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Discussion Starter #1
soooo...without getting into the boring insurance lingo, the bottom line is this:<br><br>
a hospital birth will cost us $1696 out of pocket<br><br>
a homebirth with our #1 choice would cost us $3250 out of pocket ($1554 more than the hospital)<br><br>
a homebirth with our 2nd choice (which frankly, dh may not even consider....) would cost us $2000 out of pocket ($304 more than hospital)<br><br>
i really want a homebirth, but really want it with our #1 choice mw. should we stick with hospital, sttle for #2 choice, or just go into debt for the #1 choice hb mw???<br><br>
ps--if we end up having to transfer to hospital, we end up paying for BOTH hospital plus mw, ahhhhh!
 

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I can't tell you the decision to make, I can tell you that I understand! We had a similar issue. Hospital birth would cost $2500 out of pocket and our midwife is going to cost us $5200. We decided to stick with the midwife. In our case what we pay for the midwife <b>will</b> cover our deductible for the hospital, so it is a bit different.<br><br>
Good luck making the decision that is best for you and your family!
 

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I feel you. A hospital birth and all prenatal appointments with our insurance costs us a grand total of $100. But a homebirth with a midwife would be $3000+. I'd love a homebirth, but the cost is my hesitation.<br><br>
I'll be watching this thread to see what kind of guidance you get!
 

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It matters how important it is to stay out of debt. Personally I would choose to birth with my first choice midwife. Usually midwives are good with payments so you don't have to go into debt really, just make payments for a while. Midwives here accept whatever plan you offer them.<br><br>
Some people choose a hospital birth b/c of money and regret it, and some people have a fine experience. I really really encourage first time moms to birth at home whenever possible. The chances of interventions (and often subsequent cesarean surgery) is just too familiar a first-time-mom-picture in the hospital. And vbac laws are everchanging. I know in our state certain hospitals won't allow vbacs, and now our state is trying to pass a law that says homebirth midwives can't do vbacs at home either!!! So avoiding a cesarean is a good idea...and it's just a fact that homebirth midwives have much much lower cesarean (via hospital transfer) rates than do docs and even hospital-based midwives.<br><br>
You'll just have to weigh your hospital and the docs, your finances, how much you want to birth at home, etc.
 

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We are in the same boat.<br><br>
Hospital birth would basically cost $0 for us, and we are opting to pay $3500 for our midwife to attend us at home. Soooo lame!<br><br>
We originally were thinking UC partly because of the cost, partly because of wanting to be at home, partly for the privacy/intimacy aspect, lots of other reasons, but a little past halfway through the pg, my partner made it clear that he did want a birth professional as backup, and I feel very strongly that I don't want to birth in the hospital, so paying out of pocket seemed like our only real option--making the decision easy in some ways, even though the cost still bites!<br><br>
Our midwife is very happy to take $250 payments per visit, and though it is still a sacrifice, we can keep up with that amount until it's paid off.<br><br>
Hope you find some peace of mind about the decision!
 

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I agree with the previous poster. Try to set up a payment plan with the midwife.<br><br>
Perhaps you could pay her something like $270 / month for one year to cover the cost, starting now. She'll probably appreciate the installments prior to the birth as a show of good faith.<br><br>
Or if she won't accept payments over an entire year, perhaps you could only put half the amount on a credit card and offer to pay her $270 / month for 6 months. That way you aren't paying completely ridiculous interest charges on the entire amount.<br><br>
There are endless possibilities. It all depends on how comfortable you are asking about it and the payment terms that she is willing to accept. Don't give up yet if that's what you really want!
 

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DDCC (maybe, I could definitely be a July mommy)<br><br>
My husband and I also had to make a decision between a hospital or a homebirth with a midwife, but for different reasons. Anyway, if you do choose the hospital birth I would suggest hiring a doula. A doula can help with a natural hospital birth and help keep your room as private as possible. Plus, doulas usually have clients with a lower rate of interventions and c-secs when they are part of a birthing team.
 

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Hard to say if it's worth it without knowing your finances. If $1500 (in debt, no less!) is a lot to you compared to the experience of homebirth, then maybe the hospital is best. If not, then do the homebirth #1 option. You don't sound remotely convinced of HB #2 option.<br><br>
Also, you need to figure in the rate of transfer from homebirth. If you have, say a 10% chance of being transferred to a hospital, then you'd be paying both homebirth fees and hospital costs, which may be a lot. And bear in mind that transfer rates are usually higher for first-time moms than for others.<br><br>
Hmmm, hate to say this, but I may be coming down on the side of a hospital birth for you, as the added risk of paying both could be just what you don't need with a new baby. Best of luck deciding!
 

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Discussion Starter #10
thanks for the advice :) wish this were an easier decision!!<br><br>
UC is no way an option for us, DH would never consider, and I'm personally not comfortable with that either. It's a miracle he is even considering HB!!!<br><br>
Both the HB mw's have a 10% transfer rate. I'm sure it is higher for 1st timers.<br><br>
I will definitely approach choice #1 about a payment plan...that's a great idea I hadn't though of.
 

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DDCC (I'm also on the cusp of July/Aug)<br><br>
We were in the same boat. I priced the hospital and HB, the hospital would've cost more than the HB. Then our insurance went through and the hospital ended up being mostly free and not the HB midwife option ($3,000). For the first 5 months, I was wavering so much over doing the hospital birth. As time neared closer to the reality of giving birth (first one) I began to strongly believe that HB was the better fit for me and with that conviction, I am comfortable with paying the money. I am still very happy with the decision.<br><br>
What helped me to make my decision, was that I dug deeper into what the hospital birth would entail: my HB midwife quoted me her rate and it covers everything (prenatal, birth and postpartum care), no hidden charges or fees. Whereas in comparison, the basic quote I was given for our local hospital was the bare bones minimum for an uncomplicated, no intervention vaginal birth. That meant no drugs or staff interventions. For example, just the cost of an epidural can quickly up the cost (your paying for the drug, materials, and the anethesiologists time). Or if your provider consults another provider about your care plan = consulting fee. Then you have postpartum care, how much of that quote you were given covered it? The one I was given was for an intervention-free 24 hour stay after birth and didn't cover newborn care. I work in the hospital and by no means understand the billing system but I have noticed that costs can quickly escalate. Like the cost of an aspirin, was $50!<br><br>
Are you familiar with your hospitals policies and procedures? That could help you with your decision making. Are you allowed to eat and drink during labor? Do they have a tub room for laboring in or are you allowed to shower? Do they allow rooming-in with your babe?<br><br>
I keep reminding myself when I stress over the money aspect of our upcoming birth, I get what I paid for. I believe I am paying for quality care versus what I was receiving before, which was okay care. (the hospital MW didn't even notice that I left their practice, I forgot to tell them and then I waited to see if they would follow-up). When I buy good quality shoes, I rarely say, "boy, I regret buying these more expensive shoes". I'm hoping the same holds true for my personal decision to go with our HB midwife.<br><br>
Good luck momma, whatever you chose will be the right one for you!
 

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I've been in this same situation for my last two births. With ds, we decided to go the hospital route and paid basically $0. My birth was ok. Not great, but ok. This time I've decided to go for what I really want and not worry about the money...so we're planning a homebirth. It's going to be a big financial sacrifice for our family, but at the same time, being at the hospital seems like a sacrifice also, kwim?
 

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My vote is for homebirth with the midwife of your choice. I hate hospitals and had a horrible experience birthing in one, so I would personally go into major debt to have a homebirth. I think birthing without a fight is worth every penny.<br><br>
Do you have the option of setting aside pretax dollars with you or your husband's employer? That is how we are paying for our midwife. But usually you have to do that in the beginning of the year, but they might let you do it now if you make the argument that you are expecting a new baby. We can pay for anything related to the birth with our pretax dollars: midwife, doula, postpartum doula, birthing tub, birthing kit, etc. We used $500.00 of our tax return to get started, and then each time we pay her we submit the money to get reimbursed. Then we get reimbursed the $500.00 we simply hand it over to our midwife again and submit it again.
 

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Lots of good answers already but here's my .02...<br><br>
I personally would go into debt for the birth of choice. Our pockets would have taken a pretty big hit if we'd have gone with our original option #1 (which was the only option at the time). That would have been for my son and I to leave Korea and move back to the States and live at an Army base close to Atlanta so that I could VBAC with a doc there. The Army wouldn't have paid for the flights (greater than $2000), the hotel until we moved, the rental car required until ours was pulled out of storage, the household goods transfer from KY to GA, none of it. It would have paid the hospital bills and prenatal care and we would have lived on post for free and that sort of thing but we were figuring about $5-6000 to get us there and moved in. Add to that, we'd have been separated from my husband for a minimum of 6-8 months. We were going to do it though. It would have been my only option to VBAC.<br><br>
Thankfully I found an option #2 and it is much cheaper and actually overall a better situation.
 

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I agree with irsas1<br>
check with hospital about hidden fees and also get a feel for their policies- do babies leave the mom/room at any point, what is done to babies (shots, eye gels, etc), min and max stay, how long can a mom have her water broken/be in labor w/o intervention, etc all those things that a homebirth you have your say.<br>
Then go with what your heart tells you! Good Luck<br><br>
Hospitals vary so much- I had my 2 in birthcenter w/ midwives and it was all so hands off and easy - no battles for me to fight- but it still wasn't home. I'd do homebirth but for me it's $15 copay for birthcenter vs $3400 for homebirth<br><br>
PS the extra $1554 is about $130 a month or $4 a day to put it in perspective so if you give up that glass of wine w/ dinner (not that you drink) or that coffee and muffin every morning on the way to work (not that you do that either) or that extra whatever you've paid for your midwife! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink">
 

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<span>omg sorry but this is rediculous the amount of cost just to be able to have what should be every woman's right a home birth it makes me realise just how lucky i am that here hb's are covered on the nhs, hope you manage to get your 1st choice.</span>
 

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Discussion Starter #17
the hospital we are currently with is very natural cb friendly. that being said, they DO require initial 20 minute monitoring, then intermittent thereafter. they are (b/c of state law) require eye ointment and vit k injection. and i am doing hypnobabies and just really worried about the environment not being conducive to that.<br><br>
i am really bummed about this whole thing. we have other debts (student loans, car payments, mortgage, credit cards) and i'm just not sure we can justify adding more to the pile.<br><br>
even if there are hospital add-on expenses, our MAX out of pocket is that 1650 or whatever number was close to that cost. so that is the very most we would have to pay.
 

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I would absolutely choose debt over another hospital birth. With DS1 I didn't want to pay out of pocket for a homebirth, choose a NCB friendly hospital and a group of CNMs and took Bradley classes. I ended up with a really traumatic csection which two years later I'm still kicking myself over.<br><br>
I certainly think you can have a decent hospital experience but anything outside a textbook labor and delivery (which you can't predict) gets you sucked into the chain of interventions. And I wouldn't skimp on which midwife you choose just to spend less money.<br><br>
Good luck!
 

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I know it's a hard decision, but if you can't work out a payment plan with your MW, I would just plan for a hospital birth and find an amazing doula. Good luck, mama!!
 

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I chose a natural birth friendly hospital and a group of midwives to deliver with. I didn't anticipate any problems or fights. My labor was only 3 hours in the hospital and uncomplicated. My water was broken, I had vaginal exams forced on me (I was held down for one), I was forced an episiotomy, and my baby was taken away (they wanted to take him out of the room but I at least won that fight) and he didn't breastfeed for 3 hours after the birth. They kept trying to take him to the nursery and in a weak moment I relented. They gave him formula without my consent and we had problems establishing breastfeeding. I learned that until you have delivered there, you really can't count on what they will be like, no matter what they advertise themselves as. You can check thebirthsurvey.com and see how they rate, that might give you a good idea of your provider and your hospital if they have already been rated by enough people to give an idea. I'm not trying to scare you or anything, sometimes hospital birth works out fine, I just want people to know the realities of the situation. A lot of times even natural birth friendly hospitals you have to go in fighting for what you want. Many women don't have the presence of mind or energy to fight during labor, and, they fight back.
 
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