September 01, 2011,
M.D. asks from Austin, TX on August 31, 2011
No Maternity Coverage
Hello, we recently found out we are expecting number two. I do not have maternity coverage nor do I qualify for any assistance. I had a C Section with my first so not sure about a birthing center for the second but I am interested in vbac success stories. Has anyone gone through this or does anyone have any suggestions on how to handle this? A scheduled C Section at NAMC is $9800 and that is not including doctors costs which are another $4000. Thanks in advance!
K.W. answers from Seattle on September 01, 2011
I had a successful home VBAC with a midwife. We were doing what is called "shadow care". I had a hospital team that was my backup plan in case I needed to transfer....only they didn't know they were the backups. They thought I was planning a hospital birth. (They wouldn't work with me otherwise. Birth politics suck.) While this dishonesty was a little uncomfortable for me, it put me in the interesting situation of doing a side-by-side comparison of two different maternity care systems.
The midwife was consistently more diligent, more alert, and more committed to making sure I had a trouble-free birth.
The hospital team checked my urine for sugar and proteins once. The midwife did it every visit. The hospital team checked my blood once, noted I was anemic, and gave me iron pills. The midwife checked my blood, noted I was anemic, gave me iron pills, checked again, adjusted dosage, and checked again to confirm I was no longer anemic. The hospital's plan was to check me when I came in for delivery and give me a blood transfusion if I was still anemic!
At every step of the way, the hospital's plan was to save me with technology. The midwife's plan was to make sure I didn't need to be saved in the first place. She also did all my postpartum and neonatal care for the first six weeks after birth.
Make sure you are giving birth somewhere you can get to a hospital if you need it. Home VBACs are probably not appropriate for the Alaskan wilderness! Talk to a reputable midwife and see if she would describe your situation as low-risk. She'll take many factors into account, including the details of how your first surgery was done.
If you are a good candidate for a home VBAC, you will probably get the best care by doing so. And it's a *lot* cheaper. In your last few weeks of pregnancy, pay for one or two prenatal visits with the hospital so they have your records and know who you are if you need to transfer. It's probably best not to tell them you are planning a homebirth. ;) Just surprise them.
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R.P. answers from Portland on August 31, 2011
First - try the public assistance programs - you may qualify for medicaid or medicare - I always forget which is for kids. In Oregon we have a program called Healthy Kids (the medicare/caid program) and everyone qualifies for it, but it is kind of like sliding scale state insurance (I know I am not describing this well.)
As far as the VBAC - I did it! We went with naturopathic midwife as the OBs I talked to (that would even consider VBAC) said we would induce at 39 weeks. I knew this would lead to a C-section so we searched for a provider that would do VBAC and not consider inducing. I was a god candidate for VBAC because my body was not the reason for the C-section my baby was - she had a prolapsed cord so not enough room in the birth canal for her head and 2 layers of cord - and we waited 2 full years before getting pregnant again. We birthed in a birthing clinic. The total cost was $4600 - none of it covered by insurance. If we had opted for home birth it would have cost $3300. I bet Austin has a number of naturopathic doctors that also have the extra Midwifery liscence.
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J.T. answers from College Station on September 01, 2011
I had my 2nd without insurance and it was actually CHEAPER to have him than it was his 2 brothers on insurance. The hospitals and Drs charge insurance companies more, and your deductible and co-pay are usually based on a % of that, so it's more.
Usually, if you are paying cash, the Drs and hospitals will give you a discount. When you go at 34 weeks to register at the hospital, PRE-PAY! They give you one flat fee that covers everything and they will not bill you more afterwords. For us, it was 1800 for a normal, vaginal delivery (BUT that was 11 years ago) and we prepaid it. We also worked with our Dr. and he was $1200 plus tests. So, it ran about $3500 all said and done. We also pre-paid the anesthesiologist $800. I went quick, so there were no additional fees from him (they charge by the hour).
Just negotiate your charges and you should be fine. Most Drs let you pay in installments so you can spread it out over time. The hospital is a different matter. Just talk to them.
Good Luck and congrats!
S.B. answers from Redding on August 31, 2011
In California, we have the AIM program. It stands for Access for Infants and Mothers. It is specifically for mothers who don't have maternity benefits but make too much money to qualify for Medi-Cal.
I would contact your local county health department and ask them about programs in your area and how to qualify.
Many states are cutting back on programs or talking about doing so due to budget issues. But I would start with your local health department.
P.M. answers from Tampa on September 01, 2011
I didn't have a successful VBAC, but I'm ready to try one again with number #3 whenever that should happen! I'm a huge advocate for VBACs and definitely think you should contact a Midwifery group Birthing Center and see if you are a good candidate!! Not only is a VBAC cheaper, it's much more healthy for you and baby. Midwives are much cheaper and offer better emotional support and time during your prenatal visits and actual labor and birth.
L.R. answers from Wausau on August 31, 2011
Check into insurances so that you can get coverage by final delivery usually have to wait 3 months before coverage will kick in.
C.O. answers from Washington DC on August 31, 2011
CONGRATS!!! I'm sorry to hear about your insurance difficulties...
Check into private Blue Cross/Blue Shield maternity coverage....you might be surprised at what you get!!!