May I vent?

2junebabies · October 2014

Hi ladies. I used to come on this board before my daughter was born in June of last year. As we are thinking about conceiving again I am re-entering into the world of natural birth.

With my daughter I was able to have a med-free, intervention-free hospital birth. This time, we were considering home birth as an option but we had to buy a new car this week a few years earlier than expected after my hubby was in an accident (he's fine). So now we are not sure if home birth is an option. I am trying to find an OB who is open-minded to natural birth because we moved to another state after my daughter was born. I am just frustrated because I was asking women for suggestions and so many of them seem to say that home birth is the best option, that I shouldn't base my birth decisions solely on money, and they seem to imply that if I were truly dedicated to home birth then I would find a way to pay for it. We are very frugal already and save as much as we can. We don't have cable or internet, and we have really cheap phones. It just might not work out this time for home birth, and I am sick of everyone acting like it is so easy to come up with an extra $5,000, which is the going rate in my area. That's all.

CJBosquez · October 2014

I have yet to have a baby, so this is all IMO, but I think any birth where the baby and mom are ok is a good birth. If the home birth is not an option for whatever reason (money, etc), I would keep trying to find a natural-birth friendly OB at a hospital. Try the local community boards on here to see if anyone has recommendations. Personally, I think I am going to try the natural-birth-in-a-hospital route. So long as you are clear on what you want, stick to what you want, and find an OB who respects that, it should be ok. If you are truly set on a home birth, keep saving while you TTC to keep that option open. Best of luck!

jennypolkadots · October 2014

Hey

I really get where you're coming from. We are doing a home birth and it will cost us about $4K when it's all said and done. My insurance won't pay a penny, and a hospital birth would cost me about $1K tops. $3K difference is a lot of money for us, especially when you are paying to essentially receive less care lol

We live in Alabama where midwife assisted home birth is illegal. So we will drive about 30 minutes to be in a house in TN to give birth. No doctors in my area are really NB friendly. There used to be one midwife that delivered about 40 minutes from me but of course she retired a month before I got pregnant. I have an OB just in case of an emergency and he is considered to most NB friendly - he is really just indifferent and more "okay if that's what you want!" and I want more support from my care provider than that. My midwife and her assistant will be with me through my entire labor and also work as sort of doulas, and knowing I will have them and my husband there makes me feel confident in our birth plan.

My best advice would be to explore your options. Talk to local midwives about payment plans or about how they bill insurance. Consider driving further for more options. Look into rather or not you have an HSA/FSA account you can put money in so it is taken out a little bit at a time and not taxed. If you aren't pregnant yet, look into other health care plans that might cover a home birth. Consider getting a small personal loan to pay the midwife if that is an option. Cutting expenses where you can and selling items you don't really need can help. We are paying cash but getting reimbursed for $2500 through my FSA and hoping that maybe the midwife can use billing codes to get some payout from my insurance.

Were you saying that you had to pay cash for a car and that's why you don't have the money? I would be more inclined to get a car loan than pay cash if you needed the money for birth. We just got a new car (well, used car but new for us) and the interest rate was 2.4%.

jennypolkadots · October 2014

Also to add - if you did pay cash for the car and are open to a car loan, you can always go to a local bank and get an auto loan using the car as collateral. Rates are very low right now. $5K at 2.5% and 36 months would be $144 per month. You would pay a total of $184 in interest if you didn't pay it off early. And you can pay it off as soon as you can. This would essentially be financing your birth fee but using your car as collateral. I'm not saying it's the best option but it is definitely an option.

Of course this would depend on the car having a NADA book value of at least $5K and fitting the bank's lending criteria. Usually less than 100-125K miles and less than 7-10 yrs old. Just throwing this out there for you or anyone else who may be looking for an option. The rate will be based on a lot of factors - your credit, the value of the car, etc. but could be an option if you need one.

jennypolkadots · October 2014

I don't know op's finances I was just offering a suggestion. I am very frugal personally - no cable, no extras, never buy clothes or get my hair done or anything like that. Part of making smart money decisions is figuring out the best ways of using your money so that you don't overspend. We could have paid cash for the car I just got a loan on, but realize that the money is better off in our savings accounts gaining twice as much interest than we are paying on the car. We won't be financing our birth, but I see it as a valid option if home birth is truly what you want. I mean, if there is one thing I am willing to spend money on it is the birth of my child. Sometimes you defy perfect financial practices if something is truly a better option for your family. Especially when there are not really any good options near you that fully support natural birth, like in my case.

It is totally possible to have a natural birth in a hospital. Where I live the odds are very much stacked against you though, especially in a first birth that can often take longer. And once you add in Bradley classes ($450) and a good doula ($600) and the hospital birth fee with most insurances you are almost up to the midwife fee anyways. So I guess that's where I'm coming from. But we all live different places and have different doctors/birth centers/ etc. near us so that colors things a lot.

If you are currently financially struggling then no, a loan is not a good idea and perhaps the home birth fees are way out of reach for you. If that's the case then it's probably also not the best time to think about adding to your family either. But I'm guessing OP is somewhere in between and just frustrated that a $5k birth fee is standing in the way of her ttc plans.

2junebabies · October 2014

Thanks ladies. I really appreciate all of your responses and I appreciate that you all gave me many different ideas.

The car we are buying isn't from a dealer, it is from the owner himself who bought it new, so he wanted cash. My husband has some student loans left and we are both not open to any other kind of debt. The only other debt we want to have some day is a mortgage. The car we found is also an amazing deal and in great condition, but I do appreciate the suggestion of the loan and I can see how that would definitely work in some situations.

I do have a lot of options nearby. There is a group of midwives who deliver at a hospital about 25 minutes away and they are on-call so you can almost guarantee that one of them will be at your birth instead of an OB. There is also an OB who lists natural birth as one of his clinical interests on his website who also delivers at another nearby hospital. And there is a third practice with OBs who deliver at the closest hospital. My plan is to tour all of the hospitals to get a feel for each one, and also to ask any practice that I'm considering a list of questions about my preferences and if they would be open to them (such as limited ultrasounds, delayed cord clamping, med-free in general). I also will ask some home birth midwives for quotes to see if it is an option. So I guess I really do have a lot of options, I am just slightly overwhelmed with sorting them all out. And I certainly was tired of some women just pushing home birth over and over again.

Again, thank you all so much for your responses. Your balanced approach is refreshing.

JCWhitey · October 2014

With DS we could never afford a home birth. With this one we can, but there are no home birth midwives here so we are SOOL in the home birth department. I just searched around to find the best hospital for me, where I felt the most comfortable and found a caregiver that was on the same page as me. At my appointment yesterday my doctor basically said she was like a home birth midwife, but she has you come to the hospital instead of her going to your house. No epidural, no Pitocin, no c-sections. It's not that she doesn't/won't do them, she can't. My hospital literally has a 0% c-section rate because there is no surgeon who can do them. Places lime this probably don't exist everywhere, but even DS's hospital (which was your more traditional hospital) was very NB friendly. The doctors and nurses all encouraged mothers to birth how they wanted to and their policies clearly reflected that. So look around and find where you "fit". There's a hospital there for you.

blue+skies · October 2014

I've had one hospital and one home birth. That being said, I think had we chosen to have our second in the hospital, I would have been able to prepare for and have a med-free birth in a hospital regardless of the OBGYN/provider. I wouldn't worry what others say, do what works for you and your family. It is a good thing that you are money conscious; labor and delivery is definitely a financial decision, among other factors.

I know everything is different from state to state, and insurance company to company. But if you really want to have a home birth, some insurances do cover it. Mine covered it, but my midwife was not in network so it was at 60/40 instead of 80/20 after meeting the deductible. My midwife also showed me a letter that one of her patients wrote her insurance company that referenced research showing home births are a safe and cost effective option. She said her insurance agreed to pay the same as it would have for a hospital birth. So perhaps there may be a way to make it affordable?

Good luck to you in your journey for a med-free labor and birth, regardless of where it happens!

salmphil · October 2014

danisgossipgirl said:
Funny how different responses are in different circles. Have you looked into any hospital-based midwives? That might be a good option for you.

Exactly what I was going to suggest. I have friends who had amazing experiences with natural, hospital births at a a local hospital that employs midwives and really supports that birth choice. Don't let anyone make you feel bad about the best choice for your family. There are options.

2junebabies · October 2014

Thanks again ladies. You are all awesome and have great suggestions.

Another thing I just remembered this morning is that we have a pretty high deductible anyway, so I might end up paying a lot out of pocket for a hospital birth. I am going to look at the math and see what the difference would be between home birth and hospital birth, and go from there.

I actually got a BFP this morning so now it is really time to get the search going!

MsMacual · October 2014

Congrats! I second looking into a hospital based MW group. I've gone that route twice (second isn't here yet, but will be soon!) and it seems to be a good happy medium between an OB and a homebirth. Definitely take the time to research your options b/c what our insurance will and won't cover definitely played into my final decision. I think it also could be worth your time to interview some of your options and see which one (or hopefully ones) are most on board with your birth plan. Good luck with your search and I'm sure whatever you decide will be the best option for you and your family.

jennypolkadots · October 2014

Congrats!!

I am SO jealous of all of your options. TBH my first choice would be a CNM in a birth center or even hospital based birthing center. But that doesn't exist within 2 1/2 hours of us. Even midwife assisted home birth is illegal where we live and we have to travel 30 minutes to a rented birth house past the TN state line. Makes me so mad!! I am so happy you have choices, all of which seem a great fit for the birth you are looking for.

High deductibles is what pushes most women towards home birth. Especially if you would add a doula to a hospital experience, it probably isn't a significant difference in $. My insurance has a $300 deductible and pays 90% after and I'm pissed they won't pay a dime for my birth, but our birth options really suck and I don't believe I will have a good shot at a natural birth otherwise. That's where I was coming from in listing the other options that others may be interested in. Given the limited options I have, I would happily go into debt for the best chance at a positive birth experience. Thankfully, we won't have to do that but I don't blame someone who does.

2junebabies · October 2014

Thanks!

It looks like the hospital-based midwives are not in my network (another thing I hate about insurance). We have found two home birth midwives who are very reasonably priced. You are exactly right, @jennypolkadots, with our deductible and the cost of a doula a hospital birth would end up costing almost the exact same amount as a home birth. We are going to interview the two midwives and see if we click with either one. What they have each told me via phone and email sounds great so far. I am thankful I have plenty of time to look into it, because with my daughter I just rushed into finding a provider. It's so funny that I didn't think I'd get to have a home birth at all but now it seems like we will.

kateslp · December 2014

I'm so glad that I had a home birth. The ob gym practice I went to was not that supportive of a natural birth and I honestly know nobody who did have a complete narcotic free natural birth in a hospital

painttheair14 · December 2014

@jennypolkadots‌ are you in Kentucky? I am too and had a home birth. Although few and far between, there are midwives who believe in the cause enough to risk practicing.

deux · December 2014

Congrats! Just wanted to mention that all of the midwives I've worked with are incredibly flexible on when and how they get paid. Families often barter and/or go on payment plans, some midwives even use a sliding scale fee. And many use a third party insurance billing service to make sure you get the most out of your insurance. This time it looks like our insurance is paying for about half of their fee. Even though my current midwives have a contract that they must be paid by X date, I know they'd never hassle a client who is clearly making an effort to pay them.

jennypolkadots · December 2014

@painttheair14 - nope, we live in north Alabama. Thankfully we are very close to the TN state line. My midwives both live in Alabama and our prenatal visits are local, but for the birth we have to drive 30 minutes past the state line and utilize a birth house. Really stupid laws. My house would be safer, as it's 5 minutes from a brand new hospital just in case. My midwives are wonderful though and DH and I trust them completely.

I've found it pretty funny throughout pregnancy when I tell someone I am being cared for by a midwife, the general idea is they are like a witch doctor or some old lady with no medical knowledge. Our midwives bring a lot of medical equipment to births - pitocin, iv fluids, oxygen, etc. and transfer at the first signs of danger. After 30 years of practice, their transfer rate is around 8% and the majority of those are for mothers requesting pain medicine, and that includes the 3% that truly need a cesarean. All of their intervention and mortality stats blow our local hospitals out of the water. But I usually just let people believe what they want to and just nod and smile. They can think we are crazy, that's fine.

I was wrong the first time around about our insurance. Somehow they have decided they will pay out of network rates. So we will pay $1200 plus 30%, so $1740 instead of $3K. We may even get some of the $1740 back after she bills them, since she bills them a $4K fee. So we are pretty happy about that. We have been using an FSA so we will get anything we pay up to $2500 back from that, saving tax as it's deducted from my paychecks.

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