My husband and I have been wanting to add a new addition to our family of 5 for a couple of years now. Finally, in December, I got that positive result on the pregnancy test and am currently 9 weeks along and due in mid-August (don’t worry, the photo is taken later in pregnancy!). We were so elated to finally be pregnant! I quickly found myself in a conundrum though. We are self-employed and have a very high deductible health insurance plan because it’s what we can afford. It doesn’t have maternity benefits and has a $12K deductible per person and a $22K out of pocket maximum per family per year. A hospital birth in our area would be in the neighborhood of $13K-$16K (for a 1 day stay and including OB and pediatric care), but I am over 35 and in the high risk category so it could be much more if there are interventions they deem are necessary. I would assume with the birth, we would hit our out of pocket maximum. We don’t have that kind of money laying around, so I started looking into alternative options.
You may be able to tell from other posts on my blog that I tend to learn toward natural healing. Four years ago, I went through years of serious illnesses going undiagnosed and pretty much feeling uncared for and cheated by medical doctors, so it wasn’t much of a stretch for me to seek outside of the medical realm for this birth. So far it has been an enlightening experience to say the least. Already, I’m so much happier with the level of concern and care I’ve received.
As I see it there are 3 valid options for pregnancy care and birth:
1. Seeing a medical doctor or OBGYN and delivering in a hospital (cost $13,000 or more + lab work)
2. Going to a birthing center with a nurse midwife and delivering at the birthing center (cost $3,000 + lab work)
3. Seeing a midwife and delivering at home (cost $1600 + lab work, but billed at cost)
HOSPITAL EXPLANATIONS
For me, seeing a medical doctor and delivering at a hospital is out of the question because of the cost. Even if it was a possibility, after all the research I’ve done and the experiences I’ve had, I would still go with home birth and I will explain why later in the post. Also, with a hospital birth, the doctor I want is not generally the one who delivers my baby because of the “network of 8” OBGYN practices. This leaves me feeling nervous and unprepared for who I will see on the day I go into labor. I have also waited more than 2 hours for my prenatal appointments and then get 5 minutes with the doctor once I get in. I lump in murse-midwives that are connected to the hospital in with this group because there is not much difference in my opinion besides the fact that they try to encourage labor with no pain relief. There is pain relief readily available at the hospital and induction practices. Birth is seen as an emergency that needs drugs, technology, interventions, procedures, and seasoned professionals. Birth takes place in a sterile (yet potentially ridden with infection) environment that is made to feel “like home” but still feels like a hospital. You may need to share a room with another mother.
BIRTHING CENTER EXPLANATIONS
At first, going to a birthing center felt like a natural transition for me because all of my other births were in the hospital and birthing centers have a bit of a hospital feel and are staffed by nurse-midwives even though they are not connected with the hospital at all. However, when I started looking into it, it just seemed like the birthing centers were charging a lot more to simulate a home environment. I don’t think I need to pay $1,500 more to go to a place that’s meant to feel like home, but isn’t. After you have the baby, you have a few hours there and then you need to leave and come home. That didn’t seem very appealing to me. In a birthing center, I am also not sure who I will see on the day I go into labor as there are generally a network of 4 or 5 midwives who are on call on different days and times. Having a baby at a birthing center is safer than having it at a hospital and just as safe as having it at home. There is no synthetic pain relief or induction at birthing centers, but there are natural ways of dealing with these processes. Birth at a birthing center is seen as a natural process for a healthy woman that needs minimal or no interventions. You may need to share space with another mother.
HOME BIRTH WITH A MIDWIFE EXPLANATIONS
Honestly, I had never even thought of having a home birth until 4 (yes 4!) of my neighbors had given birth successfully at home. One was in a birthing center and she is planning a home birth in May. I couldn’t believe the positive experiences they had and how each of them said they would definitely give birth that way again (and 2 of them have). Before studying about it, I thought home birth was unsafe and risky. However, after reading countless studies and 7 books and counting, I have found that home birth is actually safer than hospital birth and just as safe as at a birthing center because you avoid the interventions that can cause side effects and infection (like epidural, IV, induction, episiotomy, infectious diseases that permeate hospitals, and high C Section rates). You are more relaxed and free to move around as well as eat and drink. You have 1 midwife in whom you build a close relationship with. She will be there for every prenatal appointment and for the entire birth (not just the last 5 minutes like the medical doctor) as well as for postpartum care. She is trained in emergency situations and brings oxygen and other needed equipment as well as birthing assistants who are trained as doulas (labor support). She will transfer you to the hospital, which happens about 2% of the time if there is a true emergency. There is no synthetic pain relief or induction when birthing at home, but there are natural ways of dealing with these processes. You have a lot more flexibility, control over nearly everything, and ease of mind by giving birth at home in my opinion. And best of all, no IV. I swear having the IV in my arm and not being able to drink during my hospital birth was worse than any labor pains I ever had! Birth with a midwife is seen as a natural process for a healthy woman that needs minimal or no interventions unless there is an emergency.
I have very fast labors, so I think even though I have never had a labor without pain medication, I will be able to get through it ok. I have read hundreds of success stories and if they can do it, I can too!
Here’s a video from my midwife Richelle Jolley explaining why home birth is safe. Have a looksy and see if it’s right for you.
MY FIRST PRENATAL VISIT WITH A MIDWIFE
My husband and I were invited to my midwife’s home to have my first prenatal appointment with her. It lasted 2 and a half hours in which we got to know each other and her 2 assistants as well as a complete health history and blood / urine tests performed at her home at the cost of ($25!). This is what the lab charges her and she doesn’t have a markup. How many OBGYNs would spend 2 hours answering your most intimate questions and I don’t know any that charge $25 for a blood test, I have paid $400+ multiple times)? I was floored by the experience, the love, and the skill by which these women work. It is an underpaid profession to be sure (and in many places, a secret profession), but most midwives feel it is their “calling” in life to help other women give birth under the circumstances in which the women feel more comfortable and safe. I am so thankful for what they do.
In the meantime, my midwife Richelle Jolley and I have talked on the phone and emailed back and forth many times. She has helped me with pregnancy complications and health issues, and helps me with diet, exercise, and supplements so I can be as healthy as possible. Just to compare with my doctor and hospital experiences, I never once talked with an OBGYN on the phone, and never emailed. I had to call and make an appointment to come in (and wait up to 2 hours) in many cases if the nurse that answered felt unqualified to answer my question. With my first pregnancy, I asked my doctor what I could eat and do to have a healthier pregnancy, he said “nothing just don’t gain too much weight”. That answer made me fearful honestly. This is the experience I’ve had from not just this doctor, but many, many medical doctors.
Richelle doesn’t consider me high risk because of my age. I am a healthy person, probably healthier than I was when I was 20!
Here are the pros and cons of home birth as I see it:
PRO: Individualized care
PRO: The person you have prenatal visits with is the one you deliver your baby with
PRO: Longer and more in-depth prenatal visits and nutritional counseling
PRO: Lower cost
PRO: You get to be in the comfort of your own home and don’t have to go anywhere
PRO: Less interventions (IV, induction, C-section, episiotomy, etc)
PRO: Strong friendships and bonds are created with the one who is there at birth
CON: Not covered by insurance (although some birthing centers are)
CON: Natural pain relief techniques take time to learn and aren’t a “quick fix” like an epidural
CON: Hospital technology is not available if truly needed in an emergency
In my case, the last one isn’t much of an issue to me as there are 2 hospitals less than a mile away from my home. My midwife has been practicing for 13 years and has had to transfer to the hospital in 2% of births, most of which were the mother choosing to go so she could have an epidural. She has had 0 deaths of mother or baby and has attended over 300 births. I think that’s pretty good odds if you ask me!
Home birth isn’t for everyone, clearly. However, I hope I have opened your eyes to it’s safety and the amazing kind of care and support that comes along with a midwife.
If you have any comments about home birth or why I am choosing it, please post a comment, I’d love to hear from you!
Please note these are my own personal opinions. I have not been paid to write my views on this subject. I would also suggest you speak with your doctor or midwife before trying anything I suggested in this post. I do not in any way pretend to be a doctor or to give medical advice! I implore you to find out for yourself!
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Well stated.. I have my fifth child on the way and I wanted a home birth more than anything but my insurance does cover a Birthing Center birth and not a home birth.. I have not found a midwife that cheap around here.. In TN the cost is more like $3500-$4500… My plan is to take what I can get as far as what I wanted in my birth.. I don’t like the drive.. The not knowing who is going to deliver my baby.. And the having to get up and leave again soon after.. But it is the closest thing to a homebirth experience I can get..
Author
Ugh, I hate that it’s so expensive in your area Tosha! Is $3500 what the midwives charge in your area or was that for the birth center? It may be cheaper in the long run to forgo the insurance and go with a midwife even though it’s not covered. How much is your deductible? In a perfect world, money wouldn’t be an issue and you could have whatever birth you chose without worrying about the cost, right? I’m with you, I really lean toward midwifery care because it seems like the other options just have so many flaws. I have a couple friends who delivered in birth centers and loved it though. You don’t have to worry about keeping your house clean :). I have older children (my oldest is 12, youngest is 6) so I feel like I have it a little easier in terms of my children being pretty independent and keeping up with their chores, etc.
It is paid for in full for me to birth in a birth center.. If we had the money saved or could afford payments we would still have a home birth.. But we can’t afford it! I just wish insurance companies would realize the money they would save if they covered home birth! But I am looking at the Pros of the birthing center and “working” with the cons.. The biggest con for me it is a two hour drive to the birthing center.. 2nd is having to bring food and they have a tiny fridge and only a microwave…!!
Author
Oh, I see. Well, a birthing center is a great option too and one I would feel happy with under your circumstances. Is the birthing center close to a hospital just in case? The drive will be difficult for your prenatal care, but in the long run will save you a lot of money. It won’t be too bad until you have to go every week, but if you have a “normal” pregnancy, I think they will still let you come every other week until you deliver. I also think they will let you bring a cooler and a hot plate and things from home to make their space more comfortable. I would also recommend a doula in your area who is also a monitrice (can check dilation), so you are not driving all that way to get checked only to find you’re not in active labor :). I don’t know if that happens to you, but it happens to me a lot!
After my experiences in a hospital (none of which were bad) I think that if I ever have another (not saying I will, mind you!) I would heavily consider a home birth after reading what you said in your post. Everything you said has been something I have thought about after this last one. I’d love to ask you more questions sometime!
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Adrienne, I applaud you for looking into other options and making an informed decision based on your likes and dislikes. I can’t say I had a terrible experiences in the hospital with my births either, however my pregnancy and births were numb (not only from anesthesia, but from just having no say in my own treatment). I had a couple things happen that I disliked and had no control over, but overall they were nice experiences. I didn’t know any alternatives even existed until my neighbors started having their babies at home. I have never had a doctor watch out for me and care about me like my midwife does. I’m just another name on a paper. My personal opinion is that birth is beautiful and natural and is not an emergency that needs medical attention, but I also respect others who disagree with my view.
I love this post. I applaud you for taking the time to really research and ask questions! Also, to be strong enough to share your opinion respectfully, assertively and objectively. Too many are closed-minded, allowing their “health care providers” to intimidate them with fear. Birth is a beautiful, natural thing. It should not be feared. It should be a sweet experience. I took a 12 week natural birthing class and went with certified nurse midwives at Timpanogous hospital. The greatest fear I had was that they would force me into a C-section or some other dangerous intervention when it wasn’t truly necessary. I had so much anxiety about it. Luckily, I was able to have a natural birthing experience at the hospital; however, it wasn’t the feel of home. I also had to be very insistent about what I wanted. The staff was shockingly uninformed. It took 10 minutes for the nurse to figure out the (mandatory) heplock IV until my husband instructed that unscrewing something needs to be turned to the left. (WOW) Most questions we asked were met with “I’m not sure” or completely conflicting answers between staff members. No one knew what was going on. Needless to say, I did not feel safe or reassured by being there. I think the way you are doing it is courageous (because of all the fear mongering about the subject) and awesome. I’m sure you’ll have a beautiful experience and I know you can get through it!
Author
Brin, thankyou for sharing your experience with honesty! It wasn’t until I started doing research on alternative options that I started to realize how little control I had over my previous 3 pregnancies and deliveries. I can’t believe how inept the nurses were for you, that’s terrible! I do find my midwife is much more supportive and knowledgeable than any OB and spends a lot more time with me than my OB ever did and I appreciate that. Thanks for your comment.
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