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Natural Birth
Ladies, I need your input
I have a bit of a dilemma here. Long story short, we moved from the Boston area to Shreveport, LA about 9 months ago. I had my son at a wonderful hospital in Cambridge, and even though I didn't have the natural birth I hoped for, it was still a positive experience. The hospital was committed to keeping their c-section rates down, my OB was perfectly fine with me having a med-free birth, and the nurses were wonderful.
Shreveport is a different story. All the hospitals here have ridiculously high c-section rates (around 38%), and every single mother I've spoken to has had a c-section. That really worried me, and since there are no midwives in northern Louisiana, I was especially apprehensive about giving birth here. Well, I am 13 weeks pregnant with our second baby, and I've been seeing an OBGYN who at first seemed very easygoing and open to a natural childbirth. Since I became pregnant, he's made several comments that if I want to be induced at 39 weeks because I'm sick of being pregnant, he would be happy to induce me (even though I made it clear right off the bat I would do anything to avoid another induction). He also said he wouldn't let me go past 41w. Since then, I've been hearing from other women that he will do c-sections for "bigger baby estimations," posterior babies, etc. This especially freaked me out, as my son was 9lbs 2.6oz and posterior at birth.
I found a birth center about 40 minutes away, and I spoke with the midwife today. She was very kind, and encouraged my husband and I to come in and meet with her, check out the birth center, etc. The 40-minute drive isn't a concern to me at all, but here's the catch: they don't accept my insurance. She said we could file a claim for reimbursement with our insurance company after the birth, and that *might* work out (but we have Tricare, so you never know), and her normal fee is $3200. Right now DH is in school, and while we're getting by financially, I'm not sure we could swing $3200 out of pocket. The midwife said that she has a student who is almost finished with her midwife certification, and if we're comfortable having her at our birth (the owner/other midwife would also be there) she would be willing to give us a discount.
What would you do? I'm so torn. I really, really don't want to stick with my OBGYN and regret it later, especially if he favors unnecessary interventions. On the other hand, we're trying to be very careful with $$ right now while DH finishes his degree (he also works). Thank you for reading, and I'm sorry this turned in to a novel.
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Re: Ladies, I need your input
You already know your doctor is a big fan of interventions and that he feels slimy. How can your birth proceed normally, naturally, and safely if you are unable to trust your provider? Birth should be in a quiet corner of your cave away from those that would try to harm you. Your instincts will keep that baby away from that mook as long as it can, then you'll hit the time limit and be wheeled off to surgery.
Maybe that's not the case, but from what you've said, he is not the doctor for someone wanting to do as much as they can naturally. You can trust your body, and if you're having a normal pregnancy, you should do everything you can to do it your way.
Money is the overwhelming issue for a lot of people. What does that $3200 get you? Prenatal care, labor/delivery, and postnatal care at 1, 3, 7, and 14 days? If so, that is definately worth it. I am paying $3780 out of pocket for my care that includes all of that for an in-home birth plus a midwife and an asst. (most likely a student midwife or another midwife but could be an RN too). And I have insurance that would make my birth cost a lot less in the hospital too.
If they take payment plans, could you do $500/month for 6 months, or $300 a month for 10 months? Christmas is coming up, save those cards with cash in them
I had an epihany last night that, "this is what it is all for, a healthy baby." Your hubby is going to school to provide for your family, if you can some how scrap up the cash to have a home birth, then you're doing it for your family too. This isn't a pair of shoes or a new car when a used will do. This is your family and you need to go with your gut.
At the very least find a better obgyn, he doesn't sound very encouraging.
I wouldn't necessarily count on them to reimburse our claim either (a girl can hope though, right?).
The only thing that concerns me is that the semi-decent OBs in the area aren't in our network, either. Definitely a bummer.
I've never had stellar health insurance, so I usually pay over $2k for any hospital or in-care birth, so to me $3k for the birth experience you want, would be worth it.
You also have a lot of time to save up and by comparison, I'm guessing you spent at least a couple thousand on your wedding, so why not consider this a gift to yourself for an experience you can never repeat. Either that or keep shopping around for OBs until you find one that is acceptable.
...baby #3 is here...
Thank you for the advice, everyone. I talked to DH about it, and he said we should go ahead and schedule a consultation with the midwife at the birth center (we're going there a week from today). He also said it was worth the $$ if it meant I wouldn't have to recover from a c-section. I had my gallbladder removed when my son was 9 months old, and I was in the hospital for a week. The recovery was horrible and painful, and I can only imagine what the recovery from a c-section would be like. To the pp who asked, I do have a doula, and while she did point me in the direction of some natural-birth friendly OBs, unfortunately none of them are in my network. This has been a headache, to say the least.
I will keep you all updated on what we decide to do. Again, I appreciate the advice.
If none of the semi-decent docs are in network I would probably scrape together the money.
you have time and speaking of Christmas could you ask for money to go towards your MW fees for gifts this year?
That would be kosher in my family but I know it might not be in others. You could consider it a gift to yourself.
Also remember that non-covered medical costs are tax deductible over a certain amount which this should be so you might be able to get some/all back at tax time check and see if it would fall in that category.
the only concern I would have is if you needed to transfer for some reason what would that cost be or is the hospital covered?
I asked the midwife the exact same question; there is a hospital directly across the street from the birth center, and she said if for whatever reason I needed to transfer there Tricare would pay for it (her husband is a reservist so she has Tricare too).
I agree with this. I had pretty good private insurance but still ended up paying around 2,000 for my DD's birth. I'm not sure what Tricare's deductible/copay is, but you have to calculate the difference for a midwife birth, not just the absolute dollar amount.
I'm not going to downplay what 3,000 dollars means, but it's not a crazy sum of money for a birth, especially if you could get a discount.
would the midwife give you a discount if you transferred to her care later in your pregnancy? wait it out with this OB covered under your insurance for another 3-4 months then switch over?
also, could you apply for your tax return right away in the new year and use that money towards your OB? you definitely still have time to save, but I completely understand, the money won't just appear.
glad you are going to at least meet with the midwife, hope it all works out!
My advice is to go with the birthing center. We are paying out of pocket for our homebirth and the price is the same. We were allowed to break it up into payments and we've been on a tight budget that allows us to finish paying for the birth by my last appointment in December this year (due Feb 28th). Ask about a payment plan for the amount or remaining amount if the whole birth isn't covered by insurance. I think it is worth the money spent to have a happy birthing experience. Sometimes a birth that doesn't go well for the parents can be severely traumatizing. Personally I would rather spend the money than have regrets about my child's birth and my labor/birthing experience.
Also, look into the hospital closest to the birthing center. Though an emergency transfer is way unlikely you should prepare yourself JIC. Usually midwives who do homebirths or who work at birthing centers still have a good relationship with their back-up hospital so it should be okay but it is good to be prepared.
It's so frustrating! I wouldn't mind as much if we were in an area that had midwives, because I would be fine with seeing a midwife in a hospital. But yeah...I'm definitely going to give Tricare a call tomorrow and discuss the process of filing for reimbursement after a birth at an out of network facility, and see how it goes. I'm not hopeful, but DH and I talked quite a bit yesterday and we're both more than willing to cut corners (even more than we already are!) to have a positive birth experience. I'm also going to check out the transfer hospital in Marshall, to see if they have any midwives on staff.
This made me think of flex spending accounts. Is that offered to military families, or is it only a private sector thing? We are putting a lot more in this upcoming year since we know we'll have the hospital bills. It's taken out of your paycheck pre-tax. It still means you have to figure out where to save that money elsewhere, but it feels better to me psychologically to have the money automatically deducted from my paycheck over the course of an entire year than to just get slammed with a big bill after the baby is born (in addition to the tax benefit). If that's an option for you, it would really give you 15 months to save, instead of only 5 or 6.