My very first “all’s well” prenatal appointment with a nurse midwife came with a $16,000 bill. My husband and I were graduate students, which meant that we were frugal, but we were also good at research. We had priced getting pregnant beforehand. That one bill, a single cystic fibrosis test (for which I’d been quoted $180 by the lab), cost more than we expected to pay for prenatal care and the birth. Our new-baby euphoria all but fizzled as we realized we would be playing nine months of Russian roulette with medical bills.
No toys for you, baby!
Of course, I fought. Over the phone, in person, in writing, at every level. But one night, when my husband got home and found me drafting new letters to collection agencies and insurance companies, he confiscated my file folder jammed full of phone calls transcriptions, lists of names, copies of letters sent.
“You’re done,” he said.
I did not intend, however, to take my grudge against the U.S. health care system so far that our next child would not be born a U.S. citizen.
But there would be a next time, and next time, I vowed, I would not be a pawn in the game hospitals and insurance companies play with one another.
I did not intend, however, to take my grudge against the U.S. health care system so far that our next child would not be born a U.S. citizen — my husband, even keel to my crusader bent, would never be swayed into something so ridiculous. But here we are.
An interview with Viviana of Mamás y Bebés
Viviana is the woman behind the super awesome Spanish-language website Mamás y Bebés. In this interview we talk babies and compare/contrast North American and Central... Read more
In January, if all goes well, I will deliver my second baby in highland Mexico. While there are some terrifying components to this arrangement — mostly having to do with language barriers and cultural differences — I confess that I am mostly relieved.
The farther I progress in my pregnancy, and the more experiences I have with the medical culture of Mexico, the more relieved I become.
This is not because I imagine for one moment that Mexico is a paragon of modern medicine or that my experiences translate into those of Mexicans across the country, or any of that. And I could very well change my mind entirely before this whole ordeal is through. For now, I am basking in the simple one-on-one humanity that I have been met with so far.
Imagine, if you will, walking into a bright, sunlit hospital where the waiting area for a given doctor has fewer than a dozen chairs. The receptionist-nurse greets you and apologizes because the doctor will be just a minute. There are no forms.
When the minute is up, the nurse waves you over and you walk down a passageway into the doctor’s office. By office, I don’t mean exam room. I mean a room that is taken up primarily with a large wooden desk. There isn’t clutter, exactly, but the desk isn’t a sterile field either. There’s a computer, files, photographs, and a few anatomical models. It might be a professor’s desk, or a lawyer’s.
Dr. O., a man in his early forties who looks a bit like a chubby Charlie Chaplin but thankfully isn’t funny, stands up and comes around the desk to shake hands with you and your spouse. Then he gestures to the two leather chairs opposite his own.
For half an hour, sitting in chairs, all parties fully dressed and eye-level with one another, the doctor asks and answers questions, occasionally fleshing out the database form on his computer. Of course, there are language barriers, Spanish vs. English and metric vs. imperial systems, but these are patiently overcome. Only once you and the doctor are satisfied is there any move towards the exam room.
The doctor shows you the bathroom and hands you a cotton gown to put on. When you come out, the nurse who has come in for this second phase helps you onto the scale (which reports in kilograms, a blissfully meaningless number), but it is the doctor himself who takes your blood pressure and raps on your kneecaps with that little hammer. Then there is an ultrasound: the right number of everything, a strong heartbeat, oh, and it’s a boy.
A few minutes later, you are dressed again and sitting in the leather office chairs. The doctor hands you a DVD of the ultrasound, tells you to schedule your next appointment in four weeks, and shakes hands all around again. As you leave, you pay the receptionist for the appointment. 500 pesos, or about $40.
Maybe there are doctors in the US who treat patients this way, but I have never met them. I don’t doubt that a majority of doctors would like to treat patients this way, if only the system would allow it.
Of course, as tickled as I am by Dr. O.’s system in terms of how I stand to benefit from it, I can see how aspects might make Dr. O.’s life miserable.
For one, Dr. O. isn’t part of a practice.
“Of course, I will deliver your baby,” he told me during my second appointment. This made my husband and I giggle. Our first child was delivered just after a shift change at our hospital: the midwife and delivery nurses who oversaw our son’s birth had only just arrived. We learned the midwife’s name from the birth certificate.
Furthermore, while Dr. O.’s consultorio is located in a hospital, he operates independently.
“You pick the hospital,” Dr. O. explained. “Then you call me, and I will come there when you are in labor.”
So now we embark on a project to compare birth packages at various hospitals around the city. To this end we are handed glossy brochures with descriptions of rooms and their amenities, birth classes, and a la carte items — like a bed for my husband and extended stays. Our options include private and public hospitals, and we will weigh in details like proximity to our home, but it is thrilling to be able to choose.
I know Mexico is no medical utopia, not by a long shot. But it is a treat to feel like a consumer, rather than a rat in a maze.
Better still, without inexplicable medical bills to hyperventilate over, or hours lost pushing 1 for English and 3 for billing and then languishing on hold, I sure feel a whole lot healthier.
I’m not being anti-american at all here, but I honestly can’t believe this is how your medical system works. Your baby has no say at all over the income, employment or benefit level, why should his or her birth be comprimised because you don’t have a spare £16k lying around? I know the Scottish system isn’t perfect, there are tales of grumpy midwives and your Cys Fib test would only have been carried out if there was a risk of it, but this way seems to treat having a baby like you’re buying a hamburger.
Coming from New Zealand. I feel the same way. I’m really shocked that your system in the US is set up the way it is. It’s a basic human right to have free medical care when you need it.
Wow! Good for you all for taking your birth, happiness, and finances into your own hands. You definitely can not rely on the warped medical system here. A great read on the medical system is “Cover Me: A Health Insurance Memoir” by Sonya Huber. She’s hilarious and looks at having a baby without insurance as well as trying to keep herself healthy. Great, great book!
I am starting to feel the same way about our medical system myself. I had no problems with my Medicade covering my first birth with a birth center based midwife, but now I am on a different Medicade provider and they are covering the prenatal visits with the same midwife, but not the birth itself with her unless it is, according to them, “medically necessary”. Needless to say, later on today, I am going to switch to a Medicade provider who i know will cover my pregnancy and birth with my midwife 100 percent. i fully trust my midwife and cannot imagine birthing in a hospital just because this provider dictates that i should. I had a totally intervention free, out of hospital birth with my first child and would like to keep it that way for my second. It is absolutely rediculous that this provider is pulling this stunt and I am not at all happy.
I’m curious what would happen in the event of a placenta previa or abruption? Does the hospital have the facilities to accommodate that sort of delivery?
Additionally, yes your child will be a US citizen, but he will not be able to run for president (in the unlikely scenario that he would like to, lol)
I had a hospital birth with my first daughter and it was, in every way, not what I wanted. I’m not here to talk about the birth that was not what I envisioned, but my second daughter’s birth… which was amazing! I had a waterbirth at Lisa Ross Birthing Center using the HypnoBirthing Method. I had seven of my family members present for the birth. It was a calm, serene, loving, supportive environment. The midwifes were helpful, encouraging, even empowering. My fiance was in the tub with me, supporting my body and helping me breathe through it. My family was there surrounding us with positive energy and love. My 6yr old daughter was there to share in the experience of a drug-free natural water birth. The only thing that did not go as planned was that my photographer friend was unreachable at the time I went into labor, so the only pictures we have of the birth are the ones my sister took with her phone! Fortunately my dad recorded the birth so we do have that precious keepsake, along with the wonderful memories of our waterbaby Ophelia’s birth <3
I think that there are safe, healthy, hospital alternatives out there, and you should do whatever you can to have the kind of birthing experience that brings you a healthy baby and makes you one happy momma!
I am SO glad that we live in a state that is friendly to midwives, birth centers, and home births! I am planning on having the baby at the Birth center because I feel the same way about the mainstream medical system in our country. Not only is the birth center so much more supportive of a woman and her partner during labor, but it is way more budget friendly than delivering at a hospital because they don’t make you stay there for 3 days, and the only medical procedure you may have to pay extra for is the stitches if you tear or get an episiotomy. I think birthing in the USA would be so much better if all of the states would allow midwives to practice at home births and birthing centers, because then all low risk births could happen outside of the hospital, and only the ones who really do need a medical intervention for the safety of the mom or baby will need to go into the hospital.
Hi there. I agree with the bulk of your comment accept for one thing. Yes, all low risk women can birth outside of the hospital if all states supported midwife attended home and birth center births, but the media, mainly Hollywood, as well as those pregnancy and birth shows, have instilled so much fear in women about the labor and birth process, that it is going to take quite a while to turn the notion that labor and birth are something to be feared around. only then, will low risk women find it much better to birth outside the hospital rather than in it.
Agreed; I watched videos of home births and with midwives when I was pregnant, and I thought those women were crazy. It took having a routine, low-risk birth at the hospital to realize that it’s not really that critical.
This is very true, but we all know that doctors absolutely love to make something that is low risk turn into high risk with a bunch of unnecessary interventions just so that they can artificially speed up a normal labor, then give something for the extremely high pain it produces, all so that they can keep you nice and quiet and push you out of the l&d ward much quicker so that they can make as much money as possible. Of coarse, I have heard this from other women, I have not experienced a hospital birth myself thank goodness. I have heard that if you come in just as you are ready to give birth or very close to it, they do not try to push unnecessary interventions and medications on you.
i juss have a question i had my daughter over here in the us and im about to have anouther baby next month.. my daughter and her dad are in mexico i came back to have the baby.. but i want to go back to be with them so i was wanting to have the baby in mexico.. is it hard to bring the baby back to the us if he was born in mexico? i juss dont want it to be hard to bring him back wne i come back.. does anyone know about this? please help!!
I was paying for health insurance when I became pregnant with my second child, because my assumption was that I would be covered. Instead, after the baby was born, I got a letter from my insurance saying they won’t cover anything, And got slammed with a bill that took 3 years to pay. My third baby was delivered by my husband, in our van,(oops)and insurance free. WAY BETTER