You know – we thought we did everything right.
Before we even started trying to get pregnant again, I told my husband we had to find a homebirth midwife who would take me as a VBAC patient, and one that could accept our insurance. If we couldn’t find that, quite frankly, I didn’t want another baby.
If you’re a VBAC mom in Chicagoland, your choices for out-of-hospital birth are essentially limited to one homebirth CNM (possibly two, but for us, only one) in this area, so we met with her to make sure she was a good fit. When it came time to think about payment, the deal was sealed when we found out that our midwife takes our insurance. We couldn’t come out of pocket, so that was immensely important. We don’t have thousands-of-dollars laying around to pay for a birth, and I only had to pay a $100 copay for my last two births. Paying thousands, in our situation, seemed like a luxury we simply could not afford. It was a deal-breaker. Right now we have one steady income that doesn’t cover the bills, and the rest of our expenses are (barely) covered by the combination of scholarships, grants, and loans I get from school. We confidently chose this midwife knowing that our expensive insurance would handle the payment that we couldn’t. This is why we pay for insurance, hello?
Then, we found out that coverage we signed up for last year isn’t the coverage we actually have now because they keep decreasing it every year, and it’s going to get even worse in 2011. Starting in January, almost NONE of our homebirth expenses will be covered because of a massive deductible increase, and what is covered will cost us a ton more than we anticipated when we made the decision to start trying to conceive last January.
Suddenly, I’m in my second trimester, and discovering that we’ll have to pay thousands of dollars out-of-pocket to have this homebirth, which is exactly what we had been trying to avoid all along. We thought we were being smart. We thought we were planning ahead. But nothing could have prepared us for our employer’s insurance coverage to change so drastically.
So, I’m panicking. And melting down. And crying – both literally with tears and figuratively on Facebook/Twitter, etc.
Few people seem to really understand. They say, “But it’s only money! Isn’t your birth experience worth more than that?”
Uh – YES – my birth experience is worth more than that. I could have gotten an extra 2 weeks of short term disability payments after my last birth if I had just agreed to a scheduled repeat cesarean delivery, but I decided that nobody could put a price on my VBAC.
HOWEVER – I was working then. An extra couple of short term disability checks didn’t matter that much in our lives. Several thousand dollars DOES matter now – and we only have about four months to come up with it. According to the contract with my midwife, full payment is due when I’m 36 weeks pregnant, and she doesn’t have time to play “Let’s Make a Deal” with every broke mom who shows up on her doorstep. It was made abundantly clear to me that payment is my problem, not hers, which is totally fair. Everyone says “Find another homebirth midwife!” but there isn’t one… not when you have a uterine scar.
Would I consider a CPM? Nope, no way. Why? Because CPMs are not licensed in my state and I do NOT want to deal with the stress of worrying about CPS taking my baby away. I’m trying to eliminate stress – not pile more on.
Would I consider an unassisted birth? Nope, no way. Why? Because I would never be comfortable birthing without trained support who could calmly handle an emergency if my uterus did decide to rip apart where that scar is. I want someone here with a doppler, Pitocin, and skilled hands in case there are any variations from the norm.
Could I labor at home the whole time and then go to the ER? No. To me this is essentially the same as doing an unassisted birth with a uterine scar. My midwife specifically wants to be here the whole time I’m laboring to monitor me carefully because of the uterine scar. Some people may think that’s alarmist, but it’s the only kind of care I’m comfortable with.
So now I feel like I’m just completely screwed. Do we cancel our insurance and use the premiums to help pay for the homebirth? I could get on Medicaid to pay for the labs/ultrasounds/etc, but it wouldn’t cover the homebirth, and what if something happens to my other kids, which it often does? Or my husband? We’d have no coverage for them. Illinois offers the All Kids insurance program, but we’d still have to pay for it, and it doesn’t cover my husband at all. If he got hurt, we’d lose everything. How can I take that chance?
We’re going to talk again this week to HR about a flex spending account, but the amount of money we’d have to deduct from our paychecks will leave us seriously in the hole.
I have no idea what to do. I’m spinning. All I do know is that I should NOT NOT NOT have to be thinking about this right now. We already worked this out BEFORE we started trying to conceive. But now I’m being punished because Blue Cross Blue Shield thinks that “high usage, and rising health care costs” mean that they can screw over our well laid plans to have the birth we envisioned. And don’t get me started on what it would cost us if I ended up needing to transfer to the hospital.
I know everyone who reads this is saying “Oh, you can figure it out if you really want to…” which makes me want to stab myself in the neck. I’m a resourceful person, but I can’t work with nothing, and right now we have nothing. For example, after searching high and low for weeks, I broke down into tears last week on the floor of fucking Carson’s because I couldn’t find an affordable dress to fit my growing belly for this fancy awards show I am expected to be at to receive an award for my YEARS AND YEARS AND YEARS of tireless academic work. That damn award ended up making me feel completely miserable, and now, so is the stress of this unpaid-for homebirth.
I deserve a fancy dress. And I deserve a homebirth. But sometimes no amount of deserving overrides the need for cold, hard, cash.
There aren’t even enough expletives in the English language for me to finish my thoughts on this, and I’m sure you’re all begging me to stop whining now.
TFB out.
UPDATED TO ADD: No, I am absolutely NOT going to set up a donation fund. Someone suggested that on their facebook page and immediately had a dozen commentors calling me a freeloader and accusing me of being a scam artist. I do not need to deal with any more bullshit than I’m already dealing with. For every person that would like to help, there are 50 that will talk relentless shit about me all over the internet for it. I like to keep my name out of the mud whenever humanly possible.
SECOND UPDATE: I have an appointment with IL DHS next Monday to discuss getting on the FamilyCare and/or Moms & Babies programs, which we more than qualify for. It could help offset some of the costs that our regular insurance doesn’t pay for, but I don’t think it will pay for my homebirth itself because our midwife does not take the state’s insurance. It *could* potentially help pay for the labs and other fees that are NOT covered under my midwife fee, and could also certainly help us pay the hospital in the event of a transfer. However, I don’t know/understand all the details yet, so as of right now, this is only a *possible* partial solution. Still, I’m hopeful.
THIRD UPDATE: We got on the FamilyCare supplemental insurance, which is helping cover what our insurance isn’t covering. The rest of the money is coming from a Flex-Spending account that we set up, and we’ve been able to afford to contribute to it because of a combination of extra scholarship money, and me making a little cash through blog sponsorships. Our homebirth is now paid for.
BCBS sucks. They just suck. We had supposedly good coverage with them and they paid a whopping $250 for our healthy home birth (which likely would have been a crash section + NICU at a hospital in these parts). They would have paid in full for a f*cking circumcision, though.
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