Saving money on having a baby

Midwives are cheaper than ob/gyns if you can find one in your area. New Mexico allows lay midwives to perform home births (they are medically trained but are not nurses), if you are comfortable with that option. Otherwise there are birthing centers, and midwives in hospitals. Nurse-midwives can't do epidurals or C-sections, but they can do intramuscular shots of pain meds in some states, not sure about New Mexico. Midwives can also do uncomplicated pre-natal care. They will refer you to a doctor if you ask or if they think it's a good idea.

I've been looking into this too because we are going to start trying in February; insurance covers delivery, but I have a phobia of having my spine touched-- a real phobia, I had bad panic attacks during a spinal tap-- so while I probably will have to use a high-risk ob/gyn for the pre-natal care, I want someone to do the delivery who does not automatically think "epidural."

There is a book called "Giving Birth," by Catherine Taylor, about midwives in New Mexico. Its philosophy is probably too crunchy-granola for you, BUT if you read it you will see that's the author's bias; the midwives themselves and their patients have every philosophy you can imagine. A lot of the names and places are real and might give you an idea of where to start googling.

Jenny,
You seem like a good candidate for a home birth. Take it for what it's worth, but I think you are. The help of a midwife would be great.

Hey, that's great Becky! I'm so happy for you!

Andrea

First, a midwife delivered Chance (the dr. was too busy with other patients, and it was known that I might have her anyway). didn't help on costs. but I will look into that a bit further. It really shouldn't cost the same, I would think.

Second, I'm uncomfortable with a homebirth since we live nearly an hour from a hospital. If something were to go wrong, it would take too long to get there. That scares me. Other than that, I'm nearly open to the homebirth idea, moneywise. Don't think any midwives live within 30 miles of us, anyway. DH, on the other hand, says absolutly, no way in hell, ever, have a homebirth.

Maybe have an EMT live with us? LOL!

Keep the ideas comin'!!

Other info:
*already mentioned in this post, but we do live almost an hour away from nearest hospital. It is also the only place to have a baby, there are no birthing centers or clinics. The hospital in our county cannot do babies (they can't afford that kind of insurance either).
*after a quick check in the phonebook, there is only one place that does OB, and I already go there. The midwives are also there.
*went to the NM dept. of Health website and found a list of registered midwifes. Yep, only two within 2 hours, and both are at my dr. office already, one is the one that delivered Chance.

When I had DD3, we had overlooked an exclusion in our insurance policy and the insurance didn't cover DD3's hospital bill when she was born. I negotiated with the hospital and they took a little less than seventy cents on the dollar as payment in full. Of course, at first they told me that they had to have payment in full even though they give huge discounts to insurance companies. I still feel that they should have given me a 35% discount instead of just 31% but I didn't want to get too greedy and end up having to pay their full, overinflated price. My first offer to them was only 60 cents on the dollar. Their counter offer was the standard 90 cents on the dollar so I think I did pretty well Anyway, you should be able to at least get 10% off plus a payment plan. When I got my 31% off, they expected and received payment in full. Payments with a credit card are considered payment in full (at least around here).

It's all free over here, sorry! I just wanted to say I'm really pleased for Jenny and Becky

My way is definitely not cost-effective! We spent about 38K!

It is a shame that costs are allowed to be so inflated for childbirth. I don't know how you all without insurance and child-bearing do it! I am not financially disciplined enough to do it.

Vonnie

With DS12 I didn't go to the doctor until I was 6 months along. I also refused the "routine" ultrasound and did not go to the every two weeks appointments after 32 weeks or the weekly after 38 weeks. We just couldn't afford it. I had just delivered a year before, and I was young and healthy. I also negotiated with the hospital for a payment plan. It took 24 months to pay off his delivery at $200 a month. I'm pretty sure that it was about 75% of full price.

I think that most of the prenatal care is overkill. We are so excited (or terrified) to be pregnant that we blindly follow the doctor's orders. Pregnancy is a very natural occurance, and we have managed to really intitutionalize and micromanage it unnecessarily.

If I hadn't been high risk with DD4 she would have been born at home.

Just my two cents...

Between that and the usual overkill: grill the heck out of the doctor or midwife about whether each procedure is REALLY necessary.

If time is not of the essence, you could wait a while and save up.

Actually a combination of most-of-the-above:

1. Wait to TTC until September 2005, meanwhile squirreling away cash to pay for baby costs.
2. The baby will then be due sometime in the summer, so that you can go stay in Lubbock and take the kids along.
3. Use midwives-only for the pre-natal care and delivery, and grill them about what really is and isn't necessary. Or, use them only for the pre-natal care, but a doctor for the delivery if you really want that epidural.

I looked at what I wrote above and it could lead someone to believe that I am already pregnant; I am not, as far as I know; we are going to start TTC in February was what I meant. Sorry to disappoint!

Also please no one say anything about even that on my blog, because I sent the url to a "real-life" friend and I don't want people in my "real life" to know until a few months after it actually happens.

This this thread has been resurrected:

We decided to hell with it. You can't ever really afford to have kids, so we are now 2 days overdue with baby #4. Some of the ideas given were really good. The hospital does give us a 15% discount for being self-pay, and the dr. will knock off about that much too if we pay it all after delivery. Which we will be able to do thanks to a good crop this year. We will still be in the hole in our operating account, but baby will be paid for (funny, the dr. office didn't go for the "have three babies, get the 4th free" thing I suggested. LOL!).

I had stated in an earlier post that I would have considered a homebirth if we were in town. But since then (wow, has it been a year!!??), I have decided ABSOLUTELY NOT!!! It just isn't for me. Maybe for someone else, and everyone that suggested it please don't take offense. Just because I live in "little house on the prairie" doesn't mean I want everything to be like the olden days. LOL! However, I could be looking at a "truckbirth" if this labor goes too fast! LOL! (I actually do have some towels in the truck just in case my water breaks or worse on the way. Hey, I'm not messing up leather seats!!).

Thanks again for all the suggestions, folks! And wish me luck for whenever this baby decides to get here! I'm just hoping to make it to the hospital intime for the epidural!!

If you follow the pattern and labor for only three hours, you won't have time for an epidural!!!

Six hours, probably. Three hours? You'll be a third of the way done by the time you get to the hospital!

If you're too late for an epidural they may still be able to give you Stadol through an IV. Worked for me.

Anhata
www.familynaturally.com
Your Family's General Store, Naturally

Ok, I finally got all the bills in for having Andrew.

The total came to just under $12,000.

There were no complications, it was a vaginal delivery. I went in at midnight on Friday/Saturday, came home Sunday afternoon. The only un-natural thing I had was the epidural, which was $1,200 (and totally worth it. I didn't feel an ounce of pain the entire time, not even pushing. And that is saying something when the kid weighs over 9 pounds!!). But everything else was what was so expensive. This sux. Now I have to pay it. Which wouldn't be so bad if profits from farming weren't the same as they were 50 years ago, while the cost of farming has increased dramatically).

Can you challenge this bill? How could the price have gone up by over 50% in the last 3 years? I know that OB-GYN is incredibly expensive because of the high rates of malpractice suits .. but holy moly! Is that $12,000 for the complete pregnancy, or just for Drew's birth?

Maybe they increased since last time for the things that go with the epidural, like the IV (I think most hospitals put an IV in you when you get an epidural)? And maybe they gave you some Pitocin this time and didn't tell you, but didn't give it to you last time so you're charged for it now and not last time? Still, yikes. I live in a high cost of living area and my local OB charges $2900 for normal vaginal delivery-- $3600 is what they charge for a C-section (plus hospital costs).

Jenny, that is an enorrmous bill! I'm flabbergasted. Did they feed you caviar non-stop to run up that bill for your bit of the hospital stay? Long live the National Health Service, if it wasn't free we'd never be able to afford children.

Zillah

I am trying to remember what Max cost when he was born 15 years ago. But I know it was no where near that amount and it couldn't have possibly gone up that much!
Jenny when you get that itemized statement, don't be surprised when you see they charged you 50.00 for a 12 pack of pads. After my dad died, we asked for an itemized bill, and he used 2 boxes of tissues....10.00 EACH.
I am in the same boat, and it is truly outlandish what they charge.
M

I've heard that hospitals charge the uninsured more than those with insurance, because the insurance companies are able to negotiate a lower rate for their members. Like the uninsured/self-paying folks can afford to pay more? Hardly. I hope you're able to negotiate and get that bill down!

Whew, thank goodness for our national health service here in the UK!! My DS was free!

The hospital will certainly take much less than they say they will. If you had been on insurance, say Blue Cross-Blue Shield or something, they would have pre-negotiated a significant discount. Why should they care who's name is on the check? They'll take whatever amount they would have gotten from an insurance company. They say they won't, but they will.

Do you know anyone who has had a baby on insurance from that same hospital within the last couple of months? If you did, if she would give you a peek at her bill, it would be a good starting place. Your itemized bill will help you out to. I'd be shocked if there weren't at least one overcharge... there always is. Also, you can call BS on $10.00 boxes of tissues before you even start negotiating on a payoff.

If I'm remembering right, I got 40% off of the bill for my last baby by paying it all upfront. [Editing to say: When I say "upfront" I don't mean before the baby came. I mean in full, when the bill came to my house.] My parents lent me the money. I hated borrowing from them, but what are you going to do? My daughter was in the hospital in May for 5 days and instead of negotiating a discount, I did a payoff plan of $100 a month. I'm sure we'll be paying that until she graduates highschool! It probably would've been smarter to get them to come off of the bill and pay it all off at once, but we really didn't have the money and we can handle $100 a month without too much trouble. Good luck. Insurance is REALLY frustrating!!! It doesn't seem to be getting much better, either.

-Kay

Well, we went to the hospital and the dr. office to negotiate.

We managed a 15% discount for both. Not much. The itemized statement didn't have any $20 box of Kleenex. If they do, it was absorbed into some other cost (probably the room). The dr. office said they usually only give a 10%, but since I've been paying regularly, they upped it to 15%. DH was kinda hard on the lady at the hospital, but they wouldn't budge past 15%. We took it and ran.

I'm waiting to hear back from the epidural people.

Last baby for us. Can't afford any more! LOL!

Wow! I would suggest that you ladies come to the UK on 'holiday' and just happen to go into labour whilst you're here. Stay with one of us for your next babies - hell, actually you could stay in a 5 star hotel and probably come out of it cheaper. I feel a business idea coming on....

Too late to be helpful, but possibly helpful to someone else. We didn't have insurance when we had baby #3 and had to do a hospital birth. When we went in to talk to the billing department ahead of time, the lady slipped us a little tip. She said that if you pay before you leave the hospital they charge $1500, but if they bill you they will charge $5000 (supposedly because of the people who take a long time to pay off their hospital bill). From the statements I have gotten having babies with insurance, the insurance company only pays between $2000 and 2500. BTW the lady also informed me that it is the same sort of billing procedure for any hospital visit.

Hope this helps someone.