Frustration... You GET what you PAY for!

PLEASE!! Forgive my Ranting and Raving and Venting... but I MUST just SCREAM a little!

I have recently canceled TWO client consultations because the clients stated that for "financial reasons" they could not consider a home birth.

WHAT is WRONG with this statement??

Do people REALLY understand WHAT they are "getting" for the deductible and co-pay they PAY to the doctor and the hospital?

Consider the costs of hiring an OB/Gyn to conduct a delivery and the costs associated with hospital birth:

• OB/Gyn fee: $3000+
• Hospital: $6000+ (if vaginal, uneventful, with no interventions)
• Minimum Cost: $9000

Insurance will pay a percentage of scheduled benefits after deductible and co-insurance are met.
(Not to mention the "allowable" amount they will consider paying! And charges that they deny.)

So, consider this:

A $10,000 total bill [doc & hosp] (Remember... this doesn't include ANY additional costs such as:
anesthesia/medication, supplies, medications, newborn care, nursery fees, pediatrician fees, anesthesiologist fee, etc, etc... and certainly doesn't TOUCH the costs involved with complications, cesarean section, extended stays, and NICU care!)

Now, suppose the patient's Deductible @ $500 & Co-insurance @ 20%...
Patient Responsibility: $2500 AT LEAST.
ADD additional costs that are almost inevitable and the patient responsibility goes UP!

Consider that the cesarean rate for most doctors and hospitals is OVER 30% and that infant mortality and morbidity rates (death & health problems immediately after birth) put the US in the BOTTOM of the list of industrialized countries...

Now... there's me... a home birth midwife of 16 years and a small-business woman.

My fee is $3500 ! Self pay clients get up to $500 off in available discounts. And what does the client get for paying out of pocket?

• a specially-trained home birth attendant and her assistant(s),
  
• self-determination (her birth ~ her way, including water birth if she desires),
  
• daddy intimately involved in labor support & helping catch baby if he desires,
• no strangers, and plenty of one-on-one, continuous labor support,
• no unnecessary interventions,
• freedom to move as she wishes,
• freedom to eat and drink what she wants,
  
• freedom to birth in the position of her choice,
• having her children, family and friends in attendance according to her wishes,
• immediate skin-to-skin uninterrupted contact with her baby,
• delayed cord clamping,
• immediate breastfeeding,
• the option to keep her placenta, to do with as she desires,
• Midwives at her beckon call, 24/7,
• shall I go on...??
  

DO NOT forget all the prenatal visits she has (average number visits: 11) that are an hour in length EACH.
Midwives that are on call 24/7 to answer her questions, continuous labor support, 24/7 postpartum and breastfeeding support...

COME ON PEOPLE!! This is a HUGE DEAL!

Your doctor won't take your call to talk about the nightmare that bothered you. He won't spend an hour with you at each visit to talk about the issues you need to know or talk about. He won't teach you how to avoid a cesarean section or how to turn your posterior baby around to anterior. He will teach you NOTHING about supplementation, nutrition, fitness, or complementary modalities to help you stay well. He won't educate you about your true informed consent and declination options regarding Rhogam; genetic, gestational diabetes & GBS testing; Circumcision; or the myriad of other important things on your list! He won't come to your home help your baby to latch on to your engorged breasts at 2am, spending the night to help at the next feeding.

Home birth midwives have a hospital transfer rate of ~10% and a cesarean rate of 3-4%.
Studies show that the risk of infant death at home or hospital is the same (for low-risk, term women).
Midwifery clients have:

• higher satisfaction ratings about their birth experience,
  
• breastfeeding success rates that are higher,
• circumcision rates that are lower...
• and the list goes on!
  

The study below indicates that an uncomplicated, vaginal birth at home costs 68% LESS than a hospital birth.
What is 32% of the $10000 total fee above? $3200. Most of my clients pay me $3000.
So there you are... Midwifery and home birth are a huge financial savings to women and their families!


You REALLY do GET what you PAY for!


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The cost-effectiveness of home birth

References and further reading may be available for this article. To view references and further reading you must purchase this article.

Rondi E. Anderson MS, CNM and David A. Anderson PhD

12 February 1999.

Abstract

As health care costs increase and a growing number of women are without insurance, the one health service that every family needs deserves further attention. Even for the 40% of births covered by Medicaid, safe birthing alternatives that permit a reduction in the $150 billion Medicaid burden would allow the United States to devote more resources to other urgent priorities. Informed birthing decisions cannot be made without information on costs, success rates, and any necessary tradeoffs between the two. This article provides the relevant information for hospital, home, and birth center births. The average uncomplicated vaginal birth costs 68% less in a home than in a hospital, and births initiated in the home offer a lower combined rate of intrapartum and neonatal mortality and a lower incidence of cesarean delivery.
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My RANT is complete.