27 answers

Uninsured Pregnancy

I'm asking a question for my sister who is about to try getting pregnant. She and her husband are wondering if it would be cheaper to go through the labor and delivery uninsured (they probably wont qualify for medicaid) instead of spending lots of money on maternity insurance as well as pay the high deductables. We understand that if there are complications it would obviously be costly, but has anyone else done this to save on having a baby? She would also like to be delivered by a midwife, and maybe deliver at home, is this significantly cheaper? One of the glitches is that she will also have to be monitered throughout her pregnancy (probably just with a bunch of blood tests) because she has high prolactin levels which resulted in two miscarriages in the past year. She's currently lowering her levels, and getting ready to try getting pregnant again, but to some degree she will be considered high risk. I guess basically we would LOVE any advice on cheaper insurance, how to cut costs, and any experiences giving birth at home or with a midwife during a high risk pregnancy.

What can I do next?

Featured Answers

Be very, very cautious. And decide how much you want to risk for a lower price tag.

My sister-in-law, who was preparing to deliver what appeared, up until the time of birth, a very healthy baby boy, lost him at birth, at home, with a midwife. As he was being born, the cord wrapped around his neck. Had the birth been in a hospital with emergency services at hand, he probably would have lived. The home setting with a midwife, who was not qualified to deal with such a complication, proved to be lethal to my little nephew.

Get aflac BEFORE she gets pregnant. It has a cheap monthly payment and I think they pay about 3-4 thousand. Definately AFLAC.

More Answers

Being pregnant is stressful enough on it's own, especially with 2 miscarriages under her belt. I can't imagine the stress of not having insurance as well. Anything can happen with pregnancy and delivery, and if not planned for, probably will. Tell her to get some kind of insurance.

I am insured through my husband's work, but the deductibles were $1500 per person, which meant the least we could spend for a hospital birth (out of pocket) was $3,000--$1500 for me, and $1500 for Baby, since he counts as another person to apply the deductible to the moment he's out.
For a variety of reasons, I chose a home birth with a direct-entry midwife, which my insurance did not cover. We paid about $2,500 total, but that included all prenatal care, birth care and all postpartum care. It was a bit of a gamble because if we'd needed to do a hospital transfer the insurace deductible would've just started ticking even after we'd spent $2,500 for our midwife's care--the total cost could have escalated to $5,500 or more if there had been last-minute problems. But things were great and I had a healthy, well-monitored pregnancy and I would make the same decision again (and again, and again).
The home birth midwife I used is a highly experienced professional and the care I received from her was always thorough and personal and evidence-based. Some home birth midwives may charge less, but I believe experience is priceless and she was the right care provider for me and my family--price isn't always the determining factor.
I cannot speak about the details of your sister's particular health issues, but I have had babies at a hospital, a free-standing birth center, and at home. All were good, positive experiences, but the caliber of care I received at the birth center and in my own home are simply unparalleled. I had constant, direct access to my midwives via cell phone and pager for my entire pregnancy and the personal care I recevied made me feel like I was the only pregnant woman in the world--it was that good. The only reason I did not go back to the birth center for my third baby was because I didn't want to travel in labor again, so we stayed home and had my provider come to me. I live near a hospital, so if there had been some unforseen complication, I likely would have traveled to the hospital in my own vehicle, not necessarily an ambulance. (But I agree with the poster who said ambulance rides are spendy--it was about $800 for an ambulance from Brigham to Salt Lake a few years ago, and it was considered "non-emergency" travel because it was a transfer to Primary Children's and our insurance did not cover such a ride. BTW, that was for the hospital-born baby, and for an allergy issue unrelated to his pregnancy or birth.)
Most potential complications can be detected long before labor starts. Most midwives will not (and by law, CNMs are restricted in some ways) offer birth care to mothers who fall in a "high-risk" category, but the exact definition of "high-risk" varies from midwife to midwife. I suggest your sister start shopping for a midwife now so she can know her options and find out everything she can do to keep herself as healthy and normal as possible.
Another option to consider is the Birth and Family Place in Holladay. It's a licensed, free-standing birth center and the certified nurse-midwife there, Becky McInnis, is probably the most experienced and skillful CNM in Utah. She caught my second baby and I have only positive things to say about my experiences with her and at the birth center. It is top-notch in every way. Currently, I think the birth center fee is about $1,500 and the prenatal/birth/postpartum care is about $2,000 with Becky, but many insurance plans do cover portions of a planned birth center birth with a CNM. CNMs can also prescribe meds, if that is important to your sister. Direct-entry midwives cannot prescribe, although they do travel with all medical equipment and meds necessary to stablize a mom and baby if needed.
If she chooses to have a hospital birth, consider taking Bradley Method classes and using an experienced doula. Both strategies will save money by helping her avoid unnecessary and expensive interventions (usually offered by well-meaning people) at the hospital. A good doula is worth her weight in gold and a couple hundred dollars for a doula is a blue light special compared to the cost of an unwanted epidural or an unnecessary cesarean birth. Many doulas certified through DONA will also barter and trade services with mothers.
If you'd like more specifics---names, numbers, etc.--message me. I'm not sure if your sister is in Utah or elsewhere.
Best wishes!

A.: I am not sure about the insurance, but I can say DO NOT have the baby at home, especially when she is uninsured and doesn't have insurance.
I had my first baby girl at home where she sustained a major brain injury, which could have been 100% avoided had I been in the hospital. Yes, 98% of pregnancies can be delivered by a new york taxi cab driver, but I was one of the 2% and we weren't even high risk, and we had the most highly recommended midwife in the county.
If we hadn't qualified for Medicaid, after the fact we would have been charged upwards of 400,000 in hospital bills. DO NOT HAVE THE BABY AT HOME. It's stupid and irresponsible, and I can say that with out anyone pointing fingers at me, because I had mine at home, and she was at the brink of death. Trust me, this is not something you want to risk for any sort of "better environment". I, more than anyone understand why people want to have their babies at home, and I more than anyone understand the risks involved.
If you want a midwife and a cheaper option get a licensed Midwife (ones who only deliver in either birthing centers or hospitals).
She should also try to get maternity insurance before the fact. Try going to the medicaid office as well, they can be very very helpful.

Definitely check CHP+ You can google it and it will take you to their site with all the info.

Be very, very cautious. And decide how much you want to risk for a lower price tag.

My sister-in-law, who was preparing to deliver what appeared, up until the time of birth, a very healthy baby boy, lost him at birth, at home, with a midwife. As he was being born, the cord wrapped around his neck. Had the birth been in a hospital with emergency services at hand, he probably would have lived. The home setting with a midwife, who was not qualified to deal with such a complication, proved to be lethal to my little nephew.

Get aflac BEFORE she gets pregnant. It has a cheap monthly payment and I think they pay about 3-4 thousand. Definately AFLAC.

There was a law passed in the late 90's that actually makes it illegal for insurance companies to consider pregnancy a pre-existing condition. So if she gets insurance after getting pregnant, she should still be covered. And if they say she's not, then she has ammo against them.

I've heard good things about Aflack insurance, though I've never used it myself.

Homebirth attended by a midwife is not only significantly less expensive (in my area a homebirth with a qualified midwife is about $2000 where a hospital birth is $6000-7000 for an uncomplicated birth w/ no anesthesia) but it is actually safer for low-risk women. There is incredibly less risk for unnecessary interventions which run rampant in hospitals and end up starting a snowball effect.

So yes, it's cheaper and it's safer.

It has been a few years since I looked into this, but, at that time it was $300 a month and you had to be paying into the plan for at least 11 months. So if you planned it out and were able to become pregnant quickly then you would be paying $3300-$4000 or so for the insurance. The out of pocket cost for a normal birth and ob care with no extras at all was $6000-$7000. So the insurance certainly seemed like a good idea. Just get the current prices and make the decision from that.
Take Care,
B.

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