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Hello! (Intro) & insurance hospital vs hb questions

Amber6486Amber6486 member
in Natural Birth
I have posted a couple times and also have introduced myself in TTC, but thought I should formerly intro myself here as well.

MH are eeeeeeeeasing into TTC - stopped bc pill after our honeymoon in May (to let my cycle get into it's natural swing of things) but have and continued to use condoms. I began prenatals and am weaning myself off the wine ;) and I started charting this month. Learning a lot about temping and cm and my cycle in general. Buying a house in March and preparing our finances to be baby & sahm friendly. We will stop using condoms and use the natural bc/rhythm method in January since that is the earliest we feel financially prepared to get pregnant - but we will start TRYING after getting into our house.

So- with my work... We have open enrollment with insurance and I have to decide on whether or not to sign up for it within the next two weeks- and I will be stuck with it - no choice to opt out unless I quit or get fired- for an entire year.

Getting onto DH's insurance is not a choice as long as I work for a company that offers insurance: dumb policy IMO but of course their hr dept didn't consult with me ;)

Not thrilled with my insurances 'no midwife and no HB' policies so we are trying to figure out a way around it. It is group insurance- so I could literally meet my ObGyn on the day I am in labor. Yep. No way to feel out how nb friendly he/she is. No way to even choose whether it is a he/she.

Thinking of OOP pay to MW for hb and keeping my ins 'just incase I should be admitted into hospital'...

Or just out right paying for my own health insurance on the exchange and picking one that is MW hb friendly....

Or quitting at the end of pregnancy and switching to DH's and having a midwife in hospital (which his insurance will pay for) but I wouldn't get to go to her until very end of pregnancy.

Any advice? Any suggestions or ideas?

I'd really like a natural Bradley method birth. I'd really like it at home, as I have had previous hospital trauma. BUT I feel strong enough with myself and support team (good friend that is doula, DH supports nb, hb, mw... Says I should do whatever makes me comfortable and doesn't cost a fortune) that I could give voice to my wishes in birthing in a hospital if I just HAD to...

In the mean while we are touring the hospital twe would be going to regardless of what insurance we have (sat) and I have an ObGyn apt Monday for my annual and I will ask about insurance policies & practices.

Absolutely any creative solutions or thoughts would be helpful. I know this seems like a lot of pre planning but I will be stuck w/ this insurance during pregnancy and birth so I have to think ahead. Or maybe I'm just being paranoid.
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Re: Hello! (Intro) & insurance hospital vs hb questions

  • sschwegesschwege member
    Welcome!  I'm a SAHM as well and love it!

    Is there an opportunity to drop down to p/t forfeiting your benefits and making you entitled to your husband's?

    Are you absolutely sure your insurance won't cover a Certified Nurse Midwife if you have a hospital delivery?  I would call and triple check and find out if there's a way to make a case for them to reconsider.  That's surprising! 

    One other idea, what about a family medicine doctor?  Some will do prenatal care and deliver babies.  Might be worth looking into because it might increase the likelihood that you would know who was coming to catch the baby!
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  • Amber6486Amber6486 member
    I have called and spoke to two different customer service reps and also talked to an ObGyn nurse and all said that Kaiser does not have mw's in my area. The kaiser group plan gave me a list of hospitals in my area to choose from that have the kaiser delivery docs - and after researching them all, I found the one that seems most nb friendly and that is the one I am touring. They HAVE midwives... But they are not with Kaiser (my insurance group) ... It's a weird insurance... They keep calling it "group insurance"..? I have a regular fam practitioner w/ them but they require their ObGyns to be assigned a hospital at which they take turns - it is .... Odd.

    One benefit to it is this: the kaiser doc is only there while they are scheduled to be there... If my doc is scheduled to go home, the next one would come in. So I won't run into a doctor trying to rush me/induce me so he can make is kids school program or tee time ect.

    My doula knows how to catch babies and has a ton of experience and learned from my areas most prominent midwives - one of my questions to my ObGyn on Monday will be if it is against kaisers policy for my doula to catch baby. I will ask hospital the same question when I go on Saturday.

    Am I naive to think I could just not interact w/ hospital staff and just sorta... Be 'renting' the room out? And use the doc if something goes awry? I typed up a birth plan that even states that I prefer to be left alone and if staff needs a question answered they are to not address me, as I am working on labor, but to instead address my doula. I intend on taking the birth plan to hospital tour and ObGyn and asking them if they see anything that is just NOT going to happen due to policy- and see where that leaves me.

    HB MW OOP is a potential solution but it would leave us quite strapped financially and Bradley method classes would be out of the question- which would you spend the money on?

    As for part time, it wouldn't be financially possible and also not a choice at my work. Financially possible only if I went back to work right away after three months bc our savings would be enough for DH to feel comfortable. Which would u choose?
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  • sschwegesschwege member
    While your doula may feel qualified to catch a baby, that is not her job.  Her job is to be a support person to the mother, that is what her training is and IMO what she should be doing.  I can't imagine any hospital or doctor agreeing to allowing a doula to act in place of a MW or doctor, safety reasons aside, there's the whole legal issue associated with it.

    If it were me, I would labor at home as long as possible.  Have your doula come to your house first, she will be able to help you decide when it's a good time to go to the hospital.  If you arrive late in the game, it shouldn't matter as much which doctor is catching the baby.  With my second I arrived fully dilated, the triage nurse went to get the back-up MW, she checked me realized I was complete got the main MW in there so I could start pushing.  I was so focused, it was my DH who later told me it was actually two MWs who came to triage, I thought it was the same one!  This isn't to discount the importance of having supportive provider and hospital, but if you can labor at home for most of your labor, you will probably eliminate some of what is concerning you. 

    I did not have HBs nor did I take Bradley (I did Hypnobirthing), so I don't think I could really say what I would do.  Seems like if you were having a HB and had a doula you would be less likely to need a class since medicated pain relief isn't really an option at home.  Part of what you are fighting against in the hospital is knowing that all you have to do is ask. 

    I would much rather be home longer after the baby is born, that for me would be top priority.  But that's just me, everyone feels differently and certainly there is no right or wrong!
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  • Amber6486Amber6486 member
    I've checked and double checked and will continue to check (at hospital tour and ObGyn apt) about the midwife option.. I know it is weird but is think the whole 'group insurance' thing is weird in general... Maybe weird is just their flavor. Idk.

    I suppose I could live with a stranger catching our baby but... I am totally paranoid about them being in my room threatening induction & c sections and offering drugs- and that is the main reason I would really like to be at home. So... Out of pocket hb w/mw is certainly is an option for that reason. Thanks for helping me brainstorm through all this.. It helps to know that others think of these things and I'm not being weird!
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  • soulcupcakesoulcupcake member
    It can be tricky navigating insurance and what they do/don't cover. I'd definitely hire a doula if you go the hospital birth route. If the hospital your provider has privileges at is not big on low intervention model of care then have a doula is a good way to go. Also, a lot of mamas that planned med-free hospital births did the "wait until I'm in transition" to go to the hospital. If you're not there to receive unnecessary interventions then it puts less stress on you. If you can stay home as long as possible then that's a good thing.

    My insurance with #3 and #4 usually only covered CNM attended homebirths, but I still had to pay OOP and submit a claim for reimbursement after the birth. I had CPMs, and while I know some that were able to get theirs covered, it depended on the state. This time, insurance absolutely does not cover homebirth, so we have paid OOP, though a reduced fee for my insurance. She does have an insurance biller that has had success with getting clients 50-60% back. So we may go that route.

    If choosing between Bradley classes and a homebirth, I'd absolutely forgo the classes. You can always opt for the Hypnobabies homestudy course.
    G 12.04 | E 11.06 | D 11.08  | H 12.09 | R 11.14 | Expecting #6 2.16.18.



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