Femme Economics*: The Cost of Child-birth
Homebirthing is popular these days, but for lesbian and transgendered couples who are likely to be less financially solvent and less likely to have great family medical insurance, this is an even greater trend. Add to the mix the fact that midwives are much more used to serving same-sex couples than the staff at a hospital might be.
At-home birth with a midwife not only lowers the chances of some complications during birth, a lower risk of post-birth infection, and has a lower cesarian section delivery rate, there is another great reason to birth at home: It’s cheaper. Much cheaper. In fact, sometimes a third of the cost of hospital birth and allopathic care.
When choosing to have a baby, we might think of the cost of sperm and all the thousands it will cost to raise the dear one and then put it through college. The first thought is not usually about the thousands that might be spent on that one big day. Buying enough sperm for a few tries is pennies compared to what a couple might spend in two days at the hospital, even if you have great insurance. In most states, many health insurances will cover care and birthing by a midwife if she is a Nurse-Midwife, which means she is also Registered Nurse. This trend in insurance coverage comes along, of course, because home birthing saves money.
The Home Birth Guide online says:
‘œHomebirth is considerably less expensive than having birth at the birthing center and hospital. As opposed to hospital birth which costs somewhere between 6000-10,000 dollars for vaginal birth, homebirth costs anywhere between 1500-3000 dollars. This also means that homebirth is also cheaper than giving birth at the birthing center which can cost anywhere between 3500-5000 dollars.’
A Labor of Love further explains:
‘œA hospital birth requires a physician, whose fees range from $1500 to $3000. In addition, there is the cost of the anesthesiologist, hospital costs, cost of supplies and other fees. In contrast, the fees for a midwife, who typically assists in a home birth, range from about $1000 to $2000. The midwife’s cost generally includes prenatal care, childbirth classes, as well as birthing supplies.’
Is it safe? I read a very well-researched essay at Storknet on this very topic and found the most interesting piece of information which eases the little bit of fear I have about home-birth:
‘œFor true emergencies that require transport to the hospital, women laboring at home 20 minutes from the hospital have the same access to emergency surgery as women laboring at that same hospital. Many hospitals cannot prepare for an emergency surgical delivery in less than 20 minutes. The ACOG standard is currently “30 minutes decision to incision” for all non-scheduled cesarean sections.’
There are even ways to save if all doesn’t go as planned and there are complications during pregnancy. I happened to be reading up on childbirth and pregnancy from the Managed Care perspective which suggests staying at a hotel next to the hospital if you must be on bed rest. It is considerably cheaper and most likely a lot more comfortable if you cannot be at home. If you are planning a hospital birth and having false contractions or those that are very far apart, staying over-night at the hotel will be easier on your wallet.
On a personal note:
I’ve been seeing a naturopathic midwife in Seattle for two years now even though for a while I was not settled in with a partner, just in case I didn’t find the special one and might go it on my own. She spends up to an hour at a time with me on my health issues and this midwife helped bring some of my favorite children into the world. Seeing a naturopathic nurse-midwife without insurance (on cash discount) costs me much less per visit than the same cash discount did with a GYN. We are now building a real human and holistic relationship which will be inordinately comforting when I get pregnant and give birth. And that, my dears, is something money and a ‘œsafe and sterile’ environment cannot buy.
*Obviously, the ‘œFemme’ in this topic refers more to feminine organs than performance of gender. I do know plenty of butch identified people are choosing to give birth these days. This article just falls under the category of my Femme Economics because wanting to be a mom is a part of my own femme identity.
Very exciting. I find the hospital/birthing center/homebirth question a tough one. I want to be safe but I want to be comfortable and I don’t want to be overmedicated. I’m leaning towards a birthing center right now. But then I’m not pregnant. The idea of a midwife is also appealing….and I could meet with some after becoming pregnant to see if they’re viable option.
Moorea: this was a really informative article and I’m forwarding the link on to Jeanine. We haven’t even considered the birthing options since we’ve been completely focused on just getting pregnant. It will be interesting to learn if she’s open to the idea of a home birth. I have to admit that I’m not sure either one of us even know what her insurance covers for a traditional hospital experience, but you can believe I’m all about keeping tabs on the costs! This is a good one for the files. I hope I get to refer back to it.
Great post. On the other hand, there are many progressive OBs and hospitals, and for women with high-risk pregnancies (such as mine!!!), home birth may not be an option. I had a wonderful experience with a progressive, queer-friendly OB at NYU Hospital. And it was covered 100% by my insurance (sadly, French baby clothes aren’t…) Good luck to all of your on your quest for queer parenthood; enduring fertility treatments can be quite the Mr. Toad’s wild ride experience, but it’s all worth once you have the baby. Cheers, Jennifer (new mom to Nadia)
Although the cost wouldn’t be an issue to me (free healthcare in the UK) I would definitely prefer a homebirth should I ever decide to have children.
You might want to find out the restrictions on what pain medication can be given by a midwife – in the UK for example, midwives can’t prescribe anything, whereas in New Zealand I believe that they can prescribe from a restricted list.
I’m not against home births, by any means, but I will relate my own experience, just as a data point: My partner had a “perfect” pregnancy. No complications, no morning sickness, and no weird cravings. A week past her due date, our doctor scheduled an induction. All went well for the first 24 hours, then the fetus’ heart rate plummeted and the doctor called for an emergency C-section. Four minutes later (not 20) she was on the operating table, and three minutes later we had our son. Given how much his heart rate had dropped, I’m convinced he wouldn’t have made it if we hadn’t been in the hospital and my partner already had an epi line in.
She may have been a rare case–and it’s possible the induction had something to do with it. By no means am I saying everyone should have a hospital birth–but just so people know these situations can happen….
Just thought I’d reply to the last post. It’s quite likely that the induction, combined with standard hospitals procedures for managing labor, are what made the C-section “necessary.” Your baby may never even have been in distress — electronic fetal monitors have a high rate of false positives. Or the doc may have simply wanted to go home. C-section rates rise on Friday afternoons, before shift changes, before major holidays, and around 7 am (because docs often have office visits scheduled at 8).
For low-risk pregnancies, a home birth is at least a safe as a hospital. You’re much less likely to have technological interventions or a c-section. The AMA won’t publish the studies, but check the British Medical Journal, the Royal College of OB/GYNs, and the World Health Organization for good data.
My thesis work is on home birth. If you live in Northern Colorado and are planning a home birth, I’d love to talk to you. I’m making a special effort to get a queer perspective. You can email biasiollia[at]yahoo[dot]com.
That said, first births tend to be more difficult. About 40% of first-time moms who want to birth at home end up going to the hospital. But that rate drops to 10% for subsequent babies, so don’t give up hope.