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January 04, 2005
Homebirth Blues
Whoever knew that organising something that seems so simple would be so hard to get done and so frustrating? At times I've felt as though I was trying to organise a hiking trek to the Moon with 2 of every species on the face of the planet. Via Pluto.
Partially, I blame the insurance company that covers us. Mostly because it's a plan for people based in Alaska and Washington, which is where the company is located that took over the company PreZ works for. Meanwhile, we're stuck over on the opposite coast. Now they have coverage that extends across the country, and I believe even internationally, but nonetheless I'm sure that our provider network is much more limited than were we located in the 2 states this insurance plan mostly caters to.
A belief that was cemented when the vast majority of homebirth midwives I found in a doable radius weren't considered in-network. And while out-of-network coverage isn't as bad as no-coverage, considering the astronomical fees medical professionals ask in the US, it's not a pleasant alternative.
Then there's the fact that there are very few homebirthing midwives around. And we live in a relatively metropolitan area (25 miles from NYC). There are plenty of nurse-midwives around, but most are associated with a hospital or sometimes a birthing center, which isn't what I want. In Holland homebirthing is the norm, my brothers and I were born that way, and as far as I know all or most of my cousins were too. It's a function that is usually provided by your local GP.
I know my mother once mentioned having problems getting my youngest brother homebirthed, as we were living in the UK at the time, and homebirthing had been out of vogue there, much like here (though I believe that here in the US in the 1920s doctors who felt threatened by midwives managed to get it outlawed for a couple of decades as well, which will also throttle popularity). I had hoped that some 20+ years later I'd have an easier time of it, but apparantly not.
Initially I had my heart set on one person, who seemed pretty much the only one in the region covered by our insurance. At 32 miles it would be a bit of a hike to the practice, but I figured it was doable. Until I realised that our insurance company's provider list contained an old address for her, and her new/current address was 55 miles away. Which of course immediately relegated that possibility to the realms of 'last resort'. Spending an hour and 20 minutes or so each way to a check-up didn't strike me as fun. And that's in good traffic, and the Tappan Zee Bridge doesn't have good traffic for certain portions of the day.
Then the next issue was to see whether or not I could use this other midwife who lives closer by. She was originally listed our provider list, but the list is out of date, and she no longer works at the center she was covered for. So it was a merry-go-round of trying to find out whether or not her private practise was covered on our plan. Which it wasn't, of course. Our insurance would cover 70% of out-of-network services, leaving us with the other 30%. However, the midwife's billing person then tried to get me in under an exception that meant they would cover everything. Apparantly I probably qualified for that, because the only other person who was on the provider list was the 55-miles-away person, and that would be far enough away that I would meet the criteria. After my calling the billing person, her calling our insurance, PreZ calling our insurance, rinse and repeat after the weekend, we finally got word that aside from verification of the details from the provider/midwife, I'd get the exception put in.
You would have thought the insurance company would jump at the chance to cover something that's going to be much less expensive than a hospital stay with an ob/gyn and nurses and possible anaesthesiologist and medications and drips and god knows what else. Statistically it's much less invasive, which means that that would cut other potential costs down (c-sections, medications). But the easier natural option remains the road less traveled in this country, unfortunately.
And so a good bunch of weeks after we first started to try and organise this, I finally had my first midwife's appointment on December 21, the winter solstice. We seem to have a theme going that way, as we found out I was pregnant on Halloween, the autumnal equinox.
Posted on 01:35 AM to: Pregnancy