The Cost of My Free Birth

You may remember that I had lamented about the lack of obstetric options available to me here on the Colorado prairie. I’m due with my sixth baby this May.  My former midwife retired. There is no hospital or birth center within 85 miles of my house.  There is no place to get prenatal care here either, unless I saw a certain doctor (or his partner) who had previously defamed my character.  The birth centers in the Denver area won’t take me because I’ve had too many babies.  Most homebirth-midwives won’t come out here, as they are concentrated on the Front Range.  The local Nurse Practitioner won’t take me because I’m over the age of 32.

Out of desperation, I decided to go with the hospital-midwifery practice at University of Colorado Hospital in Aurora.  It’s 101 miles away and they take my insurance.  I thought hospital-midwives would be a good compromise.

I have changed my mind.  I am having my baby at home with a homebirth-midwife.  I’m going to explain why…

One day in November I had a prenatal appointment.  I scheduled it for my husband’s day off.  It was at the main campus of the University of Colorado Hospital.  We were running late.  Yes, I hate to run late and I have no one to blame but my own disorganization, but it’s not an easy feat to get five children out the door and on the road for a road trip.  (When I lived in South Jersey, going 100 miles [in different directions] would get me to New York, Connecticut, Pennsylvania, Delaware, or Maryland. Those were whole different states and they involve bridges or tunnels. 100 miles here just about gets me to a doctor. It’s just different.) Because I was running late, I called them on my way there. After being on hold for about 30 minutes, I finally got someone. That someone was an appointment-maker at the UCH call center.  I explained the situation.
“I can put a note in your chart,” the appointment-maker replied.
“Can you let them know?” I asked.
“I have no way to contact them,” the appointment-maker explained.
After this merry-go-round, I realized the conversation wasn’t going anywhere. When we

UCH midwives

The museum had a free day that day, so at least it wasn’t a total wasted trip.

finally arrived at UCH campus, I ran in while Kevin found parking and brought the kids up.  I practically ran all the way through the hospital to the tippy end of the hallway where the UCH midwives were. Then I waited in line for ten minutes to speak to a secretary-receptionist-lady.
“You’re thirty minutes late,” the secretary-receptionist-lady said. I’ve spent ten minutes of those thirty here in your line ma’am.  “They can’t take you.”  I explained how I lived over 100 miles away, how I tried to call, etc. I had to reschedule.
“How can I call you better in the future?  Is there a way to call directly?”  I asked. No there was not.  There was a phone on her desk, just two feet away from us both.  I just walked away.  Ran away crying actually.  Blame it on pregnancy emotions or something, but how can I trust these people to bring my precious baby’s new life into this world when I can’t even call them?  At that point I came to the realization that I. just. can’t. do. it. I can’t do the hospital.

The next day I sent an email to the UCH midwives through their secure online system. It was something like, “Please call me.  Here’s my number. It’s not an emergency, but I need to talk.”
A hospital-midwife called me.  I explained the situation.
“Well maybe we’re not a good fit for each other,” the midwife said. “Maybe you should try a closer provider.”
A closer provider?!  I wish I could try a closer provider.  It never fails to amaze me how Denver-area-people know that the Denver suburbs don’t really go east of Aurora, know the Kansas border is a good 180 miles from Aurora and yet not realize that there is a whole lot of prairie in Colorado.  People live on this prairie.  People have babies. Those babies have to be born somewhere.  Yes, she was right.  We’re not a good fit.  I cannot do the hospital.  I cannot handle not being able to contact them to tell them I’m late, to tell them whatever.  There are times where I need to talk when I’m not in labor.

I swallowed a lot of pride and rescheduled a prenatal appointment for their satellite location over by Park Meadows Mall.  At least that campus isn’t a zoo, although it is another 20 miles further away.  I still needed prenatal care for my baby.  I was determined to find a homebirth-midwife, but I needed to be taken care of meanwhile. Kevin and I figured a way we could financially finagle the homebirth-midwife. I posted to my area’s swap group. Someone there put me in touch with someone who’s not on facebook (who is actually an acquaintance of mine) who has had her babies at home. The aquaintance actually lives about 25 miles from my house, but she’s still “out here” on the prairie.  I called her midwife, who was used to going out here.  I met her, TheHomebirthMidwife, talked it over with my husband and we made the change.

Homebirths are so much more relaxing.  Here I am in my own bed,minutes after Baby2 was born.

Homebirths are so much more relaxing. Here I am in my own bed, minutes after Baby2 was born.

I also sat down and figured out the cost of my free birth. My chief reason for choosing the UCH midwives was that I could have my baby there for free.  Although a hospital, they had birth tubs and I could have a water birth.  At a hospital, I would want a doula.  I was speaking to a potential doula and she told me that they charged for the birth tub.  I checked this with the UCH midwives, and yes, they charged $275 to rent the birth pool.  This $275 is not covered by insurance.  (A scheduled-unnecessary-Brittany-Spears-style-caesarian is covered, but no water. This makes no sense.)  And then if I hired a doula, I’d be out another $700-ish for her services.  Doulas are also not covered my insurance.  My “free” birth would cost me about $1000.

Although we have a $3000 deductible on our health insurance, we also have an out-of-pocket maximum of only $4000.  We “make” our out-of-pocket maximum no problem, every plan year.  I was semi-recently chatting with someone who was in disbelief over this.  As I explained to that person, we have more medical expenses than most and all seven of us are on the same insurance policy.  We all share that deductible and out-of-pocket number.  Vince is in speech therapy, which insurance pays for.  Vince has MRIs and followups from his brain tumor.  Another child of mine has a bone deformity in his leg.  This requires an annual brace and semi-annual followups and x-rays.  My baby, at the beginning of the plan year, required some followups from his hospital stay last March when he nearly dehydrated to death from the stomach bug.  (They think he outgrew whatever caused him to go down so quickly.  He’s doing great now.)  We make the out-of-pocket maximum in just a few months from all that, forget about actual illnesses and my prenatal care. Because our plan year is from July through June, the baby is due in May and we “made” our out-of-pocket maximum in December, all of our covered health services are free until the end of June, including having this baby.  Because I do not live within thirty miles of an in-network obstetric care provider (or any at all), my health insurance covers my homebirth.  (It’s called a gap exemption.) Yes, I’d have to lay the cost out (because of the way homebirth midwives bill), but I would get it all back.  They would reimburse at 100%, since I’ve made my out-of-pocket maximum.

My biggest fear was having my baby on the side of I-70 in Agate.  Agate is a ghost town off I-70, about 20 minutes west of Limon.  They have a post office and the remnants of a school and that’s it.  (There are less than 20 students in the whole school.)  It is a depressing 85% abandoned falling apart little town that’s way past its prime.  Agate makes Hugo look like a thriving metropolis.  There is nothing there.  Even cell phone service is spotty, and I’ve tried GSMs and CDMAs. Having a baby in the car in Agate would be the absolute worse place to have a baby, as if having a baby in the car isn’t bad enough.  With my luck (or perhaps my pride and God would humble me) I just know I’d have the baby in the car in Agate. It’s my worst fear. Having a baby is Agate is a risk I’d take if planning a birth with the UCH midwives or at any other place in the Denver metro area.

I’ll take the comfort of my own home over having a baby on the side of the road in Agate. I’ll take the comfort of my own home over a thousand dollar “free” birth. I’m having this baby at home and I’m excited about it and I’m not dreading it, like I was before.

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