Out of curiousity (as I know you are completely keen on birthing at
home)... are there midwifery clinics in america? Where you birth at the
clinic, but they have access to 'the gear, and the doctors' if something
happens that's unforeseen? But other then that, they don't intervene
other then with natural therapies (oils, lighting, massage etc)
And when you are talking about being hooked up to a monitor... do you
mean the fetal monitor that straps around your belly to monitor for
fetal distress and contractions? Cos I really quite like being on
those... lol... but then I don't get stuck to them for ages, it's jsut
for a short time.
And what sort of rights do you have as a patient to refuse interventions?
Do you have to pay for the private midwife service? and what are their
insurances like? (I only ask because I'm trying to suss out australian
home birthing now), and are there policies and guidelines that are
policed? Because I think that's the main reason why there is a problem
with getting insurance for homebirthing midwives in australia.
Most pregnant women here will see an OB/Gyn for their prenatal care and that doctor, or a member of the practice who is on-call, will deliver the baby at the hospital they have priveleges to deliver at. So, you have to be both ok with the philosophy of the doctors in your group and also ok with the policies of the hospital they deliver.
Or, you can have a midwife care for you through your prenatal period and be delivered by that person at the hospital they deliver.
Or, you can have a midwife attend to your birth at a free standing birthing center which is either associated with a hospital or close by one. We have 3 in my area but none accept VBAC patients.
Yes, I mean fetal monitoring and I believe they also monitor contractions. The downside of continual monitoring is that you can't leave the room, go outside, walk the halls, etc. You can push the monitor to the center of the room and get on the birthing ball and they are even submergable so you can use them in the labor tubs. Doc says they re working on getting wireless ones but that will probably not happen by the time I give birth. If you aren't a VBAC patient, you can do 20 minutes on and 40 minutes off but VBACers have to be on it the whole time. Also, guess what? Just found out this morning that my doctor has to be there the whole time - he has to meet me at the hospital and he can't leave until I give birth. No wonder they had less than 5 VBACs there all last year! (My doc just started over there a few months ago).
I suppose the patient can refuse most of the intervention unless it's an emergency situation - in which case you would probably have to sign a heap of paperwork, not sure. You don't need to have pitocin, or an epidural and you certainly don't need to agree to have your membranes swept or ruptured. Most people write out a birth plan and bring copies to distribute to the nursing staff and I assume, have a plan with their doctor or midwife.
We have private insurance here and the rules regarding what must be covered by law is governed by each state. In California, where I live, midwife care is to be covered the same as doctor care and homebirths should be covered by all insurance. They don't make it easy though. It's much more difficult to get reimbursed by your insurance company and in most if not all cases, the midwife charges up-front and has a part time billing person try to get the money back for the patient from the insurance company after the fact. I have a $2950 dedudtible through my insurance so no matter what, I am going to pay that in any given year before my insurance will pick up 70% of the allowed cost for any services that are covered. The midwife I hired the last time charged $4200 - broken up in payment plans - so, after the yearly deductible would be met, I would try to get 70% back of what ever was left. The hospital birth, if all goes well, should be around $2200.... last time, with the surgery and the NICU stay, it was around $9k out of pocket total. This is not to mention that my insurance premiums are $400+ a month for me and my son. DH has his own cheaper policy.
My personal fears have to do with timing and being restrained on the car ride over because as I recall, that ride was excrutiating and before I got in the car, I was doing pretty well. Had breakfast, took a shower, curled my hair. Got in the car and AHHHHHHH!!!!!! Got to the hospital and I was ok again, parked, went up the elevator. Than had to be monitored in a bed for 20 minutes before admittance and AHHHHHHHHH!!!! Worst thing ever was being in one place without being able to move. When we moved to labor and delivery, they immediately had me filling out paperwork - I had pre-registered so I don't know why there was another 1/2 hour's worth of paperwork - and they inserted an IV. So, along with the monitor cords, I also had a fluid line and was pretty much stuck on the bed.
Don't want to get to the hospital too early. Don't want to get there too late! Don't want to be stuck in traffic.
The rest, I can handle. My doc will make sure I don't have an unneccesary c-section because he doesn't believe in them. And he will be there the whole time.
I'm going to have a hospital birth. There I made up my mind.
Thanks for your post, CharlieCats. That was nice.