Doula question??

klcl8981

Is it better to hire a doula if you don't have insurance? Is it less expensive than paying out of pocket for an OB/GYN practice, involving blood tests, ultrasounds, NSTs, etc??

armandos_girl

I think you're confused about what a doula does.  A doula provides emotional support to a laboring woman, like a labor coach.  She is knowledgable about the birth process, but she is not trained or qualified to deliver a baby.

azzyberry

Doula's do not provide prenatal care.  They are there to be an advocate and labor support person during delivery and post partum.  You would still need to be under the care of either an obgyn or midwife.

klcl8981

Oooh... What about hiring a midwife? Can I hire a midwife to do my prenatal care at home or something? And still deliver at a hospital??

I guess I am totally confused..

armandos_girl

There are midwives who do hospital deliveries (you'll want to find a certified nurse midwife).  Most of the time, they work along side doctors in an OB clinic.  Depending on the midwife, they may do fewer labs, NST's etc.

Generally, the sort of midwife (not a nurse, but a "trade" midwife, who has studied at midwifery school and apprenticed under other midwives) that comes to your house is not certified to deliver a baby in the hospital.  However, their fees might be lower, because insurance usually will not cover that type of midwife.  I honestly don't know though.

drpayne

You can go to a midwife instead of an OB, assuming you are low-risk, etc.  Some are associated with hospitals and some are not.  You need to do some research in your particular location.

klcl8981

armandos_girl:

There are midwives who do hospital deliveries (you'll want to find a certified nurse midwife).  Most of the time, they work along side doctors in an OB clinic.  Depending on the midwife, they may do fewer labs, NST's etc.

Generally, the sort of midwife (not a nurse, but a "trade" midwife, who has studied at midwifery school and apprenticed under other midwives) that comes to your house is not certified to deliver a baby in the hospital.  However, their fees might be lower, because insurance usually will not cover that type of midwife.  I honestly don't know though.

I had a midwife deliver my first child, but she was part of a practice also with doctors. I delivered at the hospital. I'm almost considering a homebirth. Does anyone know if THAT is cheaper than prenatal care at a practice + hospital delivery???

armandos_girl

So, I know it's none of my business, and I know accepting public assistance is often controversial or flameworthy on these boards, but I hate to see someone choose a particular mode of birth or prenatal care based on what is inexpensive.  What happens if you have complications and need to see a high risk doctor? 

You do know that if you are pregnant and without insurance you can apply for public assistance (i.e. Medicare etc.)?  Your state probably offers a program.  At the very least, it would be a sliding scale based upon what you can afford to pay.  Like I said, none of my business and I certainly don't know your situation.  But I thought I'd let you know it may be available for you.

klcl8981

armandos_girl:

So, I know it's none of my business, and I know accepting public assistance is often controversial or flameworthy on these boards, but I hate to see someone choose a particular mode of birth or prenatal care based on what is inexpensive.  What happens if you have complications and need to see a high risk doctor? 

You do know that if you are pregnant and without insurance you can apply for public assistance (i.e. Medicare etc.)?  Your state probably offers a program.  At the very least, it would be a sliding scale based upon what you can afford to pay.  Like I said, none of my business and I certainly don't know your situation.  But I thought I'd let you know it may be available for you.

I do appreciate your input, but regardless I am heavily considering a homebirth. The more I read about it, especially one midwife in particular in my area, the more appealing it is to me.

drpayne

klcl8981:

armandos_girl:

There are midwives who do hospital deliveries (you'll want to find a certified nurse midwife).  Most of the time, they work along side doctors in an OB clinic.  Depending on the midwife, they may do fewer labs, NST's etc.

Generally, the sort of midwife (not a nurse, but a "trade" midwife, who has studied at midwifery school and apprenticed under other midwives) that comes to your house is not certified to deliver a baby in the hospital.  However, their fees might be lower, because insurance usually will not cover that type of midwife.  I honestly don't know though.

I had a midwife deliver my first child, but she was part of a practice also with doctors. I delivered at the hospital. I'm almost considering a homebirth. Does anyone know if THAT is cheaper than prenatal care at a practice + hospital delivery???

Where I live, a hospital birth runs around $12,000 without insurance (around $3000 for the OB and $9000 for the hospital).  That's a routine vaginal birth, no meds, no anesthesiologist, etc.  The birthing center we are looking at is around $3500 for everything.  

Green*Flamingo

Just playing devil's advocate here, since I personally think homebirths are great, but what if you are high risk later on in your pregnancy and can not deliver at home? I think that lining up state services to receive prenatal care is the right thing to do, and then if you have a home birth later that is great.

Don't skimp on receiving the proper prenatal care simply because you want a home birth. I also can't imagine that a midwife or doula would even agree to assist with your birth knowing that you were not being properly followed during pregnancy, and therefor did not know if you were low risk enough for a home birth.

Not trying to be snarky, but put your baby's health ahead of your desire to have a homebirth. Get the proper prenatal care first.

Nechie122

Echoing what PPs said, if you're one of the small percentage of women who needs to be transferred to a hospital because of danger to you OR your baby during your home birth, you would be completely screwed. Please, please, please have some sort of insurance in place, even state aid or catastrophic coverage. That's what it's there for!

iris427

Home birth will generally be cheaper, yes.  I would expect to pay $3000-5000 for prenatal, birth and postpartum care for a home birth.  

Have you looked into Medicaid eligibility?  In some states, they will even cover some home birth providers.

If you transfer and need hospital care, you could end up owing thousands or tens of thousands to a hospital and ob/gyn.  You can work out a payment plan but it's best to consider your options ahead of time.

I think home birth is a great choice if you have a low-risk pregnancy though, cost aside.