Prenatal/L&D with Kaiser or Anthem???

amerifrau

Hi Ladies,

We're moving up to Portland at the end of the month (hubby's being transfered), and we have to choose our new health insurance.  The big issue is we're TTC baby #1 and I'm trying to figure out from afar whether to go with Kaiser or Anthem PPO. 

We're minimal intervetion people (natural as possible while still safe for Mum and baby), and I want to work with a midwife, BUT we don't have buckets of money to throw around, so need to work within the parameters of our insurance.  OH, and being able to labor in a tub for a while would be stellar ;}

Other problem is we don't know where we'll be living yet, but probably to the W/SW (maybe Lake Oswego/Multnomah, though maybe Happly Valley...).  If anyone with Anthem PPO is willing to tell me how the costs for the 9 months and then L&D added up, I'd be really grateful! 

Thanks for any info/advice!

newlywed827

Hi There!

 I had Anthem insurance and 100% natural delivery at Good Samaritan Hospital here in town.  All said and done we paid about $1700 out of pocket for the delivery and all my prenatal care.  

 I will tell you that it would be cheaper for you to have Kaiser but in my opinion you will not have the same experience and will be less likely to have  the natural birth that you want, especially for your first baby.  It IS possible to have a natural birth at Kaiser, in fact I know someone who was able to do so with her second baby. It just seems the odds might be stacked against you a bit more and when you are attempting a natural birth you need all the support you can get!  The downsides to Kaiser (in my experience with friends) are these...

-you don't get to pick the doctor who you will deliver with.  You just have whoever is on call when you happen to deliver.  In my experience, my doctor was a HUGE factor in my success....if I would have had a doctor that didn't support my desire to go natural I don't think I would have made it.

-Kaiser is very protocol driven.  They have rules for everything it seems and you may really have to fight with them to avoid certain interventions....like not having an IV during delivery or not being continuously monitored.  These may seem small but these things made a huge difference to me in my delivery.

Again, this is just my experience from the many friend I have had deliver at Kaiser....your experience could be different.  That being said, you could end up having a awful experience with an Anthem doc too.  You just have to pick the right one!  I have an awesome recommendation for you if you do decide to go with Anthem.  Also, I HIGHLY recommend taking a birthing class....we took Bradley classes and were very happy with them.

 If you need any more advice/info let me know!  And welcome to the Portland Board....everyone here is so nice and so helpful!

 Take care and good luck!

  

Portland First

I completely disagree with the previous poster.  If you search through the forums, there are lots of posts regarding prenatal and L&D care with Kaiser.  They are extremely supportive of natural delivery.  I delivered at Sunnyside (as did many friends) and had a fantastic experience.  It is true that your doctor or midwife likely won't be the one to deliver the baby, but I can't understand what difference that would make anyway.  

 It depends on your particular plan, but we didn't pay one penny out of pocket for the whole shebang.   

newlywed827

Portland First:

I completely disagree with the previous poster.  If you search through the forums, there are lots of posts regarding prenatal and L&D care with Kaiser.  They are extremely supportive of natural delivery.  I delivered at Sunnyside (as did many friends) and had a fantastic experience.  It is true that your doctor or midwife likely won't be the one to deliver the baby, but I can't understand what difference that would make anyway.  

 It depends on your particular plan, but we didn't pay one penny out of pocket for the whole shebang.   

 

I am so glad that you had a great experience at Sunnyside.  I have also had several friends deliver there and many of them did have wonderful experiences.  Only one delivered naturally though and while she did for the most part have a great experience she relayed to me that she didn't feel they were very supportive of natural delivery.  Again, this is not my personal experience so everyone should definitely check into each hospital on their own.

 The one thing I definitely disagree with you on though is when you say you can't understand how it would make any difference which doctor or midwife delivers your baby.  In my own personal experience, my doctor made a HUGE difference in the outcome and the overall experience of my birth.   I can't understand how it wouldn't make a difference?

Portland First

It wouldn't have made a difference because I had two awesome nurses who were with me throughout labor, offering suggestions and positions and doing everything possible to make me more comfortable without drugs.  The midwife who did the delivery didn't do much other than catch the baby when she came out.  The janitor could have been down there and it would have been fine.  An M.D. came in and stitched me up.  Based on my experience, the particulars of who technically delivered the baby was utterly unimportant.  It was the nurses who were instrumental in making it great.  In a more complicated delivery, it may have been different.  However, in a more complicated delivery, my only goal would have been to get the baby out safe and not care about the details.  

peachypear

I am not familiar with Anthem, but I encourage you to scroll through the last few pages of posts to get lots of reviews of local hospitals. FYI, Kaiser currently does L&D through Sunnyside (east side) and contracts with St Vincent's (west side). Kaiser is in process of building their own west side hospital, which will likely end their contract system with StV's. I don't know the timeline for that though.

As for costs, when I had DD on OHSU's PPO, all prenatal care, L&D (vaginal birth), and three days Mom and Baby came to about ~$1500. I haven't had a baby with Kaiser yet, but we recently switched due to changes in employment and by reading our materials it looks like we'd expect to pay $500.

Angelcake

I was with Kaiser during my pregnancy and am now with Providence.  I believe you get what you pay for.  Kaiser in my opinion is cheap.... but you also don't get the wonderful service.  I was lucky enough to have been advised by my birth class instructor to write up a birth preferences paper to email to the hospital as well as take with me to the hospital.  Of COURSE your birth may not end up as you want it (I wanted a natural birth and was soooo far from that), BUT, the nurses at St. Vincents stuck to my preferences as much as they could and that was wonderful.  Kaiser.....well, I had to actually call and have someone write in my file to have people stop asking me when I was being induced and about getting a c-sec.  This was absolutely not what I wanted and I even gave them NO other choice than to put me with a midwife when they didn't feel comfortable with it.  I was high risk but only because my blood pressure was high in my first tri.  They told me I HAD to see a medical Dr.   That was NOT happening!  They were being overly cautious and I was not listening to their b.s. of being induced etc.  Also, My OB who I did really like ended up leaving and I wasn't even told!!!!  I had been seeing her from the beginning of my pregnancy until I was 38 weeks and no one notified me she was leaving or left.  I heard about it when a nurse was scheduling an appt for me.  

If you were asking me I would say don't choose Kaiser.  You get what you pay for.  Although I do miss how cheap Kaiser was, I am so BEYOND happy having a PPO and being able to really choose who I see!!!! 

anvloveskme

I don't know anything about Anthem, but have Kaiser and delivered at Sunnyside in July of this year.  DD was our first child.  You are most likely to have a midwife perform your delivery based on the way they schedule rounds at the hospital (Sunnyside), but like a prior poster said, you don't get to choose who delivers you (unless you are having a scheduled c section). You can choose between Sunnyside and St. V's.

I will say, that it was not my intention to go natural, however, I feel like I would have been VERY supported if that was my decision.  I ended up having an unplanned c section after 5 hours of pushing (I have read that their c section rate is lower than the state average).  My water broke spontaneously and had been broken for 18 hours by that time and I had been running a fever that got worse.  I felt like I was very informed of what was going on and given a variety of options to avoid a c section, including consulting with more than one MD, which was what I requested.  I even had RN's switch off with me to give me different ideas/encouragement and to try different positions.  I used a birthing ball and labored for about an hour in the soaker tub.  Everyone was very kind, encouraging and professional and I will go back to Sunnyside if we have another child.

Our out of pocket for everything was $2250 and would have been around $1850 if it were not for the c section - I have a run of the mill plan through my employer and know that prior employees (when we had a better plan) have paid almost nothing out of pocket, so it will just depend on your plan.  

EliseJacqueline

I have Kaiser and have had no problems so far. I was due last week and am scheduled to induce Wednesday. My doctor didn't pressure me to induce at all! I have see two different doctors throughout this pregnancy and they have both been wonderful!!! If you do your prenatal care at Kaiser at the East Interstate I recommend an RN named Ingrid Lorensen and Dr. Jennifer Rupert. They have both been so nice and I have nothing bad to say about my prenatal care. If you schedule your visits in advance you can see the same RN or doctor for the full nine months.

Now, I haven't delivered yet so I can't tell ya how that will go, but I am delivering at St Vincent's and I have heard nothing but good things about it. My friend's baby spent three months in their NICU and she had zero complaints. Lots of friends have delivered at St. V's and really liked it.

Good luck with your decision making and your move!! Portland is awesome!!