Choosing a Provider (and the trouble with insurance)

Today we went and toured the North Shore Birth Center, which a home-like setting for natural childbirth that is overseen by Certified Nurse Midwifes. (http://www.nhshealth.org/index.cfm?Action=Information.NorthShoreBirthCenter) Originally, we were only considering homebirth with a CPM, but we have decided to explore the next step up as well because of the costs associated with paying out of pocket. After doing some research and talking to other North Shore moms, we're meeting with our favored homebirth midwife next week, and then we'll decide where to go from there. (For more information about homebirth, check out the documentary The Business of Being Born or any books by Ina May Gaskin.)

As far as the birth center is concerned, it was really nice. It is a very comfortable environment with living areas and a kitchen open for your use, as well as a full-service lending library of natural birth resources. The birthing rooms are just like bedrooms in a house, but are equipped with birthing tubs built for two. They also have regular exam rooms where you would have all of your pre-natal visits. The midwifes there, as they are nurse-midwifes, aren't as crunchy as we might like, but they are very relaxed on having all procedures and tests be optional. The most important thing for us was that they don't view birth as something that needs to medicalized but a natural part of your sexual cycle, and they are there to observe, not to dictate.

Our first official appointment with be at the birth center the day after Easter, when I will be few days away from two months along. So, we're excited about that. I have been really fortunate working where I do, because I am exposed to so much about natural pregnancy and so has David, that we feel really ahead of the game, and we don't need very much at all explained to us.

Whether I wind up birthing at home or at the birth center, we feel really great about our options. The only downside is the issue of insurance no matter where I deliver. Our concerns about insurance go both ways though; neither will cover home birth up front. Mine only covers the majority of a hospital birth if you have a wicked-entended stay, leaving us ~$3,000-5,000 in costs; in the case of an emergency c-section we would be left with approximately $10,000-17,000 of the cost; and with the birth center, they consider it an out-patient procedure and would have us responsible for ~$4,000, the approximate cost of a homebirth. Ugh. David's isn't much better, as he has a restrictive PPO. They only truly cover at Mt. Auburn Hosptial, which for an appointment would take me two hours each way to reach, and driving in the evening would take an hour with absolutely no traffic. Going to the birth center with his insurace would run us at ~$2,000 and a hosptial birth would be $3,500-10,000, depending on the care. We're certainly glad we called both companies in the beginning though to find out as opposed to after. This issue might need some more venting in the future, and we may need to become squeeky wheels in demanding more coverage. Regardless, we're still excited and looking forward to choosing our provider.