Homebirth fee schedules

Hi,

I'm just trying to research a few different IMs to organise a HB and I'm a bit up in the air about fees.

On one hand I keep hearing about the great post-natal support from IMs but on the other hand I have seen fee schedules that charge a fixed amount per post-natal visit. Surely under that system you could opt to have a minimal amount of visits and perhaps NOT get very good post-natal care?

Are you using/did you use an IM who charged per fee or offered a lump sum package deal? What did you like about the option you chose?

I'm struggling with the money side of things- I went public last time and I didn't pay a cent! I know some people claim you could pay more for an OB but I never had or needed one of those either! I had BFing issues last time and had my post-natal midwife visits extended till we were all well... for free. This is killing me!

Thanks!

Mine was a lump sum and the visits lasted as long as i needed (3rd bub so i think i had 2.....)

Hopefully you wouldnt need as much support this time for BF but then again you want the option if you are worried.

Sorry i know that doesnt really help :( Good luck!

I would have a chat to various IMs about how you are feeling and what you would like. This will give them a chance to either offer you what you want or explain clearly why they don't offer that sort of service.

From my perspective, I am on a fee schedule where I pay per ante-natal appointment and then pay an on call booking fee, a birth fee and then post natal support visits as needed. I assume that the ante-natal visits are pretty set as in there are a set number that the middie will attend as this ensures they are doing their job properly and are safely keeping an eye on you.

In answer to your question about what I like about my the option I have chosen, well, I didn't really choose this option, I chose the midwife and she came with this fee structure! ;) But I am happy with it as my last birth experience was less than desirable and ended with a c/s which I knew at the time and definitely know now, was not at all necessary. I want to do all that I can this time to avoid that and have a natural birth in the comfort and the safety of my own home. I like you went public last time and did not pay a cent, but I did pay in other ways IFKWIM!

I understand your issues with the cost. It is not fair at all to force people to pay for IMs when hospital births are subsidised and often cost more than home births. I also understand your frustration as I assume from your post that things worked ok for you in the hossy last time. Its good that you are thinking through all of this and I hope my experience and reasons help in a small way with your big decision.

Having said all that, even with the costs of an IM an homebirth, so far, I have felt it is the best money I have ever spent :)

Oh and my midwives have a little note on their fee schedule stating that if you have any financial difficulty or concerns, feel free to discuss, they may be able to negotiate a suitable payment plan.

Yeah- I'm not approaching a homebirth as a woman with prior birth trauma. I always wanted homebirths but based on the cost I decided to save on one birth and had my son a FBC. There were some issues with that- mainly my anxiety through the pregnancy about what midwife I would get, whether I would be classed 'high risk' and have to leave the birth centre and also having to birth my son on a birth stool to get him out quickly to avoid transfer and vacuum after 2 hours of pushing, which resulted in tearing. That wasn't optimal but it didn't make me feel upset about my care or labour.

I still really want a homebirth as I know it's in my life journey, and I do want to avoid some aspects of my previous pregnancy and labour experience. But I guess I don't feel like I need it so much that it's easy to throw 1000s of dollars to the cause. I guess my main thing is the post-natal costs. I could spend $1000 just on that alone and the thought freaks me out. I guess cause it's an unknown. I'll know before hand the ante-natal and birth costs but post-natal is a gamble.

have you thought about using a post-natal doula maybe instead of an IM? this *might* work out to be just as effective (no doubt there is someone with LC experience??) but also work out financially more appealing iykwim...

now i need to investigate lol!

That's a good idea- thank you :)

I hired an IBCLC last time and she was worth the expensive over the free service we had anyway. I am aware that you often do "get what you pay for" so I am prepared to pay. I was just remembering my every second day midwife visits for 2 weeks post-natally and freaking out about the $100 a pop issue! But I guess a package deal on post-natal support would be good. I hired Pinky McKay as our LC consultant actually and I think she does post-natal support packages now... hmm...

Sheesh! Pinky's package aint cheap!

yeah i reckon her packages would pack a punch LOL! she's like totally famous now lol!

We're paying a package fee, which includes all ante-natal visits, birth plan meeting with 2 MWs, 2 midwives at birth and post-natal visits up to 6 weeks. I don't know how many post-natal visits we'll need, but so far our IM has been very accessible for phone advice, visits etc.