Natural childbirth in Long Island?

January 4, 2013 4:17 PM

Natural childbirth in Long Island with Aetna insurance. Is this even doable? Do you have information that can help us?

My wife and I are expecting our first child in July. Yay. But we're starting to get really depressed by our birthing options. We'd like to do a home water birth if possible. We have Aetna insurance, which has seemed pretty meh so far. Do any of you fine mefites have information about midwife survices or birthing centers in the area (we're in Glen Cove to be precise) that either take Aetna, or work well with insurance companies? Hospitals with great birthing centers? Any glimmers of hope? Our friends in the area all seem to have had pretty wretched birthing experiences.

We're getting to the point where we're trying to figure out how much we can afford out of pocket and whether that'll cover a midwife. Not that blowing our savings on having a baby seems like a great idea.

posted by Shutter to health & fitness (8 answers total)

If I were in your shoes, I would find a local doula through DONA International and talk to them about this idea; I bet they would be likely to know based on their experience.
posted by ThePinkSuperhero at 4:43 PM on January 4 [1 favorite]

Would you consider a midwife-assisted hospital birth? The American College of Nurse-Midwives New York chapter has a midwife-finder, but I think nurse-midwives mostly only work in hospitals. (The midwives who attend home births are not usually actual nurses.) There shouldn't be any issue with insurance coverage for the services of a nurse-midwife practicing within the scope of her licensure.
posted by lakeroon at 5:35 PM on January 4 [2 favorites]

Find out how much would be covered by your insurance and how much you would most likely pay for out of pocket. Then look into local midwife or doula services. Some of my friends with insurance also wanted a home birth or used the service of a birthing center (which around here tends to be much more family oriented and focused on natural birthing, usually with a birthing tub available) and found that in either case the out-of-pocket costs were on par either way.

I had fairly mid-range insurance and had a hospital birth (used their midwives and had a birthing tub) but ended up with a c-section after 40 hours. *ahem* A C will be more expensive than a vaginal birth and my out-of-pocket costs were something like $6k. Just something to consider.
posted by amanda at 5:57 PM on January 4

I haven't found a birthing center in Nassau county (not that I'm pregnant, but when I am, we'd like to take this route, too.)

So far, the best info I have found is regarding Gaia Midwifery seems to be highly regarded, they do home births, and are apparently working to open a birthing center within Nassau University Medical Center in East Meadow. According to the website I linked, it was set to open in 2012, but I don't know if that's happened yet.

Good luck and congrats! Please come back and update!
posted by waterisfinite at 6:08 PM on January 4

I've never even been to Long Island, but here are some ideas that may help:

Get an estimate from Aetna for an unmedicated delivery. We have insurance that does not cover homebirth in any way. We found out that the average out-of-pocket cost for an unmedicated vaginal delivery at a hospital, with our insurance, was $7500. Our midwives charge $3750 if you pay before 28 weeks; $4000 otherwise. This made the decision obvious for us. So you might look at what the midwives charge compared to what people with your insurance pay on average for an unmedicated delivery.

It is unusual in my experience for midwives who are not affiliated with a hospital to accept health insurance. If you find that a homebirth is prohibitively expensive, there are a variety of things you can do to make an unmedicated hospital birth more likely. Probably the most important is to find a provider you agree with and feel comfortable with.

If your friends are not helpful in this regard, i.e., they all distrust or dislike their providers, I recommend consulting with an experienced labor doula. An experienced doula will have worked with a variety of providers and will have noticed the ones who are supportive of unmedicated birth. She may be able to make recommendations. Ask whether she has worked with a friendly provider at whatever hospitals are in network for you.

Similarly, childbirth educators who are unaffiliated with hospitals or your local ICAN chapter (it looks like they have a Facebook page) can help you out. ICAN is support for women who have had Cesarean births, but the organization tends to scope out local childbirth providers and can often give you a list. La Leche League may also be someplace that can help.

There is a lot you can do to make a hospital birth a reasonable option if a homebirth or birth center are unavailable. Hiring an experienced doula goes a long way. If you want other recommendations about this stuff, please feel free to Mefi mail me.
posted by linettasky at 7:28 PM on January 4 [1 favorite]

As I'm sure you've figured out most people in that part of Nassau County have their babies at North Shore in Manhasset or Winthrop in Mineola. There is not a birthing center option unless you want to go to Brooklyn. Maybe I'm biased, but I would not be interested in doing anything at NUMC. But I only know it as the crappy county hospital. Maybe they do have a nice labor and delivery offering these days? I'm generally of the view that statistics on child birth by hospital are non-predictive - its more a sampling of who goes to those hospitals rather than what hospitals try to impose on you. Frankly - having the children of the upper middle class is incredibly profitable for hospitals so they will do whatever they can to give people what they want.

It seemed to us like the choice of OB/Midwife +/- a Doula was more important for determining the kind of delivery. We had an OB + a Doula at a very very traditional hospital environment in Manhattan and my wife was able to have completely unmedicated birth with just 4 people in the room - me, the doula, the OB, and one nurse.


Perhaps you could reach out for a new moms groups at some of the more progressive orgs in the area? Like the Unitarians in Shelter Rock or Muttontown? Or the Rising Tide crowd? There's gotta be something like that going on in Sea Cliff too.

I thought for sure I would have a better answer for you, but it occurs to me there is almost a perfect correlation between my friends who are trying to stay in the City as long as possible and those who used midwifes or doulas vs those who ran for burbs ASAP.

(also dude - its "on Long Island" your kids first Billy Joel album is on me.)
posted by JPD at 7:22 AM on January 5 [1 favorite]

Hi everyone, thanks so much for the information! Further investigation indicates that insurance might not be too heinous to work with and it looks like Gaia Midwifery will work out. We're pretty stoked:)
posted by Shutter at 9:31 AM on January 15

For anyone searching the archives... I just did a tour of Nassau University Med Ctr and the renovations to their L&D unit are supposed to be complete by September of this year and so far it looks pretty good!

It's already got the only true birthing tub on Long Island. Post partum rooms still look like soviet era crap but will be part of the gorgeous renovations.
posted by waterisfinite at 5:16 PM on April 22