[rph3664]

I know one woman who had her baby early one evening, and first thing in the morning, about 12 hours later asked to be discharged.

The nurses objected, but she said, "I am a physical therapist, my husband is a registered nurse, and we have a 15-year-old son at home" (husband's son by prior marriage of whom he had full custody). She knew all about the screenings, and said she would be happy to come back the next day to have it done. So, she went home at that time.

I know another woman who asked to leave the hospital that same day as well. She had planned to relinquish the baby until she learned that the father had to sign the papers; she knew who he was but he was long gone and she had some very good reasons for wanting to keep it that way. This was in Arizona, about 10 years ago. Her second child, from a subsequent marriage, was an emergency c-section a few weeks before the due date and she knew he wouldn't be coming home with her right away, and she wanted to be discharged the very next morning. Since she was eating and going to the bathroom, they let her do that as well.

From what I have seen from my distant vantage point, the women who do relinquish their babies usually want to leave the hospital as soon as possible. I have heard of women who wanted to leave as soon as the baby was born, not realizing that they weren't finished yet (i.e. placenta). One hospital where I used to work required women to stay for 2 hours after delivering the placenta, and then they could leave if they wished.

[cherokeesummer]

Originally Posted by CEG

Many insurance policies do not cover out of hospital birth so women do not have a choice, other than to pay thousands out of pocket. If the rights/desires/wants of the women were respected in the hospital this wouldn't be an issue.

I've heard this before but I'm unsure on something, feeling really stupid here LOL but...what would they need insurance for? Meaning if they were at home having a baby on their own with no doctors there who would they need insurance to pay? (I know this has to be a stupid question since nobody else has asked it LOL but I figured I'd ask!).

[rph3664]

Originally Posted by cherokeesummer

I've heard this before but I'm unsure on something, feeling really stupid here LOL but...what would they need insurance for? Meaning if they were at home having a baby on their own with no doctors there who would they need insurance to pay? (I know this has to be a stupid question since nobody else has asked it LOL but I figured I'd ask!).

Midwife fees? Ambulance charges if things go haywire? I've even heard of physicians who attended home births, although not for a long time since, among other things, you can't get malpractice insurance if you do that.

[CEG]

Originally Posted by cherokeesummer

I've heard this before but I'm unsure on something, feeling really stupid here LOL but...what would they need insurance for? Meaning if they were at home having a baby on their own with no doctors there who would they need insurance to pay? (I know this has to be a stupid question since nobody else has asked it LOL but I figured I'd ask!).

I am planning a homebirth with my current pregnancy. I need to pay for my prenatal care with my midwife, I had a pap smear, standard blood tests, an ultrasound next week, my midwife will be on call for me 24 hours a day 7 days a week and then stay at my home with me while I am in labor and until I am stable postpartum, then I will go back for a check-up in 6 weeks. Homebirth does not = unattended birth. As an L & D nurse I know I do not want to be subject to hospital protocols, continuous fetal monitoring, and all the other non evidence-based practices out there. I have pre-registered with my closest hospital in case of an emergency which my insurance company would also have to pay for.

It's a shame that insurance companies haven't caught on to the fact that homebirths save them thousands of dollars per birth and reduce charges for unnecessary interventions. I am lucky that my insurance pays for hombirth but not everyone is that lucky.

ETA: there are several physicians also attending homebirths in my area, same info applies

[Nefertari1279]

"I the FEW cases I have been involved in, once the parent is aware that CPS will be notified if they try to take the child, they usually don't mind staying that extra night!?"

Were those normal healthy babies or one's with serious health concerns? That makes all the differance.

As long as Mom and Babe are stable and everything is good, early release shouldn't be such an issue. (Holding the threat of CPS over the parents heads, just to get them to stay doesn't seem right to me)

If the baby's health is in question , then I could understand getting CPS involved, but otherwise its overkill.

[Nefertari1279]

Pirap:

Many women don't have any other option but to deliver in the hosiptal.

Just bacuase a woman wants to leave early, doesn't mean she has something to hide . . . . maybe they just want to be in the comfort of home.

[cherokeesummer]

Originally Posted by CEG

I am planning a homebirth with my current pregnancy. I need to pay for my prenatal care with my midwife, I had a pap smear, standard blood tests, an ultrasound next week, my midwife will be on call for me 24 hours a day 7 days a week and then stay at my home with me while I am in labor and until I am stable postpartum, then I will go back for a check-up in 6 weeks. Homebirth does not = unattended birth. As an L & D nurse I know I do not want to be subject to hospital protocols, continuous fetal monitoring, and all the other non evidence-based practices out there. I have pre-registered with my closest hospital in case of an emergency which my insurance company would also have to pay for.

It's a shame that insurance companies haven't caught on to the fact that homebirths save them thousands of dollars per birth and reduce charges for unnecessary interventions. I am lucky that my insurance pays for hombirth but not everyone is that lucky.

ETA: there are several physicians also attending homebirths in my area, same info applies

Very cool information, thank you for sharing with me. I really and truly was wondering what the process was all about. I guess I was thinking like way back old days LOL when moms had babies on the farm or something! Like was said above, I was thinking unattended and home were the same things. Thanks for the information!

So say you have prenatal visits covered by your insurance all along and you have a midwife that cares for you, do you tell them from the start its a home birth and then the insurance decides whether or not to cover or is it pretty standard that insurances won't cover it so you have to do it at a hospital or pay out of pocket for the home birth that you want?

It's a very interesting topic and I can definately see how it would be cheaper for insurance co's.

[cherokeesummer]

I think (not sure here) but think that maybe the reason why our docs and peds are so wary against sending moms/babies home is the fear of legal ramifications. I mean with mom she signs out AMA but I'm thinking maybe the peds are afraid something could happen to baby and mom would sue them for letting them go home early, I don't know but it seems legal fears are behind so much these days.

[scribblerpnp]

Originally Posted by Nefertari1279

"I the FEW cases I have been involved in, once the parent is aware that CPS will be notified if they try to take the child, they usually don't mind staying that extra night!?"

Were those normal healthy babies or one's with serious health concerns? That makes all the differance.

As long as Mom and Babe are stable and everything is good, early release shouldn't be such an issue. (Holding the threat of CPS over the parents heads, just to get them to stay doesn't seem right to me)

If the baby's health is in question , then I could understand getting CPS involved, but otherwise its overkill.

In my post I stated, "If there IS an issue," Meaning the health of the baby or safety of the baby was a concern. If the child/mom was healthy (as in the case of the OP), an AMA or d/c is OK, and obviously using CPS as a threat would be a terrible thing to do. In the hospital where I take call, I can't recall a time when the parent wanted to leave prior to the first 24 hours, but I have only been doing this for 5 years, so there is time for a first.

In the cases where I have had to call CPS, it has been due to a mother's + drug screen or the other children being in the care of CPS to begin with and the parents are trying to leave AMA thinking the child won't be taken away. In a couple other instances it has been due to the child's health (like fever at birth and a sepsis work-up in in the works.)

Thank you for pointing out that I needed more clarification to my origional post

[CEG]

Originally Posted by cherokeesummer

Very cool information, thank you for sharing with me. I really and truly was wondering what the process was all about. I guess I was thinking like way back old days LOL when moms had babies on the farm or something! Like was said above, I was thinking unattended and home were the same things. Thanks for the information!

So say you have prenatal visits covered by your insurance all along and you have a midwife that cares for you, do you tell them from the start its a home birth and then the insurance decides whether or not to cover or is it pretty standard that insurances won't cover it so you have to do it at a hospital or pay out of pocket for the home birth that you want?

It's a very interesting topic and I can definately see how it would be cheaper for insurance co's.

My insurance company as a policy covers homebirths, so I just had to make sure I saw an in-network provider so my out-of-pocket expenses would be lower. Some insurance companies do not have a specific policy not covering homebirth but do not have any in-network providers so women apply for an exception and have their homebirths covered. Still other companies have a policy of not covering homebirth so those women are out of luck. I think it is relatively rare for an insurance company to be as easy to deal with as mine.

I think ACOG perpetuates a lot of these difficulties with their policy statement against homebirth... which is not evidence based and has more to do with $$$$ than anything else. The other birth organizations (ACNM, RCOG, CSOG (Candian- is that the right name?) and of course NARM and MANA, endorse homebirth as a safe option in the low risk patient. And of course ACOG endorses birth center birth but not homebirth which is a little crazy, IMO.