My Home Birth Budget

I will be renting something like this to use as a birthing tub

I found my midwife today! I've been calling around since yesterday. Since I've had a previous C-section, it makes finding a midwife willing to do a home birth a bit more complicated (even though I've already had one successful vaginal birth after Cesarean). The difficulty lies in the midwife's malpractice insurance not covering out-of-hospital VBACs. The midwife can't bill my health insurance for a delivery at home, so I would have to pay for it myself. I wasn't going to give up & kept calling & inquiring. I've made a decision to have a home birth & it was so important to me that I was willing to pay out of pocket.
I was fortunate to find a midwife right here in Bellevue through the Mothering magazine online community, so, thankfully, I wouldn't have to do a long commute (I was prepared to do that too, if that meant I could get my dream birth). Charlene Campbell, LM, CPM is the owner of www.birthjoyeducation.com. She is originally from Canada & has been a midwife since 1985. Charlene is one of 9 children (all born naturally & breastfed) & had her own 5 children with midwives. She is not only a midwife, but also taught midwifery students for many years & produced a set of educational DVDs for midwifery students & educators. She has done many water births & sounded excited to provide this service for me.
It is amazing how things just fall into place sometimes. We had our benefit fair at work last week, & I found out I was pregnant shortly after. I now have a great opportunity to enroll in the Health Care Flexible Spending Account (FSA) to cover some of my out-of-pocket birth expenses.
In case you are curious, some of the eligible pregnancy & birth-related expenses include birthing classes or Lamaze, chiropractic services, compression stockings, fertility monitor, fertility treatment, lab work, naturopathic visits, pregnancy tests, prenatal vitamins (if any of them are not covered by one's health insurance, of course). Certain medical expenses are reimbursable under a Health Care FSA if a licensed health care practitioner can testify that the service or product is medically necessary. The examples of medically necessary services include buying or renting of a breast pump, lactation consultant fees, home birth fees not covered by insurance, birthing tub rental, & birth doula (all confirmed by me via multiple phone calls!).

Here is my home birth/post-partum budget:

1) Home birth - $1800 (if paid before 20th week of pregnancy, otherwise it's $2000)
2) Birthing tub rental - $175
3) Birth kit - $50
4) Birth doula/birth photos & video - $1475
5) Lactation consultant - $300 (Home visits run around $150/visit, & I am thinking I will need at least 2, but probably more. I could travel to the lactation clinic for only $75/visit, but it may not be feasible. Sadly, my Premera Blue Cross insurance doesn't cover a lactation consultation unless it's included as part of hospital admission or for infant's failure to thrive).
6) Breast pump rental - $50 starting kit + $45-70/month x at least 6 months.
7) Placenta encapsulation - $250

Total price: $4370 - $4470

As you can see home birth is a choice that doesn't come cheap. Thankfully, I can probably save 30-40% on at least $3500 (the annual limit) through use of the Health Care FSA. Many of my expenses are not related to home birth, but to birth in general (I would still hire a doula, do placenta encapsulation & rent a breast pump even if I gave birth in a hospital). I could probably save around $2200 by giving birth in a hospital. Some (including my husband) may wonder why a woman would choose a relatively expensive home birth when she could have a hospital birth for free. The reasons are numerous & too complex to describe in one or two sentences, & I will address them in my later posts.