Monday, March 17, 2008
Our new baby, installment #34
Our midwife came to check on us three times after the baby was born, each time staying for more than a hour, weighing the baby, giving me a once-over, talking with the older boys. From a service perspective, it was downright luxurious, not having to dress a newborn and head out to a doctor's office in the freezing cold. This postpartum care was included in the fee we had to pay out-of-pocket for a home birth -- a cost that our premium insurance policy does not cover even though we are fully insured. Just because it happened at home. Knowing that insurers had spent $25,000 for my cesarean four years ago, and had just spent $11,000 for my cousin's vaginal birth in a hospital (she was later readmitted for infection but that was a separate bill), the thought that the insurance company could pay a fraction of those costs and have better outcomes and happier moms is nonsensical. It's a very dysfunctional system.
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After my initial meeting with the midwife at Tina's home early on in the process, I was still doubtful about how much knowledge the midwife had or would need given that this was a HBAC. I kept my concerns to myself (although she can read me like a book). She seemed to nice, easy going and nonchalant. I wanted someone there who would take charge - be agressive - be strong. It wasn't until I met her again, a few days after the birth of Harrison that I realized that all of the things I wish she posessed were the very things that were counter to the process. She came to once again, give Tina and Harrison a check-up. I asked
Tina if she wanted me to stay in the room while they had their meeting and she said yes. I sat quietly in the corner and listened intently as she discussed, woman to woman, real issues - how she was feeling physically, her mental status, she asked about the other children's feelings about Harrison, if Tina' husband was doing ok, and just sat on the floor holding Harrison and speaking softly about the the post-partum period. It was then that I realized that she was exactly what this family was searching for and had found. I saw firt hand how beautiful this experience had been for them and I secretly wish this for all women everywhere.
Although Tina would not have known except for this blog, I, and many family members, including her father, had been mentally distraught throughout her pregnancy. I prayed daily for a good outcome and that she wouldn't suffer through her labor like all the other women in our family had. I prayed that Harrison would not suffer any ill effects from the delivery. I was affraid to bond with him before he was born because the loss would have been more than I could have coped with. I was wrong on so many levels. Harrison is the calmest, happiest little guy - so very loving, a baby that has the biggest smile of any baby anywhere. I had an instant bond with him when he was born and he continues to win my heart.
Tina knew not to tell us when she was in labor. Tina's dad and I both know that we would have been too emotional and would have impacted Tina's state of mind while she was in labor. She didn't need us at that moment. She needed to be alone with her husband and her midwife. She brought Harrison into this world in an environment free of chaos and drama. This is truly the most beautiful birth experience I have ever known.
Isn't the insurance thing crazy!?!?
Tina, I'm so thankful you got to experience safe, sensitive, informed, experienced midwife care, and thankful mom got to see it in action. It's amazing!
Wow, those costs are ridiculous! I'm Canadian so I just never think of the cost of healthcare. So then again, maybe it's not the cost that's insane, but rather the fact that you guys have to pay them personally (or have insurance that covers them).
In at least half of the Canadian provinces midwifery/homebirth is covered by our national healthcare plan. The catch is that to have it covered by medicaid, it has to have a regulatory body, that's why not all provinces have it covered.
Any Canadian woman that gives birth (by any means) in a hospital pays nothing (either out of pocket or through insurance). Any woman in Ontario, Quebec, and a few other provinces that gives birth in a birth centre or at home with a midwife pays nothing. Any woman that self transfers to a hospital after an attempted unassisted childbirth at home pays nothing.
While it's ridiculous that your insurance didn't cover your homebirth, it's more ridculous that there's no public healthcare in the US. It makes me so sad what Mamas have to go through in the States to get the birth they want, let alone pay for it.
I'm so glad you were able to get your homebirth with a great midwife! Let's all hope that soon every American woman will have that option. :)
Congrats on your beautiful little one.
Your mother's words are so touching! I can understand her concerns; your birth plans went against everything she "knew" was safest for you and your baby. It is so sweet to read about her amazing transformation regarding birth. Congratulations on your little one. I've enjoyed your story so much!
Tina,
I'm dealing with the *exact* same issue right now. We are spending $4,000 out of our meager savings account to pay for our upcoming homebirth because our insurance policy specifically excludes homebirth.
????
When I called to speak with them about this, asking if they realized that there are two OB's in town who will allow me a trial of labor at a hospital with a 39% published section rate (at $29,000 a pop) and well over a 50% unpublished rate, they had no answers. They simply told me again that homebirth was excluded.
It doesn't make any sense to me either that they would "rather" spend $29,000 instead of $4,000.
Simply mind boggling.
My letter writing campaign to them will begin shortly. :)
Insurance companies exclude home birth because they can get away with paying $0 for it, while still collecting premiums. And the small fraction of people who want it:
A: Care enough about it to pay out of pocket.
B: Are not powerful enough to impact the bottom line strongly enough. After all, you (or an employer. or both!) are still paying premiums, right? And of the small percentage that home births, an even SMALLER percentage makes an issue out of it with their insurance company.
But the hospitals, who ARE powerful enough to impact the bottom line, are putting pressure everywhere they can to eliminate all other options. Can anyone say "monopoly"?
The small group of home birthers need to speak up to the insurance companies AND to your state legislators to mandate coverage for ALL places of birth.
I just wanted to congratulate you Tina on your HBAC. I recently purchased your book. I was coerced into a scheduled c-section my my CNM and the OB she worked with in 2005. It was because my baby was estimated to be "too big" (4300 g) and so I wasn't even allowed to have a trial of labor. This is even contrary to ACOG guidelines. I have since become a very informed consumer and hope to have an HBAC next time, I am planning to TTC this summer!
I also really appreciate the comments of your mother. If my mom wasn't so afraid of computers I would love to have her read your blog and your mother's comments! It would certainly help to enlighten her.
Okay, I just caught up on the whole story in one sitting. Thanks so much for posting, what a great story! Congratulations to your whole family for a remarkable journey!
luckily, our military insurance Tricare paid for all but $650 for our home birth, which is a big blessing otherwise we wouldn't be able to afford it.. not on military pay.
We had our homebirth covered after SEVERAL rounds of appeals. They probably became sick and tired of us hounding them, but the process was also very exhausting for us. Ugh.
It's ironic that covering a homebirth is also in an insurance company's best interest because of it's relative low cost to a hospital birth, yet they never seem to take that into account.
I forgot to mention that the person (male) we finally reached on the phone (an actual, live person!) when seeking coverage from our insurance company did not know what a midwife was (even though they had hundreds in-network). We thought to ourselves, "THIS is the man who is supposed to decide for me whether or not we'll have coverage for my child's birth?!"
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