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Natural Birth
StefandTodd
member
Justifying the cost of home birth
StefandTodd
member
Hi all!
My H and I are discussing baby #2 and I would really really like to have a homebirth. We had a wonderful hospital birth with baby #1, but there are things that did happen that I would love to avoid with #2...fetal monitoring (they never got a "good" read on him, so they wouldn't stop trying), the paperwork (I was dilated to 8 when I arrived and in transition on all fours in the bed while they shoved paper after paper after paper in front of me...despite the fact we were pre-registered!), the snotty pediatrician (who gave me crap for declining antibiotics for GBS+, despite the fact it was the RIGHT choice since I arrived too late to get a second dose, and one dose alone does nothing to add protection from infection), and ultimately having to stay 48 hours b/c of the GBS+ thing (fine for baby #1, but not okay if/when we're talking about having to leave baby #1 for TWO nights to have baby #2).
Anyway...all things I'd like to avoid. I'd really like a homebirth.
The problem is we currently spend over $1000 a month for our medical insurance, and our OOP for a hospital birth is like $150 for all prenatal stuff and $250 for the birth itself. From what I have researched in my area, a homebirth would run $4000 for everything.
My insurance absolutely will NOT pay for ANY part of a homebirth. I've researched that, and there is no way, no workaround for that.
Has anyone been able to negotiate parallel care between their OB (I can also see Midwifes within my current practice, but they're probably also not going to be SUPER homebirth supportive) and a homebirth midewife practice? If I could get my prenatal care primarily through my insurance, and then see midwife's from 32ish? weeks on and have them attend my birth at home, I'm wondering if I can find a more reasonable "rate". It's not at all that I don't think $4000 is a steal for a homebirth...it's just that my H is not super on board for that, and it does seem like a whole lot OOP when we're already paying so much for medical insurance where we could have a pretty all around "good" birth for next to nothing. I just keep thinking the difference is between "good" and "great"...and I'm only going to do this one more time in my life...is the difference between good and great worth $3600??
I'm really struggling with this. Any experiences you could share or ideas you have are so welcome. TIA 
This discussion has been closed.
Re: Justifying the cost of home birth
I'm not sure if good vs great is worth 3600.
We don't have maternity coverage (just "complications of pregnancy") so our HB OOP price is 2400 and my insurance has covered all the labs but if they didn't my MW does a discounted price for labs which is 100.
If I was in the hospital we would pay at least that much for an uncomplicated vaginal delivery , so for us we went with the HB (again, this is our 2nd)
I'd see if you can find a better hospital/OB/MW and talk to them about your concerns that you had with your last birth and THEN decide if that 3600 is worth it.
I haven't read other answers but I'm sure they'll be fairly similar to my own.
Whether or not the price is worth it is a very personal decision. Everybody's priorities and financial situation is different. We had a similar discussion when we got pregnant this time around and decided it was worth it. We had very similar reasons, but have relocated since our last birth and my local hospitals now have a 40+% csection rate. Those stats scared me. My H only wants two children, at least from birth (we want to foster and/or adopt later on), so according to that plan this will be my last birthing experience. We decided that the money was worth it. We would spend that much on a family vacation so why not spend it on a family beginning?
Have you looked to see if there might be a birthing center covered by insurance? It might be a happy medium between the two. Our insurance is covering my midwife/home birth as an out-of-network provider. This means that instead of not paying anything, we will be paying around $2k out of pocket. It's not a price that comes easily to us but we don't have any birthing centers within an hour of our home so we didn't have any other alternatives to the hospital. Good luck with your decision and I hope you find something that works best for you!
I really believe my homebirths were the safest option for myself and my babies, so yes, it was totally worth every penny.
Also, my prenatal care and appointments were night and day different than with an OB and even the hospital based MW practice I saw with my first (until I switched). I can't even tell you what amazing care I have gotten- especially this time around.
I can't even tell you how grateful I am that I was able to have my babies at home.
We are in a similar situation and decided that we couldn't justify the homebirth because it was going to be too expensive because I have already been seeing a hospital midwife so I would owe her about 1000 and then owe the hb midwife 5000 and then if we did need a hospital transfer we could be looking at possibly 8000 when everything was all said and done. Plus we still have bills to pay for DS2 after the hospital made a lab error that resulted in NICU time.
Needless to say, I am not happy to be giving birth in the hospital but my hospital midwife is very understanding and said that she will do everything in her power to make the experience as enjoyable as possible. She even recommended signing out AMA if they try to pull similar BS again. She also said that if baby is born too fast to make it to the hospital (which is one of my biggest concerns since I have a history of precipitous labor) that she will be waiting for us at the hospital to make sure everything goes smoothly. She even said that I could go to her at her office if we wanted to avoid the hospital altogether (which I was surprised at and probably wouldn't do but thought that it was very nice of her to offer).
I am just nervous about the pediatric part of the hospital experience. I plan to talk to our pediatrician and ask him to come see our LO if we get another awful ped on call like last time.
9 angels in heaven-3 in my arms and 1 in the NICU
Mono/di twin girls: Josephine born to heaven and Evangeline born Earthside at 25w
I'm pretty scared that if I don't get to the hospital in time for 2 doses of antibiotics again, they'll make us stay 48 hours (or, my other option was to take FIVE vials of blood from my 7 lb newborn!!!!). I don't imagine I'll be very ready to leave my LO for one night, let alone TWO, especially just after giving birth to his little brother/sister.
Sigh...I really want a homebirth....
Thanks for all the feedback ladies. Gives me a lot to think about. I'm also going to talk to my doula. She's attended almost 800 local births and had a first hospital birth and then two homebirths...and my H adores her and trusts her tremendously, so her opinion on it might get him on board more for the cost. Of course, she's another $800 we'll be spending for the birth of baby #2. Heh.
Why is our Country so messed up that giving birth at home with midwives instead of in a hospital is a COST concern?!?!?!....it is SO MESSED UP.
Thanks again
With DS, we weighed this. We decided to pay $0 for the hospital birth (but $950 for a doula) rather than $4k for CPM birth. This PG, I just couldn't do it again. I have some unique health issues that OBs largely disregarded with DS and a MW takes into consideration and is medically a better fit for. We are paying $3,500 for a CPM this time.
That said, I do still use my insurance some. I have an OB that agreed to see me just three times during the PG while I see the CPM the rest of the time. Because of my HMO, if an insurance OB orders my labwork, anatomy scan, diabetes test, and Group B strep then I pay nothing for those. If the CPM sent me, I would pay 100%. Do you live in an area where you can shop around? As you can see from my story, between the babies we found a cheaper MW (who we like even more). Actually the cost is the same, but this MW offers an early payment discount, which is why we get the extra money off. Some MWs may agree to a lesser rate if you pay quite early and/or if you pay in cash. An independent MW may be more willing to negotiate than one with a practice with an admin staff or a MW partner. Also, DH's company will have open enrollment before I deliver. I am on my work plan now, but we will price out the cost difference between the plans and what they might cover that my insurance doesn't cover. In a group/company plan, maternity is not a pre-existing condition in my state.
I think it is such a personal decision. What would you be giving up to pay for the birth? Is that worth it to you? What would you be gaining? Is that worth it?
More Green For Less Green
Like others have stated, only you can decide the monetary value of HB vs hospital birth. I just wanted to point out that you might not find a great savings in seeing an OB til 32 or so weeks and then switching to a MW.
At about 28-30 weeks into my pregnancy with DS, I looked into switching to a MW at a birthing center. I was surprised to find that they would give me NO discount for only seeing them in my third tri and for the birth. I would definitely check with the HB MW that you'd like to use and see if there's even much of a discount if you start seeing her later.
Best of luck in your decision making!
That's another big thing for me - I had an amazing doula with baby #1, and she cost us $800 (worth is a million times over!)...I think I'd rather have a hospital birth with her than a home birth without her...but ugh...SO costly. I am eager to talk to her more and get her thoughts though too.
Thanks for the response
We paid $4500 OOP for our home birth. For us, it was worth every cent. I didn't feel chewed up and spit out after my home birth like I did after my hospital birth. I didn't have to deal with the after effects of surgery. I didn't have to spend hundreds, if not thousands, of dollars on counseling to deal with a traumatic birth. I didn't want to cry every time I thought of how my child came intto the world.
These are just my personal experiences and I am certainly not trying to make general statements about hospital birth or home birth experiences. But yeah, totally worth it for me.
Our MW doesn't feel strongly about a doula unless a woman is a FTM, has an OP baby (where labor will likely be long) or had a prior traumatic birth. We are still on the fence, as I had a 63 hour labor with DS and a traumatic birth experience, but I feel fairly grounded about it now thanks to a processing group I did for 6 months.
We had some issues with our doula's follow-through with post-partum care, so we would not hire her again, but another issue is that she was very pricey which we simply don't require for this birth since we are already in a supportive enviornment. If we do hire a doula, we will hire a student for cheap or someone who provides an additional service (like professional-level photography).
More Green For Less Green
I'm in a similar situation- only a bit reversed. I had a birth center birth (free standing with CPM's) for my first child and paid $4200 OOP. With this baby, I am seeing a CNM group at the local hospital and will be delivering there. My insurance will cover this at 100%, with no co-pay. This time, I can't justify spending the extra money, even though I had a great experience the first time. It's such a hard decision.
I did some research about doing something like you suggested- seeing an OB or hospital MW to cover all of my prenatal appointments up until the end, and then switch to the homebirth MW, but there wasn't a discount for that. The HB MW told me that the delivery is the most expensive part, so the fee remained the same no matter what week the first appointment took place. Not sure if anyone else would be like that, but just wanted to share my experience. GL with whatever you decide is best for your family!