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.

Posted in Lincoln County: A Case Study of the Sad State of Healthcare in Rural America by with no comments yet.

Marathon Day

I call my outrageously long trips to the Front Range areas Marathon Days.  I absolutely hate Marathon Days, but for me they’re a necessity.

I don’t live near real stores.  The local town has a wonderful (not very super) supermarket.  For what they are (a small supermarket is a small town), they’re great, but they don’t always have everything.  What they do have is expensive.  Their selections of fresh produce and organics is limited.  For my size family, it pays to make the trip to the wholesale club for just groceries.  The same goes for the hardware store. And that’s not counting other items that plain just aren’t available here.  For example, since ALCO is closing, there is now no where within maybe 70 miles of my house to buy a pair of jeans.  I do a lot of shopping online.  Amazon Prime is a necessity for living out here.  However, there are just some items that need to be touched or seen in person and these items also mean a trip to a real store.

I don’t live near real doctors.
I have already written about the lack of obstetric options here in rural Colorado.
We also have some unique medical needs in our family.
My kids have speech problems.  The local speech help is almost non-existent. Years ago for one of the older ones, we tried the Early Intervention help.  The lady showed up only half the time.  Speech problems need consistency.
One of my children has a rare bone deformity.  One time I brought him to the orthopedic doctor that comes down from Colorado Springs monthly.  It was for a second opinion.  “I’ve never seen this in person before,” he told me.  “There’s not much in the literature about this either,” he said. Um, duh, I knew that. “I can’t help you.” Well at least he was honest.
My son Vince had a brain tumor resected last year.  He needed a pediatric neurosurgeon. There are a few in the Denver area on the same team.  Before surgery when we wanted a second opinion, we had to take him 500 miles to Kansas City. Needless to say, there ain’t no pediatric neurosurgeons or pediatric neuro-oncologists in Lincoln County.
Even the local ER isn’t a real ER. When my baby was sick last year with dehydration from the stomach bug and I brought him to the ER for an IV, they could not get his vein. Meanwhile two more hours went by where the baby got sicker. I finally walked out of the local ER and drove straight to Children’s Hospital where they got the IV the first time, admitted him to the PICU and kept him in the hospital for six days. In retrospect I believe if we had stayed he might not have made it.
There is a doctor’s office about a half hour away. They never have the same doctors twice. They are in and out of there like Grand Central Station. They’ve had a few good ones now and then, but they leave. There was one here for maybe two years that was an awesome doctor and awesome with the kids and now she’s moved to another state. Now they literally rent out doctors.  It’s like a temp agency for doctors that they hire their doctors through.  Talk about inconsistent care.
Traveling to the Front Range to see real doctors is a necessity for us.

Now that you know about the necessity of Marathon Days for us, I would like to walk you through a Marathon Day with us.  Yesterday, we had a Marathon Day.  I will share yesterday’s agenda with you as an example.

7:25 a.m.- The bus picked up Vince and took him to school.  I didn’t want the day to be a total loss or Vince to miss his class St. Valentine’s Day party.
The other children and I did our normal morning routines.  We did our morning chores. We did about half our schoolday.  They all took baths and changed into “town” clothes.
11:00 a.m.- We picked Vince up at school.  I chatted with the teacher to touch base on how he was doing.
11:15 a.m.- We left the local town and headed to suburban Denver.
1:00 p.m.- We arrived at Costco.  The children and I sat down at the Costco Cafe and ate lunch there.  We grocery shopped. We changed diapers.
2:05 p.m.- We arrive at the satellite campus of Children’s Hospital (five minutes late) for Vince’s speech therapy.  Vince normally receives his speech therapy on the computer like Skype, however, at the stage he is in, he gets more out of speech in person. Speech in person seems to hold his attention better.  I would say an in-person speech visit is worth three telespeech sessions.  This is just for the stage we’re in.  I think there is an equal benefit at other stages.
2:15 p.m.- The other four children and I leave.  We all went potty.
2:25 p.m.- We arrive at Sprouts.  The older two children and I had previously discussed an action plan on who was to grab what item so that we could be in and out. We just needed a few fresh things to get us through.

Running into Lowe's...

Running into Lowe’s…

2:38 p.m.- We arrived at Lowe’s.  It was maybe a quarter mile from Sprouts, just far away enough to make it quicker to take the car and necessitate being in and out of car seats.  We had previously discussed action plans on quick buckling ins and buckling outs.  We had an item to exchange there and one to return.  It was difficulty to find a new item for the exchange item. This delayed us, as well as painstakingly checking the replacement to make sure it did not have the same defect as the original.
3:05 p.m.- We arrived back at the satellite campus of Children’s Hospital. We were late. The speech therapist was just finishing up with Vince and we actually observed a few minutes.  She then reviewed his progress with me in person.  We all went potty.

Filomena took a picture of a lady in the waiting room and Vince played with the touch board in the background.

GirlOne took a picture of a lady in the Children’s Hospital waiting room and Vince played with the touch board in the background.

3:40 p.m.- We left the Children’s Hospital parking lot.  I really wanted to stop at IKEA but I resisted the temptation since I had just about enough time to get to the midwife on time. We headed south on I-25 and left suburban Denver for Colorado Springs.
4:34 p.m.- We arrived at the midwife (four minutes late).  I had a prenatal check.  Everyone went potty and we changed diapers. The midwife has tons of toys and they got an hour of playtime.
5:52 p.m.- We were back in the minivan, all buckled in and ready to leave. I looked at the time and realized that in spite of my best intentions, we wouldn’t make Mass.  Mass was in 8 minutes on the total opposite end of Colorado Springs. It was rush hour, too, and weekday Masses are quick. I reluctantly headed to Costco to get gas.
6:30-ish- After filling up, we stopped at Culvers and bought a chocolate milkshake.  I distributed it into separate cups so everyone could get a little bit.  This was their treat because they were so so good and cooperative for me.  I stayed in the Culver’s parking lot for a few minutes to make sandwiches.  We headed out of Colorado Springs towards home, eating our sandwich dinner on the way.
8:10 p.m.- We arrived home.  We unloaded a few things from the car.  I readied everyone for bed and didn’t get everyone in bed until nearly nine.

260 miles. We were only gone 9 hours and 15 minutes.  Usually our Marathon Days are closer to twelve hours.

Before I moved out here, I never understood the actual reality of not living near real stores or real doctors.  I never understood what nearly a two hour ride each way to a metropolitan area really meant, or what it meant with little children.  I didn’t anticipate that my children would have such unique medical needs.  I didn’t understand how limited access to quality healthcare could really be when I still live in the United States of America and not among an aboriginal tribe.  I never imagined that I could live in a farming community, yet still live in a food dessert.  I never knew what it meant to be 100 miles from everything and the circumstances that would make Marathon Days a way of life on the prairie.

Marathon Days are a way of life for us.  I’ve become more efficient at Marathon Days over the years. I am hoping that if you are perhaps considering buying a little patch of heaven way out west left of Nebraska and over a crest that you will take the reality of Marathon Days into account when planning your move.  I didn’t and I’ll add Marathon Days to the “What I Wish I Had Known” Category.

Posted in Also Known As Logistics and Management in a Large Family, Knowing What to Do to Feel a Little Bit Less Like the Woman in the Shoe, Lincoln County: A Case Study of the Sad State of Healthcare in Rural America, The Irony of a Food Desert Surrounded by Farms, What I Wish I'd Know Before Moving to My Little Patch of Heaven Way Out West by with 2 comments.

Obstetric Options in Rural Colorado

If you haven’t already heard the great news, I am having another baby in May.  Yes, Baby6. It shouldn’t be a shock.  We’re Catholic and married and healthy and of child-bearing age.

Finding out that I am having a baby should be very joyful.  Kevin and I are delighted. However, there are two things that have put a damper on our happiness.

First, this is our sixth baby.  While I look at it as God pouring His abundant blessings upon our family, some loved ones don’t seem to have the same opinion.  This hurts.  From the no congratulations at all, to the half hearted congratulations, to the “I hope this  is your last one”, to the “I feel so bad for your other children, they are still babies”, it seems a lot of people have something to say and it isn’t always nice.  This gets to me.  I knew there would be naysayers and that’s why I have been avoiding telling people.  I normally like to tell people as soon as I get that plus sign, but this time I knew that there would be more naysayers and I did not feel like dealing with it.  I have been suffering through the first trimester nausea and tiredness in silence.  I am a very outgoing sharing person and for me to not be able to tell you about my sorrow of sickness and my joy of expecting is quite torturesome.  I have kept it under wraps because of the naysayers.  Although well-meaning, the naysayers are hurtful.  Also, if it is a my-choice-my-body culture, why is having a sixth baby suddenly fall out of the my-choice-my-body realm?

The second thing that has been putting a damper on the joy of expecting is that I wonder where I am going to have this baby.  I will spend the rest of this blogpost talking about obstetric options in Rural Eastern Colorado.  Obamacare was supposed to increase access to healthcare.  You forgot about the Colorado Prairie, President Obama.  I guess I shouldn’t be surprised.  The Front Range and Mountains forget about us, too, so why would the president remember?

My first baby, SonOne, was born at St. Francis Medical Center on the eastern edge of Colorado Springs after a failed home birth.  I remember we found a midwife quite easily.  We spoke to a few and were drawn to two.  We interviewed them both.  It was no-brainer on who to pick.  TheMidwife, as I’ll refer to her here, had had umpteen children of her own, was married for over thirty years, was a Christian who seemed to share our values, etc.  We clicked with her personality-wise, too.  TheMidwife lived in Colorado Springs, but we combined grocery shopping with prenatal appointments.   Although my first home birth failed, I delivered my other four babies at home with TheMidwife.  Those labors all went relatively smoothly and we bonded more with TheMidwife and grew to love her more and more each time.  Shortly after I had Baby5 (Son3) TheMidwife retired.  This means I need to find another obstetric care provider for this baby.  That should be simple.  Let me tell you that here on the prairie, there are few and far between obstetric options.

My first option would be to find another midwife.  Of course I realize that no one would be TheMidwife, but finding another midwife should be easy, right?  Well, wrong!  Actually, it seems that like malls, Wal-marts, and real stores, midwives in Colorado are all concentrated in the Front Range area and a few are scattered in the mountains.  For midwives, real stores and even the state legislature, the Colorado Prairie just does not exist.  “Oh, I’ve been out there,” one said.  “I delivered a baby in Peyton once.” Peyton is right outside of Colorado Springs.  I live maybe 70 miles further east of Peyton.  “Do you live close to Kansas?” While I realize the 37th Parallel is pretty unimpressive, I still live way closer to you than I do Kansas. “Really?” Yes, really.  After calling about every midwife in Colorado Springs and Denver, I actually found four who would be willing to come out here.  That was great.  They all seemed like nice ladies.  No one was TheMidwife.  The problem?  They were all super expensive, about double what TheMidwife charged me.  TheMidwife, because she had known us for so long was pretty flexible on her payment terms, too.  Starting over, I realize I would have to again build a rapport with a new midwife.  I am off the street, or in this case off the prairie. They bill insurance, but after payment and after the birth.  United Healthcare, my insurance company, has a tendency to spazz out.  I don’t blame midwives for not trusting them and wanting their money ahead of time.  I don’t trust United Healthcare either.  I cannot trust them to reimburse.  I just can’t afford the price of a new midwife.  As I said, those four rare midwives who are willing to come out here are DOUBLE the price of TheMidwife.  That’s a lot of cash, cash I don’t have.

My second option would be to see Dr.Denver or his partner Dr.DenverPartner.  They are OBGYNs who practice in downtown Denver.  Once a month each, they come down to the Lincoln Community Hospital in Hugo.  I could schedule my prenatals in Hugo, just ten minutes away.  Labor would be in their affiliated hospital in downtown Denver.  The thought of rush hour traffic in labor after a two hour journey scares me.  I already rode in a car in labor when I had to transport to the hospital for SonOne.  It was torture.  I do not look forward to repeating that experience.   Denver rush hour traffic on top of that? Nope.  That is an experience that I can live without.
Dr.Denver and Dr.DenverPartner are the only two obstetric doctors who come to Lincoln County.  They are both part of the same practice.  I saw Dr.Denver once when I was expecting my second baby, DaughterOne.  I saw him during one of his monthly visits to the Lincoln Community Hospital.  He did my initial bloodwork and first prenatal visit.  Shortly after that visit, I changed my health insurance and Dr.Denver was no longer on the network.  I opted for a different OBGYN who was in Colorado Springs and on the network.  (I was kind of scared during that pregnancy because I had had such a bad experience with SonOne’s delivery.  I doubled up my prenatal care with TheMidwife and an OBGYN. )  I never saw Dr.Denver again. I received a bill from the Lincoln Community Hospital for the copay, which I paid.  A few years later, I happened to check my credit report. There was a negative item on the credit report which up until that point I had been unaware of.  After further investigating, I realized that that negative item was an unpaid co-pay from Dr.Denver’s office.  I had never been to the actual office and was unaware to even expect a bill from that particular doctor practice. TheDoctorOffice had misread my address and I had never received my bill.  The bill was returned to them.  Instead of calling the Lincoln Community Hospital or my phone number which was also on the same paperwork, TheDoctorOffice had simply sent me off to collections. The collection agency had made no attempt to get in touch with me.  Checking my credit report was the first time I had even suspected that the copay paid to the Lincoln Community Hospital was not the sole copay.  Upon doing a lot of investigating and finally learning of the due bill, I immediately paid TheDoctorOffice their $42.  I spoke to Dr.Denver himself who assured me that the information would be removed from my credit report and that the problem was taken care of. I took him at his word.  Over another year after that, I checked my credit report again.  (I have since learned to check it more often.)  The outstanding amount was still showing as outstanding and as a negative unpaid item. What?! That same baby that I had seen him for the initial prenatal appointment that time was potty trained and this lie on my credit report was still there only because TheDoctorOffice staff cannot read an address properly and further cannot properly notate that they received a check.  In our modern society, your credit report is your reputation.  Your credit report impacts jobs, insurance rates and credit worthiness. Dr.Denver failing to correct his mistake is calumny.  I sent Dr.Denver an email (online to his practice) and left him a phone message.  When he called me back he told me that people don’t expect to pay for healthcare and “if you paid” and all this bologna.  No, I had paid 18 months before that and had a printout from my bank’s online bill pay to prove it, which should have been in front of him since I had sent that in the email.  He called me back in a few days and said he investigated, found I had paid (duh) and would reverse his calumny.  No apology.  I did write to the Lincoln Community Hospital CEO to make him aware of the situation.  He was very sympathetic and apologetic, however, it really wasn’t directly under his supervision since Dr.Denver is kind of like an outside contractor with his hospital.  May the CEO’s soul rest in peace.  If I cannot even trust Dr.Denver’s office staff to read my address correctly or even slightly investigate returned mail, how can I trust them to read my chart correctly?  If Dr.Denver cannot be trusted not to falsely defame my character for a total of three years, how am I supposed to trust him to bring my precious new baby’s life into this world? The truth is I don’t trust Dr.Denver and by extension Dr.DenverPartner. They are on my insurance network now.  Even if I had no fear of riding in the car for two hours in labor and then through downtown Denver traffic, Dr.Denver and Dr.Partner are not an option for me.

My third option is to see the nurse practitioner in Limon through the second trimester and transfer to a different obstetric provider later in my pregnancy.  This was my plan, at least temporarily.  I would see TheNursePractitioner and at least get prenatal care until I decided what I was going to do.  I called up the doctor’s office in Limon.
“Hi, this is Laura. I need to make a prenatal appointment with TheNursePractioner.”
“What’s your date of birth?” the secretary-appointment-maker-lady asked.
I told her.
“The first prenatal appointment I have available is…”
I made the appointment.  It was 2.5 weeks from then.  I was getting dangerously close to the point in my pregnancy where I should have already seen a provider.  She assured me that that was the first available.
The day before the appointment they called me to confirm the appointment. “Yes, I will see TheNursePractitioner tomorrow at 11 am.”  I told them.
A few hours later I got another call.  “Laura, you cannot see TheNursePractitioner tomorrow. She only sees low-risk patients, patients up to 32.”
“32?” You remember you asked me my date of birth when I called to make the appointment, right?
I asked if TheNursePractitioner would at least see me to do bloodwork.  Nope.
“TheNursePractitioner is not an OBGYN and you are high risk.”
What? After five babies, I think I got this baby thing down.
Yeah, so apparently since I am at the ripe ol’age of 36, seeing TheNursePractitioner for some prenatal care is not an option for me, either.

Lincoln County is bigger than the state of Delaware.  There is nowhere to have a baby here other than your own home with those rare four midwives who were willing to come out here. The OBGYN that comes here occasionally and delivers in Denver is a liar. TheNursePractitioner that sees mothers for prenatal care won’t see me because I am over 32.

Then I thought, Maybe a birth center wouldn’t be so bad.  A friend of mine had two of her babies in birth centers back east.  Birth Centers are kind of between home and a hospital. They are staffed with midwives.  Sure the closest one is in the Denver area, but maybe if I left early enough, it wouldn’t be so bad.  I could have a water birth.  It’s not like it’s a hospital. Plus, they take my insurance and I wouldn’t have to lay the cost out.  A birth center might be a nice compromise.  Well, wrong, Laura.  Apparently I am a grand multip. I had never heard that word before.  A grand multip is someone who has had five or more babies.  Since this is Baby6, and the Birth Center does not accept grand multips, the Birth Center is not an option for me either.  Just for giggles, I called the Birth Center in Boulder, too, and they also do not accept grand multips.

Sure I could show up in labor at the Lincoln Community Hospital.  My husband was born there back when they delivered babies and he turned out OK.  I could also drive 80 miles or so to Burlington Colorado or 100 miles to Goodland Kansas and deliver at their dinky hospitals, but they are just dippy hospitals in dippy little towns.   If I’m going to drive that far to a hospital, I may as well go to a real hospital.

So that leaves me my last option.  I could deliver at a real hospital at the edge of Denver or Colorado Springs.  I would have to get my prenatal care up there, but that’s not a whole lot different than traveling to a Front Range city to a midwife for prenatal care.  I just dread the thought of traveling in labor.  With a hospital birth, I wouldn’t have to lay anything out. Insurance would cover it all at 100%.  We will have made our out-of-pocket maximum for our plan year (which we always do) and I can have my baby for free.  I can go with a hospital-type midwife, who in the state of Colorado have different schooling and different licensing than home birth-type midwives. They would have to have a less interventionist policy than an OBGYN.  If I go to the hospital-type midwives at the University of Colorado Hospital, I could even still have a water birth.  I still dread the two hour drive in labor, but at least University of Colorado Hospital is on the eastern edge of the Denver area.   This is what I am leaning towards right now.  I have seen a hospital-type midwife there for my first prenatal appointment. The nurse drew blood.  I had an ultrasound.  Everything is looking great.  At least I am receiving prenatal care now.

So, yes, I am expecting Baby6.  Thank you.  I don’t want to hear anything but your well wishes. If you have something that’s not nice to say, just don’t say it.
Every baby is a miracle.  Every baby is a creation of God in His very own Image and Likeness. Every baby has an immortal soul. God has entrusted Kevin and me with another beautiful little one to teach to know Him, to love Him and serve Him in this life so he can be happy with Him forever in the next life.  That is it right there.

I am overjoyed at expecting this new little one, but I’d be lying if I told you I wasn’t feeling shadows in my joy, the shadows of the naysayers and the shadows of the lack of obstetric options.

Update: I switched my birth plan to a homebirth midwife and had the baby at home.

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