Thursday, November 17, 2005

No Midwife for You!

Well, the word is in, and the amazing midwives at BirthCare are NOT on our insurance. Not only that, but the center in DC is practically out of business - they only have one, single, solitary mw in the practice at this point. (And she's still not on our plan, but I'm more distressed about the general state of midwifery in the DC area.)

Anyway, unless we can front the entire cost and then be reimbursed at 80% (of what our charming insurance deems [cough] "reasonable"), we can't have midwives, a birth center, or a home birth for this pregnancy. And after our exorbitant medical expenses this year (molar pregnancy, sperm & conception costs, and Lyme disease), that ain't happening.

We do have one other possibility - if we switch to Kais*r, the birth at the birth center would be totally covered. And that's really tempting. But we'd lose all of our other doctors. For me, that would be inconvenient and sad, since I love my GP and my allergist. For Cait, that could be DISASTROUS, as her Lyme doc is most defiinitely not part of Kais*r. So that's really not an option. But I'm still interested in your Kais*r stories, if you care to share.

So, I plan to embark on a righteous and cranky letter writing campaign to work for birthing options in the DC area. If you care to join me, I'll share addresses and info on the blog as I find them. Unfortunately, it won't do anything to help THIS delivery. But maybe other women can have options in the future.


  • I'm a kaiser baby.

    Which insurance do you have? We have AWESOME options here in NYC, and if you were perhaps "visiting" the NYC area, would your insurance cover a midwife that happened to practise out of a hospital?

    Is that an option?

    Or what if you HAD to give birth at home, as there was traffic, and you cou;dn't *get* to a hospital.

    What does your insurance say about that?


    And how is Cait's Lyme these days?

    Truly thinking of you guys....

    By Blogger Shelli, at 7:33 AM  

  • So, what are you going to do? Wait, that's probably a very dumb question.

    Let me just say that I hear you on the frustration about not being able to have the birth experience you wanted. That sucks. And especially for such truly miserable reasons.

    By Blogger Trista, at 10:01 AM  

  • I'm sorry you're so frustrated with your insurance and options. It sounds miserable.

    We have a dear friend, whom you may even have met at that brunch we couldn't go to, who is an L&D nurse supervisor at a DC hospital (and whose partner is a big advocate for lay midwifery). If you'd like to talk with her and get another perspective on the options in the area, I'd be happy to do an email introduction.

    By Anonymous Liza, at 10:35 AM  

  • the other thing is, if you switch insurances, you might have a long wait for coverage for 'pre-existing' conditions. like, oh, say, pregnancy... or Cait's Lyme. Ick.

    By Blogger terri c, at 10:43 AM  

  • jen,

    assuming you could work out the pre-existing conditions issue, would it be possible to switch insurers for one year, then switch back next fall? would that be worth the inconvenience of one year without your docs? or is Cait's Lyme too unstable right now, given the change in treatment she's had recently?

    i guess no matter what you do, it's a real headache.

    By Anonymous Andrea, at 11:02 AM  

  • I wish I could help you. Our closest MW is probably 120 miles from here.

    What about a doula?

    By Blogger Blondie, at 11:10 AM  

  • Rushing out the door, but a quick response. As I understand it (and if someone else knows differently, please let me know!) if you are currently insured and you stay with your same employer, insurers cannot invoke the pre-existing condition clause. That only comes into play if you become insured from having been UNinsured or insured with a different employer.

    So yes, switching for a year is (hopefully) a possibility for me. We still have to figure out what to do about Cait. Research is in progress.

    By Blogger Jen, at 12:00 PM  

  • Good lord that sucks. What a difference insurance makes. I hope you figure out something that you are satisfied with.

    I had K for a while, and it was ok. The copays were cheap, but getting to a k center was a nuisance, and it was during part of my long battle with mental illnesses and there were almost no providers for psych care at that time. Which was a PITA. Oh and they didn't cover my allergy shots, because their doctor decided that the 18 months I had already had were enough.

    By Anonymous jenny, at 12:37 PM  

  • That sucks! Is there any way for you to go Kai$er and Cait to stay with what you've got now? (No clue whose work the insurance is through, or if you can choose to each take insurance separately through your respective jobs, or...) And as someone said, you could just swap for a year then swap back. Arrgh. What a headache! I'd personally be going with Shelli's "oops, had the baby at home" tack but of course that doesn't really help if you want an attended birth (and that's not an unreasonable thing to want.)

    Hugs & good wishes, anyway. Some days I'm glad I have no maternity coverage - I can choose whoever I want! :P

    By Blogger Kate, at 12:48 PM  

  • Just wanted to let you know that my partner, Rachel, and I have started a new blog -- "Two Georgia Mommies". I hope you don't mind that we've listed you in the 'Blogs We Read' section. Be sure to check our site out. See you around!

    By Blogger Ju., at 1:14 PM  

  • how extremely frustrating! if you can't visit NYC you could always visit boston in the last week or so and accidently get stuck here - loads of wonderful options... and you could get hitched while you were here (maybe... depends which way the wind is blowing!) - fun for the whole family.

    By Anonymous cathy, at 2:15 PM  

  • A longtime lurker here. Had to comment and say that I had both my kids at Kais*er in the SF Bay Area, Walnut Creek, to be exact. It was a fabulous experience both times. Unlike regular office visits, maternity was totally covered from office visits, tests, and delivery. Didn't cost me a cent to have two kids. Not a single co-pay for anything. And same-day appointments for any concerns I had. Your results may vary, of course, but we just moved to a state with no Kais*r and boy, am I bummed!

    By Anonymous Nancy in WA, at 3:14 PM  

  • I'm really sorry that it looks like you won't be able to have the birth that you wanted. I am however thrilled that all things Harpo are going so well. All in all? I think you're in a pretty damn good place! :)

    By Blogger Miss W, at 4:11 PM  

  • First time commenter.

    I'm currently 24 weeks so I've been dealing with similar problems of choice. My first child was a preemie, emergency c-section. In my searching I came across ICAN. International Cesarean Awareness Network. On their Yahoo list, many women have turned to homebirth with midwife, or to unassisted because of the difficulties surrounding finding a provider AND a facility willing to do VBACs. The point of this is, many of these women have been able to get their insurance to pay for the homebirth midwife, somehow having to do with services not available in network. Not knowing the laws on midwifery where you are, it may be difficult to find someone, but they are out there. I found my midwife through an ICAN contact who referred my to her (illegal) homebirth midwife who was able to connect me to mine. I'm still having to travel over two hours to avoid an unneeded c-section but it's worth it. Another place to start asking would be with local Doulas. They'll have or know of the people to talk to.

    Sorry so long, but choices in childbirth are a big thing on my mind right now.

    Talia Devane

    By Anonymous Talia Devane, at 5:55 AM  

  • Man I feel bad for complaining about our options now. I'm really amazed that you don't have CNM on your insurance there. Aren't you supposed to have *more* options in a larger city?

    Anyway, I am really sorry you have to go through this. I hope you can get it to work out for you.

    By Blogger Brooke, at 10:08 AM  

  • Hi! I am an occasional visitor, and I tried to find a way to e-mail this long, rambling comment, but was, here goes...

    I am sorry to hear that your insurance company sucks. however, there are cool OB/Gyns out there, and you might find one who treats you more like a midwife than an OB/Gyn.

    I found that it is darn near impossible to get a doc to meet with you as a consultation, but maybe ask around on a few mothering/pregnancy boards for good docs. is full of crunchy mamas, and we found a pediatrician there for our soon-to-be-born daughter (1/3/06!) who is both in our insurance plan and works with no vax/delayed vax parents. if you go there, check out the "find your tribe" section and look for your region.

    Another option, though costly, is to receive your prenatal care via insurance, and then to plan an attended home birth. (sort of the whoops we couldn't make it on time! theory) There is nothing that says just because you get prenatal care through insurance you *have* to give birth in a hospital with the docs who have been giving you care. I know of one family (not queer) who did that. I think they got a price break on the midwife attended birth b/c they got prenatal elsewhere, and were able to have "the best of both worlds"

    good luck and I am glad to hear that Harpo is healthy and happy!

    ps- sneak food in to the hospital.
    screw the ice chips.
    how are you supposed to give birth if you have no energy? my wife, supported fully by our doula, is already planning her "sneaky snack" list!

    By Anonymous Anonymous, at 2:08 PM  

  • Jen and Cait,

    So sorry about his dilemma! I was also frustrated because I couldn't have a covered home birth, but both of our hospital births turned out great, so it all worked out. We do have K and I feel like we have received reasonable care, although I know there are always those exceptions. Both of our births were in non-K hospitals, but attended by K physicians. I was irritated that we had to go out to the suburbs for Helen's birth when there was a perfectly good hospital right down the street, but my angry letters couldn't change that (they did make me feel better though). A couple things I do like about our K here in Oregon. They are pretty holistic, and don't automatically go to interventions, antibiotics, etc. They also have sent us to the excellent Children's Hospital here in town when they have had the slightest doubt that something could be serious. On another note, I think both of our hospitals did allow food in the birthing rooms, but let me tell you, I did not want any...

    So glad that Harpo is doing great!

    By Anonymous maureen, at 5:22 PM  

  • (((hugs)))

    I haven't been reading your blog for too long. Who has Lyme? I've had it for 20 years now, since I was 8...

    By Anonymous Mabel, at 5:32 PM  

  • sorry to hear about your dilemmea. I can certianly appreciate your frustration. My empolyer is switching companies and I was worried my CNM would not be under the new plan. Luckily she is.

    I can't believe you don't have more otions in D.C. That's outrageous!

    By Blogger eryn, at 5:12 PM  

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