I met with Kaiser's Head OB yesterday, and since I've mentioned this upcoming appointment approximately 37 times on this blog, I may as well tell you how it all went.
The short answer is that the doctor said No to me, but he managed to do so with enough explanations that at least I understand the answer. So while I don't love it, at least I get it now.
The long version (yes, this is me, of COURSE there's a long version!) is that we sat and discussed everything for about 45 minutes. And I'll just say right off the bat that any doctor who is willing to talk for 45 minutes until his patient is satisfied gets oodles of gold stars in my book.
What it really all came down to is the way my insurance policy works: Kaiser covers everything, and only if there's something that they medically CANNOT do, will they outsource it so someone else. So, for example, when Ryder needed physical therapy, they were happy to refer me to a place that specialized in that (and pay for most of it, too). But, as the doctor pointed out, they are very capable of helping me deliver VBAC, and are even fine with me doing so (which is not the case with a lot of insurance companies, so I really am very thankful that Kaiser is reasonable in this area). So there's no medical necessity for me to go to a birthing center. I can understand that. Even though I feel very strongly that it might be better/cheaper to go to a birthing center, I can see that my situation does not constitute a necessity. But the bigger problem, according the doctor, is simply the fact that Kaiser does not currently outsource to any midwives or birthing centers. (They used to, but that birthing center decided to stop working with Kaiser. I contacted them when I was pregnant with Kendra and when they did still work with Kaiser, but they didn't allow VBAC, so that place was never an option for me anyway.) So even if I could somehow persuade my doctor to sign a referral for me, there would be no one that they have approved to send me to. (All this begs the question of why my original doctor suggested I go to a birthing center in the first place? Apparently she needs to be better versed in Kaiser's policies! I guess I could tell her a thing or two now!)
So that's that. We then spent a long time discussing my treatment at the hospital and what measures I could take so that that wouldn't happen again. Basically, he suggested writing a birth plan with my doctor (he emphasized not just using one that I'd found on-line, since most doctors assume you are crazy and uninformed if that's what you bring in), but to write it with my doctor and include information so that it was obvious that I had done actual research and knew what I was talking about and that I understood any risks associated with my requests (such as having intermittent fetal monitoring instead of constant monitoring). And then he suggested that I ask the doctor on call to discuss it with me when he/she had time, but while I was still in early labor and able to carry on such a conversation. (Rather than, say, waiting until I'm pushing to find out that the doctor is uncomfortable with me not laying on my back for this event.) Anyway, it seemed like good advice. He also said that I was welcome to call the four hospitals where I can deliver and see which doctors are at each place when the time comes and choose which one I'd rather go with. That's still a shot in the dark, since there are 20 OBs in the area, so I'd be hard pressed to meet all of them! But at least if the two I really hated are working that night, I could avoid them!
Anyway. Now that I am fully armed with all of this information, I have to figure out what I'm actually going to do. But I feel like I have a good handle on all my options and can truly make an informed decision. So even though it would have been nice if he'd just said Yes and signed the referral, at least I felt like I was heard, like we had a good discussion, and the ball is simply in my court to do what I think is best now.
Craig and I have a lot of thinking-- and praying-- to do...
3 comments:
I'm not sure how expensive, or if it would even work when you DO have insurance, but have you contacted a birthing center and found out what they would charge you if you were paying out of pocket? It's typically much cheaper. I had Linus at a hospital, but we paid out of pocket and it was seriously about $2000 to my doctor's practice and a little less than that for the hospital (for a regular birth and only a 24 hour stay). The hospital had an aesome plan that if you paid the set price up front and before the delivery, that was the cost. And we called and worked out a deal with my OBGYN. I'm not sure how Birthing Centers work...but maybe?
It's refreshing to hear that the head OB/GYN spent so much time with you. It's rare nowadays. It sounded like he had your best interest at heart and was working with what was truly available to him, rather than flat out saying "NO" OR pretending like it would work out.
Yes, lots for you and Craig to think and pray about. We'll be praying with you!
That's awesome! It's amazing when you can figure out when you don't just take the straight answer. Good luck finding something that will work for you!
(Back to the robot verification, this is my third time!!)
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