Love Your OB or Midwife? Hate Them? Let Everyone know!

I came across this survey and thought it was a great idea so I will share it with everyone. As you all know, I am all about being thrifty but part of being thrifty is choosing to spend your money wisely. I find it very frustrating that I can look up the ratings of a new TV but I can't look up the ratings of a doctor or midwife. When it comes to birth, whether you have health insurance or not, you will probably have to spend some money when everything is said and done. So why can't I get a quality review? Well now you can! The Birth Survey lets you look up the ratings for doctors and midwives that other women have rated. I think this is a really great idea but it takes some effort on your behalf so that more doctors and midwifes will be rated. The survey is anonymous and takes about 30 minutes depending on your answers. Did you have a wonderful experience with your doctor or midwife and want to encourage more woman to see them? Or maybe you had an awful experience and want everyone to stay away from that person. Either way let everyone know about it! We (women) as consumers of birth care deserve to know the quality of our caregivers.

High Risk Pregnancy with No Health Insurance

So you just found out that for whatever reason, you have a high risk pregnancy and you have no health insurance. The first thing you should do is look in to getting state insurance. Even if you have already tried, please read what I have to say because you may yet find out that you qualify for something or more then they gave you. I was very blessed with my pregnancy in that I had no complications that came up. I did however discover that the path to getting health insurance from your state is a lot more complicated then the workers that “help” you to get this insurance would make it seem. After the birth of my son (at home) I had post labor hemorrhaging. My midwife took care of it but I did have to go to the hospital to get a blood test done to see if I needed a blood transfusion. It turned out that I did not but what I did get was a nice bill from the hospital for $3300 for the room I stayed in for 2 hours (I should have gotten a lot better service for that price, can you say penthouse?) and a blood test. I also got a phone call from this wonderful lady that worked with the hospital that showed me how to qualify for state insurance to pay for my bill. I live in Washington State so I do not know the universality of my advice but I think that everyone should at least take a look at it.

1. After you have applied to get the state insurance and they deny you or give you a “spend down” pick up the phone and give who ever is in charge of your case a call. Ask them questions! If you were denied, ask by how much, ask if they do spend down amounts (it is like a deductible), ask if you can reapply if your income changes, ask anything that you can think of! I did not do this and paid the price. I was put on a spend down of $4500. This would be nothing for a typical hospital birth but it was a lot of money for me. If you have a high risk pregnancy you really need some insurance so ask. The workers may or may not just tell you these rules. I know the guy I worked with did not tell me anything I did not ask about.
2. Once you have the insurance, it can not be taken away. My husband works a job that pays him by the hour. Some months he gets a lot, some months he gets a little, it just depends. I did not understand that if I could do without a little one month and qualify, that it would not be taken away from me the next month if he made more money. All I would have had to do is have my husband work no overtime one month and reapply. We would have been in and I would not have had to pay for anything else. So if you don’t qualify by just a bit, consider cutting your work hours a little for one month, then reapply.
3. Even if you have just had the baby or are close to having the baby apply or reapply. Don’t wait. In my state you only have 60 days to apply. If you are able to get the insurance for the month of the birth, even if it is past that month, the state will cover all charges that month. It is not like commercial health insurance, it is retro active to the time the coupon is for. Most of the charges you have will have come from the birth itself.
4. Even if you get a spend down reapply if there is any change in your income. Getting your spend down lowered will save you month so it is worth the trouble.
5. If all else fails and you have a big bill on your table call the hospital. My hospital had a woman that was in charge of getting pregnant women and children insurance though the state. It is so great having someone like that (that knows the system) on your side. They are there to help so let them do their job.

I hope this helps someone. Hopefully someday, all of my advice will be obsolete because no one will be without health insurance of some kind but until then good luck! If anyone else has tips (maybe from other state systems) I would love it if you would share them.

Pregnant with no Health Insurance

I have to say, it is really scary being pregnant with no health insurance. I was at my first job out of college and was going to get health insurance after 90 days when I found out I was pregnant. We did try so it was not a shock but it was a shock to lose my job a month later. As most people know, you can not just go out and buy health insurance when you are pregnant. It is considered a pre-existing condition and therefore you have to wait nine months to have it covered. I don’t know about you, but being as I am human, my pregnancy did not last more then nine months. I went though my entire pregnancy without health insurance but in the end, it turned out that I could have gotten state insurance at some point. So I will go over my advice for having to go though everything with no insurance. In a few weeks I will go over how to get state insurance and how to deal with a high risk pregnancy with no health insurance.

1. Midwife, midwife, midwife – These wonderful women are a life saver for those with no health insurance If you are having a normal or even slightly abnormal pregnancy, you need to pick up the phone book, look though the internet, ask your friends, or call your local birth center and find yourself a midwife. My midwife cost me $3000 for everything. This includes all appointments, the birth and well baby check ups. The only thing it does not include is lab tests because the lab will charge their own fee for that. Depending on where you live, midwife care will run you from $2000-$5000. An OB costs much more then that and they nickel and dime you for everything. My friend got charged $10 for every stick she had to pee on to see if there was protein in her urine (which they do at every appointment). For me that was included in my midwife’s fee. You will also get much more personal care from a midwife. All of my appointments were an hour long and I never had to wait more then 5 minutes. Midwives are used to seeing patients with no health insurance so they will set up a payment plan and some give cash pay discounts if you pay by a certain date. They will normally go anywhere to help you give birth, hospitals, birth centers or your home. I should note that you want to see a midwife with her own practice, not a group of midwives or midwives under an OB.

2. Do I really need that? – You need to always be asking that question of yourself. You are going to have to do your research and find out what tests you are going to do, and what you are going to skip. Ask yourself questions like “Do I really need to get a blood test to tell me that I am pregnant?” Remember, you can refuse anything and you have to pay for every test out of your own pocket. Most of the tests midwives give are very cheap ($20-$70) and most midwives will respect your wishes to do only what is necessary. My midwife knew I had to pay for everything so we would discuss it first and then I would decide if I wanted it done. Most OBs on the other hand, do not know what anything costs and will run as many tests as they can. They do not know you have no insurance and will not remember if you tell them. To give an example, I refused the blood test they do for downs syndrome and the other two diseases, but did get the glucose test done.

3. Ultrasounds – It seems like I hear so many woman that get these done all the time. I am sorry to break it to you but unless you want to spend a lot of money, I would recommend you skip all but the 20 week ultrasound. At 20 weeks, a good tech will be able to tell if anything is wrong. Some women go without them all together and that is fine too. Your midwife will listen to the baby’s heart beat with a Doppler and will measure your belly to see how big the baby is. From what I have seen, these measurement are often more accurate then ultrasounds anyways. You don’t really need an ultrasound unless your provider thinks there is something wrong. I did pony up the $150 to see my son at 20 weeks. My husband had heart problems as a baby so we wanted to get a good look at my son’s heart to see if it was normal. It was and we found it was a boy which was great too.

4. Stay Healthy – I know that we all want our babies to be healthy but it really is important to take good care of yourself especially when you don’t have insurance. The healthier you are, the fewer tests you have to do and the less likely you will have to get special (really expensive) care for you and your child. So get out and get some exercise and try to keep the sweets to a normal amount. I know you feel like a whale but it is so worth it. My midwife said that she would start to see problems for some women that gained more then 50 lbs. I gained exactly 50 lbs and was fine.

5. Consider a home birth or birth center – I know that is seems crazy but if you are having a normal healthy pregnancy, you really should consider one of these options. You home is completely free and a birth center (if you are lucky enough to have one around) is much cheaper then going to the hospital. I had a wonderful home birth and even if I have insurance next time I have a child, I am going to plan on another one. It was so wonderful to not have to travel while I was in labor and to only have people I knew and was comfortable with coming in and out of my room. I got to labor any way I wanted to with no IV or monitors. I pushed my son out in my own time with no one rushing me or threatening me with a C-section, vacuum, or anything else. If you do your research, you will find that homebirths with a good midwife for normal women are just as safe if not safer then hospital births. After the birth of my son I started to hemorrhage, my wonderful midwife took complete care of me. She had IV’s, pitocin, and other things that stopped the bleeding and stabilized me. Midwives are prepared for the most common sorts of complications. Birth centers are great too. They are set up like hotel rooms to birth in. They do have some medial equipment if you need it but it is no in sight.

I got though my entire pregnancy paying about $3500 for everything. It came out to be $3000 for the midwife and about $500 for tests and my one ultrasound. I think that is pretty good considering that the average healthy birth (not including pregnancy care or well baby care) cost about $12000 in a hospital. I hope that this helps someone. Please feel free to ask questions if you have them. I did a lot of research when I was pregnant so I might be able to help.

No Health Insurance

First of all, having no health insurance sucks. My family has been in this situation many times. It seems like every time my husband gets hurt, we are between insurances. I even went though my whole pregnancy with no insurance of any kind. So it is safe to say that I have become well versed in dealing with this sad situation (that really no one should have to go though in a civilized country but I will not go in to that). I will present some ideas for dealing with this situation. Today’s entry will deal with general no insurance and the next entry will deal with having no insurance though a pregnancy.

1. When you get to the hospital, tell everyone you see that you have no insurance until you can speak to someone who can help you. Unless of course you are physically unable to do this, then have a loved one do it for you. Do not leave without speaking to someone that deals with people with no insurance. They are sort of like hospital social workers and their job is to help the hospital get paid. They know the fastest way to do this is not though you. These people will hook you up with the right forms and phone numbers to help you get financial aid (yes they have this for hospitals) to help you pay your bills. Depending on your income and how many other uninsured people the hospital treats that month, you can get your bill reduced or even eliminated all together.

2. If you are home from the hospital and are looking in shock at the huge bill they have sent you, pick up the phone and call the billing people. Tell them you have no insurance and they will connect you to the people you need to speak to.

3. If you have all ready been denied financial aid or your bill is not from a hospital, ask for the cash pay discount. All hospitals, doctors, and ambulances have a cash pay discount of anywhere from 10-40% if the bill is paid within 30 days. I found out that putting a big hospital bill on my credit card with 10% interest was worth getting 40% off my bill.

4. If you have lost or quit a job within 2 months that offered you COBRA after you left but you did not take it because it cost too much, get out that paper work. We all know that for the most part, COBRA is joke because most people can not afford it. Well a little known fact is that if you get hurt within the first 2 months of the job loss, you can get coverage by paying the back months premiums. Whatever they would have covered when you had the job, they will cover now. When my husband got hurt and had to be in the hospital for three days ($12,000!) the hospital paid for the first months premium for us. Then we just had to pay the current month. For us, $360 was much cheaper then paying the whole bill. You can stop paying the premium whenever you are done getting the care you need. Then on top of all that, the hospital forgave the deductible we owed. I do not know if this is unique to my state of Washington or if it is everywhere.

5. Think positive. Pray if you are the praying type. I know people think that is silly but let me tell you it is worth a try. First of all, you are already in some kind of physical distress so you don’t need to go stressing yourself out, and second of all it is free so give it a try. It has worked for me many times. We have no outstanding dept from any of the many times we have needed medical care and had no insurance.

Anyone else have to go though a medical situation without insurance? What are your tips?

Uncommon Breastfeeding Tips

There are a ton of books written on breastfeeding, as well as classes and even lactation specialists that will help you get a good latch or up your milk supply but there are a few tips that no one seems to mention before the baby comes. I found that knowing this information first, helped me continue to nurse my son (he is 9 months now) even though some challenging times. We all know that breast is best and all of that. Best of all in my opinion is that fact that breast is free! That is what makes it worth seriously considering if the whole better for the baby thing does not swing you.

First of all a myth – Breastfeeding hurts like a monkey biting you (I really did read this from a book written by a mom) Fact: Come on people, if it really hurt that bad the human race would not have survived in its current form. We would be laying eggs. Done right breastfeeding does not hurt. Your boobs might be sore for a few weeks as you get used to it and your milk comes in but it should not feel like your boob is going to fall off. If it hurts that bad, see a lactation consultant. Another myth – Formula feeding is easier. Fact: This depends on the mom. For working moms I would think they are right because pumping is rather tricky, for stay at home moms it is much easier to stick a boob in the baby’s mouth then getting up and making a bottle. There is also less stuff to haul around with you when traveling.

There are a lot of assumptions that women make when they decide to breastfeed. One assumption that should not be made is that your child’s pediatrician will help you if you have questions or problems with breastfeeding. This is not usually true. Unless the pediatrician is also a lactation specialist or has one on staff they are probably not experts on breastfeeding. Most pediatricians are what I call fair weather breastfeeding supporters. They will happily support you breastfeeding your baby as long as there are no problems. As soon as there is a problem, they say supplement with formula. Even if the problem is fairly minor, they are interested in the over all health of the child, not the extra benefits of breastfeeding to your child and your checkbook. When my son was not gaining well at his 6 month appointment, the pediatrician told me to supplement with formula. He told me that this was the easiest thing to do. Easy for him maybe but not for me. I ignored him and simply gave my son more breast milk (by offering him the boob more often) and more solids. He is doing great now, no formula needed. This doctor did not even think there was another option. If you are committed to breastfeeding, you may have to do your own research to solve your problems. Pediatricians are not the best resource.

Another thing that many new moms (even me) do not know is that just because your baby does not latch well when he is born does not mean that he will not get the hang of it possibly even weeks later. I belong to a birth board for the month that my baby was born. There are several women on the board that could not get their babies to latch when they were born. They continued to pump but stopped trying to get the baby to nurse. A few weeks later, they tried to get the baby to nurse and found that the baby had no problems! So if you find that your baby just will not latch when he is born but you kept pumping, giving nursing a try a few weeks later. Of course this will not work for all babies but it is worth giving a try. A lot of new moms wonder if their baby is getting enough milk and will offer a bottle after nursing and then if the baby drinks it, assume that the baby is not getting enough milk. Babies love to suck. That is why pacifiers are so popular. A website that explains this better is kellymom.com. That website saved me so much grief. Over all I would say to give nursing a try, and don’t feel guilty if it does not work out. I welcome any other unknown tips to help women that want to breastfeed.

Ode to my Diva cup

**Warning: This entry deals with gross TMI topics.**

I love my Diva Cup. It has to be the smartest $30 I have ever spent. But I have not always been a convert; no I am a very recent devotee of the Cup. It all started when I was reading a chat board and came across some posts about Diva Cups. I had no idea what this was so I looked it up on Metacrawler. The Diva cup is a menstrual cup made in Canada. It is a small cup (imagine a tulip shape) made of silicone that is put in your vagina to catch menstrual blood. Every 4-12 hours (depending on flow) you take it out, dump it in the toilet, wash it in the sink and put it back in. Well this looked interesting but I put it out of my mind and went about my life. Pads were what I have always used and I saw no reason to change.

Then, after I had my son, I stopped in a local store that sold cloth diapers. I came across the Diva Cup. I talked to the store owner who said that she loved hers. I asked how long the cup lasts and she said 10 years. I was amazed. That is 10 years of not having to buy tampons or pads. That makes the $30 worth it. This is what sold me at first, then I started using it. Menstrual cups have a wide learning curve very much like cloth diapers. It took me two and a half full cycles to get the hang if it and no longer need pads at all, but once I got the hang of it, I fell in love. My cycle is fairly even medium flow for 4 days then tapers off. I only need to empty the cup every 12 hours. This is wonderful! I no longer have to change pads in the middle of the night, or when I am out and about at the store or mall. I don’t have to worry when I am at a park with no trash can to put my garbage in. I only think about it when I get up in the morning and before I go to bed. I also love that clean feeling. No more slimy feeling down there. It is as if I am not on my period at all. You may wonder how this is any different from tampons; I hate tampons because they always feel so big to me (even the smallest size), they dry me out, when I take it out it chafes me and I hate when you pee and the string gets wet, so gross. I have none of those problems with a cup. I even cut off the little stem on the bottom of the cup so I don’t feel it at all. I also should point out that you no longer need to worry about carrying extra pads or tampons with you. If you already have the cup in you don’t need to bring anything and if you don’t, the cup is small and comes with a little bag that fits in a purse. Best of all I an reducing my foot print on the earth by reducing the amount of waste I produce.

Now just to be fair, menstrual cups are not a new idea, they have been around since the 1920s. There are many different kinds that come in many different sizes but mostly the same shape. There is one that is made in the US called a Moon Cup. I bought a Diva because that is what the store sold. I don’t like ordering on-line if I don’t have to but you can order any cup, from any country, on-line. I also should point out that the package for the Diva says that it lasts one year. All of the other cups say 10 and I was told the Diva used to say 10 but the health laws in Canada now require them to say 1 year. I see no reason why a silicone cup can’t last 10 years. If you have problems with your cup I would say keep trying and look up any questions on the internet. Diva did not come with very good directions so I had to find my answers on-line but it was worth the effort. My Diva is super easy to use now, super cheap, and I no longer dread that time of the month. I even converted my mom. He he he.

Tips for traveling with baby

There were many good ideas that I came across and implemented in my vacation last October with my six month old. I think the best idea was to bring a sling or carrier with you. It was so nice not to have bring a big stroller or car seat to carry the baby in at the airport and when going sight seeing. We brought my homemade Moby sling. It is just a long piece of fabric so it was light weight and folded up fairly small. My son loves being carried in his sling above all else so it worked very well for us. He has a habit of losing his socks and slippers when we go places so when we were at the airport, he was in full footsie pjs. This way, there were no extra pieces to fall off and get lost.

We stayed with my grandma for the first half of the trip. She does not have any baby items at her house so we were worried that our baby might have to sleep in bed with us. He does not like to be touched when he is sleeping and wakes up if you even get up to go to the bathroom, so I really did not want to have to do that. Luckily my grandma lives in Sun City. They have a free service to rent baby items for up to a week at a time. They had a very nice, clean Pack N Play for us to use during our trip. So before hauling along things like play pens, check to see if the people you are staying with can borrow some items for you. If you are staying in a hotel, you can just ask if they have certain items. They will most likely have a portable crib available to use. I did bring along our Bumbo, which we got at a used baby stuff store for $20. We used it as a high chair and a place for our son to sit when we went out to eat. It is light weight and fit in to our suit case. He can’t sit on his own so the Bumbo was very helpful.

We cloth diaper our son so we just brought the diapers with us. It was cheaper then buying a week and a halfs worth of paper diapers. We just washed them every three days like we do at home and kept the dirties in a trash bag near where he was changed. We were staying with relatives so this was easy to do. I did not bring any jarred baby food because it costs money and he was not eating much solids at the time. When we got to my grandma’s, I found a sweet potato in her fridge and just cooked it up and fed it to him. When we went to my sister in laws, I cooked up some carrots to feed him. It did not cost us a thing. Over all we had a very pleasant trip and can’t wait to go again next year.