Unassisted, At-Home Water Birth, First Baby: Good idea/Bad idea?

Replies to This Discussion

Permalink Reply by Krista Jobe on June 5, 2010 at 9:40am

Thanks for the idea, but I don't think it'd make much difference in my ability to afford it. We just bought a house last year and are paying student loans, so we don't have room for much more debt...

And like I said, I'm planning on four kids, so it'll get to be quite a hefty price tag. :P

I wish there was a coupon somewhere out there..."half off, next year only!" lol.

Permalink Reply by mama snail on June 5, 2010 at 9:05am

I did have my first birth at home, but I was assisted by two LMs. I see no reason why a healthy first-time mom needs to allow fear to determine her decision of whether or not to have an out-of-hospital birth. I wonder have you truly added up the costs involved with insurance-approved prenatal care and hospital birth? I ask because I known several friends with very good insurance that still ended up paying more for their pre-approved care, than they would have if they had chosen to pay-of-pocket for a midwife that wasn't in network. Once they added up the costs of all of the co-pays for visits, deductibles for hospital services, testing, and postpartum follow up. Their cost for approved care was twice what a midwife would charge for the entire duration of pregnancy, childbirth, newborn assessments, and postpartum visits. These were first-time births without complications.

As a first-time mom I didn't want to have a battle during labor to avoid unnecessary interventions, or be cared for by strangers. I wonder if you speak with local midwives that can help you contact student or retired midwives that are advanced in their studies and training, who would provide you with "doula" services in your home. What I mean is that your birth would still count as an free-birth on paper (no attending provider to sign the birth certificate), but you would be in the company of an experienced woman that can help you through labor, intermittently monitor your baby, and be on the look out for complications that require transfer to hospital in case of an emergency. I wouldn't want to judge your decision either way, but there are steps you can take to have the waterbirth you long for, as well as, improve the safety of your situation. Wishing you the best.

Permalink Reply by Krista Jobe on June 5, 2010 at 9:37am

As a first-time mom I didn't want to have a battle during labor to avoid unnecessary interventions, or be cared for by strangers.

See, that's what I'm afraid of, battling the "strangers" to not have interventions. I know myself well enough to know that I will just give in to whatever they suggest if they keep at it long enough. I'm strong willed, but not strong-spoken. I know I will end up very unhappy with how the whole process plays out. I know that a doctor/nurse will suggest pitocin for example, and all my family (that does not support my ideals) will jump on the band wagon, and I'll have all these people pressuring me into something...ugh. I can just see it all. But I don't want to keep them from being there with me. There are just so many reasons I don't want a hospital birth...too many to list (or even remember all the time).

I really appreciate your ideas about adding up the true cost with my insurance...I didn't really think of that. You automatically assume it's cheaper, but who knows. I'll look into that, and perhaps that will help me decide what to do. :)

I also looked into doulas and wrote an email to one near me. I'm not clear on exactly what they do...all I kept reading was that they don't give medical attention and don't give medical advice, so I didn't really feel like there'd be much point in having one (paying for one).

I do have a friend who had EMT training (but no experience). She's an older lady and has has kids herself, but has not birthed anyone else's kids. She also has a daughter-in-law who is a nurse, and has had training in delivering babies as well. I talked to my friend about her and her daughter perhaps assisting me...She wasn't big on the idea of being responsible, having no experience... :)

Permalink Reply by Krista Jobe on June 5, 2010 at 9:50am

Have to say, I love your screen name! I love snails, so I love your picture! :)

Permalink Reply by mama snail on June 5, 2010 at 10:35am

I realize the the cost of childbirth varies greatly from one region of our country to the other. I wasn't assuming, only stating that in my specific area, the cost of a hospital birth with insurance runs an average family about $4-6 thousand after insurance has paid their part. It's the nickle and dime fees of OB co-pays, $1500+ hospitalization deductible, prenatal tests not covered by all insurance, then the additional expenses of unexpected procedures that weren't pre-approved. However, the homebirth midwives in South Carolina charge between $2200-$3000 and allow clients to arrange reasonable payment plans. This covers so much more than just attending to your needs during childbirth.

I should also clarify my "doula" suggestion. In no way was I suggesting that you should hire a doula without any clinical skills to attend your birth. Doulas can be wonderful advocates at hospital births when couples need help speaking up, she can remind you which questions to ask, different comfort measures, and when to ask for more time to consider specific decisions. But, I would be highly suspicious of any actual doula who would attend an UC to cover clinical duties. Some would say that it's unethical on her part. However, in my area it's common for LMs to attend hospital VBACs acting as doulas. (not the other way around) A retired midwife or student midwife might be a cost-effective alternative. She could possibly offer guidance (like a doula) but have a knowledge base to recognize if things veer from a normal pattern.

As far as, family and joining the band wagon, you have say in this as well. I've had two homebirths supported by my very special LMs and loving husband--no one else. We made phone calls after everyone was rested. My family did NOT support my decisions, so I chose not to surround myself with anyone who didn't have faith in the normal process of birth or my body's ability to function well.

Thanks...my girls call me Mama Snail when they are trying to be cute. My family dubbed me "Super Snail" as a child because I was never in a hurry to do things others requested. Although, I eventually got around to doing what I thought was important. =)

Permalink Reply by Cherylyn on June 5, 2010 at 4:24pm

I agree with the advice that's been given. I wouldn't recommend UC for a first-time mom because it's such unknown territory.

Have you considered having a home birth with a midwife for the first baby and then going unassisted with the other 3? You may also consider offering a trade to the midwife. Our midwife allowed us to do a trade for the majority of the cost. My husband is a massage therapist, and we traded massages for her services. You could also offer trading goods as well as services. It never hurts to ask.

Permalink Reply by Emily Howell on June 6, 2010 at 11:04am

I think it comes down to how much your birth experience means to you. When you add the 4 potential births together, the price tag of 16k does sound like a big amount. But, you might want to just think of it as 4k for now. Is it worth 4k to have a midwife-assisted home waterbirth with THIS pregnancy?

I know you're planning on having 4 kids so you're totaling up the cost, but I think you should look at your first pregnancy as a separate cost. Who knows, maybe after your first successful midwife-assisted home birth, you'll feel confident enough to birth unassisted for the next three. The cost of this first birth then could be almost like an investment for the future.

Or, isn't it possible that by the time you're ready to have your next child, you or your husband will have a different job and/or insurance and be making more money or have insurance that would cover a home birth? I think you have to take each pregnancy as a separate case, and evaluate it when you're there.

Personally, I think it would be worth it to fork over the 4k for your first pregnancy/birth. For home births, the transfer/complication rate is highest for first-time mothers. If you birth unassisted, you'll be facing these same statistics but without the guidance and medical expertise of a midwife.

I had to make the decision to pay out of pocket for my midwife, and it was completely worth it in my mind.

Permalink Reply by Krista Jobe on June 6, 2010 at 1:35pm

You've all given me a lot to think about, and I appreciate it. :)

My husband and I did figure the cost with our insurance...it will actually only be $400, assuming 40 office visits...($10 copay per visit, once a week?). This was just some rough estimation, of course, but our insurance covers about everything BUT water birth. :P Kaiser is pretty all-inclusive. The birth, hospitalization, etc. won't cost us a dime, which is why it's so hard to justify spending anything over even $1000 on a midwife. I called one that's near me (and there's not much near me) and she charges $4000...and didn't seem real willing to make any compromises.

While it's true that things may change with time (financially, or what our insurance covers) all I have to go on is what I know now. But it's not a bad thought to say I could have a midwife this time around, but not for subsequent births once I know what I'm doing. :) What I do know is our debt level won't be changing for ten years, until student loans are paid. My husband is supposed to get a raise, yearly (he's a teacher), so that will help, but at the same time, the more mouths to feed, the more financial output. :P

My greatest hope is that more Kaisers will offer water birth and have an attitude adjustment toward natural methods.

I know of only one Kaiser that does water birth, and it's in Oregon. I've toyed with the idea of renting a place for my last month or so of pregnancy so that I could birth there, but it would end up costing probably more than a midwife, and my husband would not be able to go. So I have certainly been thinking creatively to say the least. ;)

I guess I should keep researching midwives in my area and not let the expensive ones discourage me.

Permalink Reply by Q O'B on June 28, 2010 at 6:51am

If you're thinking about unassisted birth I'd recommend checking out Dr. Rixa Freeze's blog: she wrote her doctoral thesis on unassisted birth in the US and had her first child unassisted at home - however she was also a midwife assistant and qualified in neonatal resuscitation.
http://rixarixa.blogspot.com/

Permalink Reply by Ashley on June 6, 2010 at 6:58pm

I think it's awesome that you've looked into so many options and are thinking so creatively. I have to agree with everyone else on here that it's better to have the help of an experienced midwife, because when in active labor it's hard to think clearly and rationally (at least it was for me anyway!). And I've only had one birth so I can't comment about subsequent births. For me, I was fortunate that insurance covered a water birth (at a free standing birth center), but now having had the experience I would have gladly found a way to pay the $4600 it cost. The whole birth experience has meant so much to me, and I think it shapes who you are as a mother, if that makes any sense :)

Permalink Reply by WeBloom on June 27, 2010 at 2:16pm

I think only you can decide what feels right to you--especially when considering a UC.

My only advice would be to slow down on the I can't afford it b/c we want to have 4 kids. Life changes plans and we never know what happens next. Try it take it one birth at a time instead of planning for this birth with the next ones in mind. Who knows--your insurance might change in the future, or you might want a UC or you might decide to have fewer children, or you might fall into more money. You just never know. All you know is that you are pregnant now and you are navigating the best situation for this birth. The right situation for you will unfold and you are already heading towards it. One step at a time!

Good luck mama!

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