[mamachiquita]

I am really wanting to have a homebirth with a midwife. However, I am meeting so many obstacles with my insurance that I am starting to consider going with a CNM that delivers in the hosiptal only. Unfortunately, these are the only type of midwives that our insurance will cover in our area. Otherwise, I would not be reimbursed for any of the $2200 that a homebirthing midwife charges in our area. Would a CNM delivering in the hospital generally be a gentle, low-intervention option or would it be just as bad as going the standard hospital route with an OB? I am still not ruling out a homebirth, it's just that if I knew that I could have a non-invasive delivery in the hospital with a midwife I would consider that option. It is also important to me to be able to bond with the baby and breastfeed right away, as well as room in. Any experiences/opinions/ideas?? All comments appreciated!

-Laurie

 

[pamamidwife]

All I can say is, don't let money be the deciding factor. I did that, paid $10 for my birth and I got just that - a $10 birth.

Many midwives can work with you on sliding scales if you are having to pay out of pocket. We barter, trade, and discount our fees. That's the beauty of being autonomous.

I would encourage you to listen to your heart. It is harder to have a non-interventive birth in the hospital. Nothing is like having a homebirth. Nothing.

 

[mamachiquita]

Thanks for your reply, pamamidwife. I definitely hear you on the money issue. We are definitely prepared to pay the fee in full, with or without the help of our insurance. I guess one of my biggest fears right now is that we will go with the homebirthing midwife and then in some way for some reason end up at the hospital anyway and I will be stuck with a bill for the midwife but have to have a hospital birth anyway. My first pregancy was perfect and would have been ideal for a homebirth, but you just never know if you might have early labor or another complication that might bar a homebirth the second time, and then you are out all of the money that you spent on the midwife. Maybe I should just believe that everything will go well and it will.

 

[kofduke]

What about a birth center? I would think that there would be a better chance for the birth you want at a birth center, and insurance providers are much more willing to reimburse.

I don't know anything about it, but I did a quick yahoo search and came up with the Tucson Birth Center:

http://www.birthcenters.org/faqbirth.../az-bwhc.shtml

Is this something you could look into?

 

[mamachiquita]

Thanks, kofduke for doing that search! How nice of you to go out of your way to help. We did consider the birth center, but feel that we would pretty much be left in the same boat financially as with the homebirth.Our insurance company won't pay for the birth center, since the providers who work there don't accept Tricare Prime and are not on our list of providers that they will pay for. I don't think it's so much that the insurance doesn't want you to homebirth with a midwife, it's just that they already have providers on their "acceptable" list that are CNM's that only deliver at the hospital. The ins. co. told me that it would be difficult to file an out-of-network claim for a homebirth midwife since they already offer a midwife option. I guess it's just my bad luck that the midwives that will accept our insurance happen to be hospital deliverers only. I think we are just going to fork over the cash for the homebirth midwife and try to file a claim later just to see what happens. Between my husband's Air Force re-enlistment bonus and our tax return we should be able to part with the money without cutting back on other things too much. We know in our hearts that the homebirth is the right way to go for us, so I think we are just going to take the leap and not worry about the money.

Laurie

 

[LizD]

If you want a homebirth, have a homebirth even if you have to go into debt. Also check into your state's laws; most insurance companies' reps tell my doula clients they will not reimburse for homebirths though they are required to by law. But either way, hang the costs.

A hospital birth is not a homebirth. Some CNMs are as bad and worse than high-intervention OBGYNs, and most of the time the CNM is only there for the delivery, and it's the nurses and their protocols you spend your energy fighting.

You get to do this only a very few times in your life, and you deserve the very best.

Lots of luck!!

elizabeth

 

[kofduke]

Sorry about the birth center - I just know my insurance would've paid for the one here, but not a HB midwife.

Even if you don't think you'll be reimbursed, sumbit the claim anyway, and back it up with a study or too. I knew my doula (for my hospital birth) wasn't a reimbursable expense under my insurance, but I turned it in with some studies (particularly the ones about significantly reduced sections). I thought that, if I could at least get them looking at it, that it might make a difference for me next time, or in the future for moms that want that kind of support.

Whatever you decide, I can't wait to read your birth story!

 

[mamachiquita]

Thanks to all of you for responding with such good comments to my thread! LizD, that was definitely what I needed to hear regarding CNMs that deliver in hospitals. I thought that maybe they would be a promising choice over standard OBs, but it sounds like they aren't much different. Plus, you still have to deal with all of the hospital protocol. kofduke, we are planning on paying the midwife upfront and then submitting a claim anyway. If we are denied on the basis that we didn't take a provider that was already available to us, we will point out that they did not offer a midwife doing homebirth option. The midwife that we talked with yesterday said that this is how some of her clients are able to get reimbursed after initially being denied. We will definitely push for our claim to be accepted under any circumstance. Sharing a study with them is a great idea, and I think that we will do that. I think homebirth is being discriminated against unfairly be many of these companies and we need to change that.

 

[OdessaEarthenMama]

I've practically ran the whole gammut with my births. Our first was the typical hospital, I was on Medicaid, so I didn't pay a cent, but my birth also wasn't worth a cent, eventhough I did have a midwife in the hospital.

Second birth we had a birth center with a midwife, insurance paid most, we paid about $500, I was transferred to the hospital anyways after 18 hours of labor because my dd was transverse. I had to have a horrible cesarean, but my doctor was a great man (never thought I'd say that), very supportive & helpful.

My third was at home (HVBAC) with an extraordinary midwife who allowed us to pay her payments for our wonderful birth, which I even felt guilty when all our payments had been made because I have such endless gratitude towards her.

And for our next we are planning a joyously intimate unassited birth.

Its really up to you at what type of birth you want and what you get for what you pay for, but the possibilites are endless, you really can't figure out rather you got the best deal or not until its over.

In my experiences as a former doula, if you communicate your wishes strongly with your midwife & the hospital staff, it is certainly possible to have a very nice birth in a hospital, rather you have a midwife or a doctor.

 

[mamachiquita]

What an interesting perspective and take on things, OdessaEarthenMama! It is not often that one actually offers a positive spin on the hospital experience. I have considered birthing at the hospital and being completely clear and in control of how I want the birth to go, but ultimately decided against it. I agree that it is possible to have a gentle birth in the hospital, but unfortunately, from my past experience as well as others experiences, I have found that it is a rarity. However, I think my biggest reason for wanting a homebirth is that I want to be able to recover at home as well as include my son in the process. I don't know if he will neccesarily want to witness the birth, but I want him to be able to see the baby right after it is born. If we were in the hospital we would have to find someone to watch him while I was in labor and during the birth, as well as while I recovered in the hospital. I want to disrupt our famil life as little as possible. Also, since this will likely be our last baby, I think that I want to try the homebirthing experience at least once. On another note, I think that you were lucky to find a midwife that was willing to do a HVBAC. All of the midwives that I interviewed would had that on thier list of no-nos. Not that it applies to me, it was just interesting to note. I hope that the midwife that we have chosen is as wonderful for us as yours was for you!!

-Laurie

 

[LizD]

It's certainly possible to have a good experience in the hospital, but for someone seeking homebirth, I think the compromises are too great. It brings into play all the risks associated with moving a mammal during labor, and I do think a good or bad experience can hinge on the nurse, which is luck of the draw. Spending your labor arguing about intermittent fetal monitoring, heplock vs IV, etc. defeats the purpose of natural birth and takes so much wind from a woman's sails. I have met some lovely, kind nurses while working as a doula, yet none of them have the sensitivity to respect laboring women's need for quiet, etc.

I also want to point out that in some states Medicaid covers homebirth, even though the Medicaid office will probably tell you otherwise. Here in Florida women on Medicaid are routinely told they may only birth in hospital, even though the law requires Medicaid cover licensed midwives. Always do your homework!