's birth and I had to have a hospital birth (ended in a c-section). Now we're not sure if the same thing will happen with this babe and I am hesitant to pay 4K again, only to end up with another induction in a hospital. So either we'll have an induction (I hope not) or we'll have a successful VBAC at the hospital, or everything will be amazing at the end and I'll hire a midwife last minute.

I'm also Canadian, but I live in California. Everyday I lament not being at home. I miss home, so much.

Deadra, Wife to Adam , Mama to Beatrix (02/08), Hudson (01/10), and Mazarine (12/13)
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