Becoming a Mom Again and Choosing a Care-Provider

Both of my kids at about 1 wk old.

So we let out our little secret yesterday.  We're having another baby due mid-November.  I have a few followers on here that I know don't use Facebook so I wanted to share here too. I've been pretty distracted figuring things out over the past few months.  It's hard to write posts when you've got baby on the brain (and you don't want to share yet).

Things Get Complicated 

At my 8-week appointment the OB (the one in town here) informed me that I would not be able to give birth here because the Hospital does not do VBACs at all (last fall she told me she thought it was fine because of my previous VBAC--she's new here).  My daughter was cesarean-section and my son I delivered naturally.  I have given birth both ways and know that a planned c-section is just ridiculous in my case.  I had DIY-son w/in 5hrs of my first contraction and I only pushed for about 10 min.  Recovery was a dream compared to my c-section.

So, I looked around online and started looking into midwives and different options since there are a lot more options in B-town.  Looking into the financial end of things and having dealt with hospitals a lot and all the unexpected fees they throw in and their complicated billing procedures the midwife route sounded much nicer.  The OBs charge more for prenatal care, than the midwife charges for all of her prenatal visits, birth in her birth suite, and postpartum care. Appointments can be as long as I want and she only attends about 1 birth each month.  To walk in and have an all-natural birth w/ no interventions or complications at the hospital they charge nearly twice the amount the midwife charges.

Midwife fees=   X  (+ 0 hidden charges)

OB fees=     1.4X + 1.6X= 3X  or 3 times what the midwife charges with lots of extra fees thrown in.

My husband's employer is self-insured so they pay all of the medical expenses from the company's bottom line.  The midwife is not in the company's PPO but they still cover 60%.  They cover 80% of the charges from going with an OB.
Paying 40% of the midwife's fees versus 20% of the OB's charges saves us nearly $1000 out of pocket....

There is one caveat.  Both of my kids were born early 34 and 35 wks respectively. The midwife is not legally allowed to deliver me before 37 wks.  So we may have to go to the hospital if I go into labor early or have unforseen complications.  At that point I would be transferred to an OB's care, the midwife would refund all but her prenatal care portion, and we would pay the hospital fees for delivery at 20%.  I ran the numbers and with the amount we'd save on prenatal care we'd be close to the same amount for overall out of pocket charges.

Going with the midwife.
-I get a lot more one-on-one personal care,
-we save the company a whole lot of money,
-we pay less out of pocket,
-her location is much closer (and I won't have to navigate through the big unfamiliar city and traffic for every appointment and to arrive for the birth,
and
-if anything goes wrong we can still go to the hospital (about 15 min. away).

Money isn't that big of an issue but honestly I'd like to keep the birth as natural as possible and I don't want to pay the hospital all that extra money just to play catcher.  The hospital is there for emergencies and if things start looking risky the midwife will transfer me to an OB's care.  It all seems to make sense to me.

Then there's the 2.5 hr drive during labor... this doesn't sound fun at all, but I'd rather give birth in my car than have another c-section.

It's sad that giving birth to my children has to be so complicated.  Hospitals should be more accommodating to different needs. They act as if choosing to give birth vaginally after cesarean is so extremely risky that all such cases should undergo major surgery (as if that has no risks!). I also wish there was a midwife in our area... that would really help.... If only to give the hospital here a little competition and possibly reason to be more accommodating.