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Natural Birth
Torn about HB
This will be my 3rd birth and 1st time considering HB.
Okay, I am on state medicaid, which doesn't cover HBs, bc silly enough it is illegal to give birth with a midwife in my state. Luckily I live 20 minutes from the state line and there is a nice experienced MW with a birthing center 30 min from my home. She has a backup DR.
She does payments and everything, so that's great! Her fee is 2700 if paid in full by the birth, 3000 if not.
I spoke with my husband, who I expected to be a little against the HB idea, but he totally went for it, and said it happens so much in his country. We are going to see the birth center tomorrow.
The problem is, I have never gave birth at a birthing center or used a MW. My husband said we can pay the 2700 in full in one payment, and it is not a problem if that is what I want, BUT what other fees might occur?
Are there other things that we may have to shell out more for?
Anyone else do a MW birth and end up in a mess?
what should I do?
This discussion has been closed.
Re: Torn about HB
Ask the midwife about the fees, and if the $2700 covers everything, or if it is possible that there would be other fees after the birth (such as blood testing for baby, or things that might be required during birth like IV, Pitocin to control bleeding, etc.)
Also, make sure that you have a plan in case a hospital transfer is required (i.e. you risk out of the birth center care), and know what would happen with the fees in that case - how much of your birth center fee would be refunded, and would it be possible to transfer to a Medicaid-approved hospital where your fees would be reduced compared to a non-approved one?
Once you have all the information, listen to your instincts!
Since it is illegal to give birth with a MW in my state, I would be transferring to a hospital in that state, and my medicaid will not cover out of state births.
http://oi62.tinypic.com/2w73hq9.jpg
i think she's saying that medicaid will not cover a hospital birth in a different state, not that it won't be covered if it is a transfer. at least that is the way that i understood her post.
OP, there usually are other expenses that are not included in the mw's fee. i'm sure she will give you a list or be willing to discuss it with you at your appt with her.
things that are typically not covered are: birth kit, additional birth supplies (pads, shower curtain liner to protect the bed, paper towels, olive oil...etc.), pku screening, meds at the birth (pitocin, methergine, IV's, lidocaine), additional home visits after the birth, travel fees, childbirth classes, placental encapsulation, pnv's, other herbs or meds that you might need during the pg, blood tests, GBS testing, ultrasound, water birth tub and supplies (if applicable) and circumcision. there might be more, but that is all i can think of right now.
i think that $2700 is about average, depending on where you live. i also think that is waaaaay too low, but that's a whole new post.
oh, you might also want to consider using a doula.
GL!!
What state are you in?
CNM can legally practice in all 50 states, so I'm not sure what you mean by "illegal to give birth with a midwife." Some states restrict who (ie CNM, direct entry midwife, etc) can attend a homebirth, and some states are kinda ambiguous. If you want a MW birth but are restricted by insurance issues try local hospitals- many have CNMs and are more likely to be covered.
Also, birth center =/= homebirth. Does your insurance cover the birth center? Mine did, and considered it in-network. Definitely find out, call them if you need to. (That doesn't solve the problem of an out of state hospital though...)
$3000 sounds reasonable to me, but you should ask them what that includes. It probably doesn't include lab work, testing, emergency supplies, sonograms, etc. Some of that is optional (ie genetic testing) and some (lab work) is really not.
I personally don't think it would be prudent to go with the birth center if a hospital transfer would not be covered, especially if you can find MWs at a hospital near you. You can't guarantee that you'll give birth at the birth center, and you will be SOL if you (God forbid) you have to pay out of pocket for a hospital transfer or c-section. It sucks to have to make birth decisions based on finances, but that's reality and it just not responsible to take that gamble.
honkytonk- maybe because she is on state medicaid it will not cover services in another state? i'm not sure exactly how it works, as it is state by state.
sounds like the OP wants an out of hospital birth, so going with a mw in a hospital might not be ideal for her.
i would not let money stop me from having the kind of birth that i want. OP, if you do end up transferring to a hospital you can make payments to the hospital. it's not like they are going to hold your baby hostage until you have paid your bill. if you are healthy and low-risk then why assume that you will end up transferring, chances are you won't, especially since this is your third baby.
i say go for it!
I am in Alabama, and they are allowed to practice, but from what I understood, it has to be in a hospital or birthing center. The closest BC to me is just over the Tenn line (so that i why it wouldn't be covered bc of AL state medicaid), and if say I had time to transfer to the hosp in my city (30 min from the BC) then my CNM wouldn't be allowed to practice in Alabama. The closest BC that I have found in Alabama is too far from me.
As an L&D nurse in the state you want to deliver in....
I second Texas77's statement that they will not hold your baby hostage, if you have to pay OOP. Also, if you happen to get in a bind & need to used the local hospital, the social workers there can help you get on some sort of insurance coverage to lessen your financial burden. Hospitals do want SOMEONE to pay b/c chances of people without insurance coverage paying are very slim...
If you want to know what would happen, call the hospital & just say "I am close to you. If I had to be transported there emergently how would I be covered if I have AL state Medicaid?" They cannot trace the call. If they cannot help you, ask them to send you information on cash or payment system, and a mock bill for a vaginal and c/s delivery.
Trevor Calvin 12.10.07 7:26pm 7lbs2.5oz 19.75in
Emerson Claire 07.07.11 11:34am 7lbs7oz 20.5 in
Sometimes I feel like people make an effort not to understand what others are saying on these boards, but perhaps I wasn't clear. I was trying to say that since she would be out-of-state with the midwife, and thus would be transfered to an out-of-state hospital in case of an emergent risk, it would be potentially financially disastrous to opt for the home birth out-of-state.
http://oi62.tinypic.com/2w73hq9.jpg
sorry, i'll try to start making an effort to understand what others are saying on these boards.
Maybe there is a difference (from insurance standpoint) between just choosing an out-of-state hospital (not covered), and being transferred emergently (possibly covered). If you were traveling and had an emergency, they would cover another state, right? I'm not sure of the insurance specifics.
OP it would be worth clarifying the difference.
I am going to call them tomorrow, but from what I was told by my medicaid worker, if something happened and you were traveling, visiting, on vacation etc. and ended up delivering in any hosp outside of Alabama, it will not be covered at all.
An emergency could happen, though odds are that everything will be totally fine. I think I am going to go with the birthing center, If anything did happen, we would just have payments and it would be worth it I think. I really want to birth the way I want to for a change, and I don't want mine and DH's bonding moments to be ruined by perhaps getting a nasty nurse, or stress from being treated poorly. I want to be treated like a mother giving birth, not someone that need to hurry up and spit the baby out so the hosp will have a free room, and DR can go watch the game.
Hello - I'm just a lurker (not having a natural birth myself) but I do have a couple of things to contribute to this discussion.
First of all, you really should figure out what you are talking about in terms of cost in the event of an emergency transfer. The official rates on a c-section in the United States start at around $14,000 (up to $25,000 or more in more expensive parts of the country) and go up depending on additional complications.
That being said, we do have a law in this country called the EMTALA that states that no one can be turned away from an emergency room for an inability to pay. In essence, it dictates that if you find yourself in the Emergency Room with a medical emergency and no means to pay for it, the hospital must absorb the cost. I'm not sure if you will be hounded by collection agencies for the rest of your life, or if they drop it once you are able to prove an inability to pay. You can probably find out, just by inquiring what would happen in the event you were to have a pregnancy complication/emergency while visiting another state, which wouldn't be covered under your Medicaid.
https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act
Thanks for the info. After meeting with my MW today, she said they have only had 2 transfers as long as she has been doing it and usually a transfer is for failure to progress and issues from it. She says most likely we can go back across the line which is about 10 min farther that going to the closest hospital... then it would all be covered, and she would only be allowed to be my doula since she isn't licensed in my state. Only if I really needed hat extra 10 min would I be transferred to the one out of state, so that makes me feel better.