Our family is growing in many ways... Growing in numbers, knowledge, parenting skills, growing in love, in our faith, growing our culinary skills (if you can call it that), growing without gluten (some of us), growing green...........

Thursday, March 3, 2011

VBAC Update and New Plans

If you read my post from last week, you know we're wanting to go for a VBAC with our next baby (that is nonexistent at this point). We met with a dr within our network that had said they would "allow" us to do this, and we posted about the consultation. I'm not sure if my emotions showed through with that post; I really tried to keep them out. A main reason is because I wasn't having such great emotions in regards to the meeting. While the doctor said a lot of things we liked, there were a few things we did not...and my gut was not really feeling it. I walked out of there feeling uneasy and hesitant. After letting some of my feelings stew for a while and discussing things with Ryan, we both felt this OB office was not the one for us. We believe, and strongly, that if we stay with this office, our odds of having an emergency or scheduled c-section would be much too great.

For now, we have some good news and some bad news. 

The good news is, we have found a place we really like, one that we feel is our best chance at a successful VBAC. This practice is well-known in the community/state for being very VBAC-friendly, and they have plenty of experience in this area. It's also at another top hospital in the area (one of the two that we would consider - I'm sure it's an easy guess if you know where we are located). Not only that, but their philosophy toward pregnancy and delivery are way more in line with my own, which is awesome. I spoke extensively with a lady about my entire situation, including my hesitations about the other office, and she totally agreed with our concerns. Everything she had to say to me was exactly what I would want to hear (and at this point, I KNOW what I want to hear and am not easily misled), not only when it came to VBACs but also just regular care. She was so validating of what I felt (concerns, what I wanted, every little thing), which was a wonderful thing to experience.While speaking with her, I had this amazing sense of calm come over me, this sense of "this is where I am meant to be." I had to hold back tears during the call. Now, maybe all of that doesn't make sense to some people, and I'm not going to put my entire medical care in someone's hands SOLELY on my gut and intuition...but I also will not discount those feelings. They're there for a reason. Besides, I had my gut feelings AND factual information all in my favor here.

The bad news...this office is not in-network, so our insurance will not cover care there. We spoke with the insurance company and were told to write a letter explaining our reasons for requesting a benefit exception. Did we really expect them to make this allowance? Not really. We were hopeful but we were also realistic. We wrote an extensive letter that laid out the reasons we should be treated at this other out-of-network provider. We included all the ways this would save them money - because it would save them a LOT of money, really. We haven't received our actual response via email/postal mail...I'm hoping they will at least give their reasons in the response, but I'm not sure if they do that or not. I called earlier today and was given a quick (and not the most polite) response: DENIED. I was told they had emailed, but um...we've received nothing, and that was over six hours ago.

So, what does this mean? Well, it means we wait, though we're not 100% sure yet what all that means... We are waiting to see what their response is before we know if we can appeal and give them other specific information they request from us. Or we wait until we can change insurance providers. Open-enrollment, when we can elect to change insurance providers, is in the fall. We'll make the switch then to an insurance that we know will cover our care at this other practice. It will mean a higher monthly cost, but it will get us what we want and what we need. This isn't just us wanting something that is over the top. This is us wanting quality care that we need and deserve. It also means waiting a heck of a lot longer to get pregnant than we were planning. This is not really what we want, but as the chance at a VBAC and having a supportive doctor are crucial to us, if we need to wait, we wait. There are all kinds of emotions tied up in that; I won't lie. It's been a tough week and a half. There have been many hours staying up unable to sleep, many wild dreams about meeting with doctors, being pregnant, and all sorts of things. It's not been easy. But we're going to be realistic, logical, and we're going to do what it takes to get what we need. Even if that means waiting.

Now, I know some of you are wondering what is so important about having a VBAC anyway. I intend to address that. We aren't going into this because of some selfish desire for me to "experience" natural childbirth. Sure, I would love to go through that and deliver a baby on my own, the way my body was made to do. But no, that is not the reasoning. This is all for the health of a baby. We've done our research, we know the reasons for vaginally delivering a child, the risks and benefits of that versus any risks/benefits of having a cesarean section.We're going to put up some posts looking at all of that and explaining why this is so very important to us. But rest assured it's all about what is best and safest for baby (and what is safest for mother, too). Nothing selfish...unless you consider wanting the safest possible delivery selfish.


Kevin A. Puckett said...

Sorry about all this Daisy. I know this would complicate things, but is there anyway you could switch care mid-pregnancy to the office you like so at least the could handle your delivery?

Daisy and Ryan said...

Thanks, Emily! And yeah...if we were to get pregnant - with the due date being AFTER the different insurance would actually take effect, we could switch providers. I wouldn't want to be too far into the pregnancy. Not that I wouldn't trust it to work out, but...for various reasons. I don't want to be dishonest with the first provider and string them along, knowing I wouldn't be staying with them. But I also would wonder how it would work if they knew up-front that I would be switching. And there would be extra stress, and I would have to be planning things with a dr I didn't completely trust or agree with, knowing I wouldn't follow-through later, etc. AND I would much rather have all of my care at the other place b/c I feel I would be calmer and have less stress and worry with them (even if I knew I wouldn't be at the first place all the way through). Not sure if all of that makes sense.

That said, we haven't dismissed the idea of getting pregnant and seeing someone else for a short time and then switching. We've even made sure we would be allowed to do that with the insurance, etc. We just need to plan how long we would want to be at a place we won't stick with and decide how we want it all to go, how we want things timed, etc... I know this other office accepts people up through the very end of their pregnancies - a lot of people actually come in when they're very close to their due dates b/c they've realized their OB will not be as supportive as they first believed w/ their desires for VBACs (which is what we're trying to avoid, of course).

So, yeah, it's an option. Just trying to figure out how we would want to do it all. :) Thanks!!!

Becky said...

I think you should look to see if there is a midwife who is associated with the hospital you want but that is also in your network. It might be the perfect solution. You get prenantal care with the same person who would be in the room at delivery time but you still have the hospital you want. It would be worth looking into anyway.

Daisy and Ryan said...

Becky - Funny you should mention that. I didn't go into it on the post b/c we still need to learn a bit more info before I put some stuff out there as "factual." BUT the place we want to go (with a UNC office) has midwives. From what I was understanding, I could have a "team" that would provide my care..instead of seeing a different dr each time...it would consist of a dr, nurse, and midwife. I think it's awesome they have midwives at this location! There is a birthing center nearby that would be AWESOME, but...they don't work with people in my situation b/c it's too risky - they don't deliver at the hospital. Now, I don't know that I'm understanding everything 100%, which is why I didn't write about that in the post, but that is how I understand it at this point. I do KNOW that they have midwives in the office that I can/will be seeing.

I'll just have to learn more about the details once we go in for a visit. Not sure if we're going to wait for a consultation or go on and go now - depends on insurance. The first place bills insurance and we even had to pay the specialist co-pay, but I'm not sure if the other place does that yet. (I always expected consultations to be different and not have a cost b/c you're not yet a patient...but I guess it's up the individual place!) I am definitely interested in care from a midwife, though! :) I'm hoping this place is what we're looking for and will give us that service. It's something we're definitely wanting to ask more about!

This place is really neat, though...there are three ways to get care there. One is group care, which I've heard about recently but not many places do...you go for longer appt times but meet with the dr/midwife briefly, take your own stats, and then meet with 8-10 other pregnant mamas - total of like 90 minutes for everything. Really neat. Or you can have the team of a few people over you - you see the same people throughout the pregnancy, though, so it's consistent. Or (for low-risk and after-first pregnancies, which wouldn't be me b/c of the VBAC) you can even go in much less often. It's really neat. I already love this place. They even have a group care system for babies, where you meet with other moms/babies instead of always just a quick visit with a dr. Pretty cool.

Kevin A. Puckett said...

I think you could certainly find a midwife who would be supportive of providing your prenatal care and understanding that you need a doc to do the VBAC. That way the switch wouldn't be awkward or dishonest.