8 ms·

Do you have to pay to hold your newborn in the US? Land of the free indeed

wyager 5y ago
Medical is probably the single most regulated industry in the US. The US landed at the worst possible system where the government mostly only pays for medical for old people (where the returns on expenditures are very low), but simultaneously interferes a lot with hospitals and insurance in ways that make the process very punishing for everyone. You can get much better service for way less money if you avoid the red tape and do a home birth.
- aidos 5y ago
  We’ve had 2 home births now. And the 1st birth was nearly a homebirth too. They’ve all gone well for us, so I recommend them from that point of view, but on the other hand, I don’t recommend them because I’d hate to have any hand in a situation that went wrong for someone else. Our last we actually delivered on our own because the midwifes didn’t get to us in time.
  - choeger 5y ago
    While home birth is certainly possible and apparently can be a very nice experience, I strongly suggest going into a hospital for birth (you should be able to choose a hospital of your liking after talking to the nurses/doctors/midwifes working there). Birth is safe in most cases, but complications do happen. While the probability is low, the possible damage is extreme. Please consider the availability of experienced medical professionals as a safety net for mother and child! I witnessed an "emergency" C-section after 18hours of labor without any prior indications and was extremely happy that professionals were literally in the next room when this became necessary.
    - jmkd 5y ago
      As a counterpoint, home births are in general very safe if recommended prerequisites have been met. Typically: 1) low-risk pregnancy 2) within X minutes of suitable hospital 3) higher level of monitoring in late pregnancy and perhaps two midwives at birth Birth - a natural process - has been commercially medicalised, especially in Brasil (C-section rate >60%) and the US (>30%). If giving birth at home was normalised, we'd see a huge growth in natural birth and an increased availability for medical staff to support in emergencies if required. But the rates of emergencies would actually decline too.
      - bredren 5y ago
        Point 1 is a big point. Lots of things make a birth not “low risk.” Otherwise I think it’s an awesome idea and encourage people to consider it. Birthing centers are also a great alternative. I do not especially like the idea of hospitals as default places of birth, but acknowledge the potential value when needed.
    - souprock 5y ago
      I probably wouldn't have most of my family if I'd gone to a hospital. My twins would have been a C-section, and then the scar would have led to another C-section and to troubles with the placenta invading the scar. Before long the uterus just plain wouldn't work OK, and would endanger the lives of future babies. Avoiding a C-section is really important for having a large family. My 13th is due in 6 weeks.
      - captainredbeard 5y ago
        Congrats on your family!!
  - okprod 5y ago
    Very interesting. A coworker hired a professional doula and their home birth went well. I'm not sure yet what we would do.
- PragmaticPulp 5y ago
  > You can get much better service for way less money if you avoid the red tape and do a home birth. My wife had unexpected complications that would have been disastrous, possibly fatal if we had been at home rather than a hospital for delivery. I can’t imagine trying to rush her from home to the hospital mid-delivery. I’m forever grateful for the medical care we received at the hospital during delivery. It’s simply not possible to deliver the same care at home.
neofrommatrix 5y ago
Yes. For caesarean they do. https://www.cbsnews.com/news/doula-explains-why-hospital-charged-parents-39-to-hold-newborn-baby-in-viral-post/ https://www.cbsnews.com/news/doula-explains-why-hospital-cha...
- frankenst1 5y ago
  “During a caesarean, many people become shaky, nauseous, uncomfortable, even faint,” Grant explained. “These are normal physiological reactions. In order to facilitate skin to skin in the OR, an extra nurse needs to be available to assist.”
  - tobr 5y ago
    I don’t understand how that is a “mic drop” as they put it in the article. If these are normal physiological reactions, why would you charge extra for it? It must be the request to hold your newborn child that they consider not to be normal, then?
    - dboreham 5y ago
      Normally the baby is whisked quickly out of the OR to a place that's not a tightly controlled clean environment, where skin to skin contact is facilitated without charge (to the father/non-birthing-close-relative, obviously, since mother is still in recovery). Source: two sons born this way in the US.
  - deleted 5y ago
    [deleted]
tialaramex 5y ago
Sure https://www.vox.com/2016/10/4/13160624/medical-bills-birth-delivery https://www.vox.com/2016/10/4/13160624/medical-bills-birth-d... "Skin to Skin after C-Sec" $39.95 [C-Sec here means Caesarean section, a relatively safe surgical procedure to delivery a baby via an incision in the mother's abdomen. Although mostly safe, and certainly preferable to situations where vaginal delivery would incur an undue risk to mother or baby, C-Section is undesirable because it increases the rate of complications both that time, and in any subsequent pregnancy. But it's very common in the US, for a variety of reasons.]
- agumonkey 5y ago
  facepalm how long until they try to give everyone the best service according to their budget. one arm holding 30$, two arms 40$, full cuddle 70$
- prionassembly 5y ago
  I think the whole rhetoric about C-sections needs to be adjusted for a time where many older women are having babies. There's a kind of narrative about optimal pregnancy/childbirth/early care that seems to make sense for 27-year-olds who will sneeze and squeeze out their baby and shoot milk at the thought of their baby. But that's increasingly not the norm. More generally: declining birth rates are one of our top-ten societal problems if we think 50-100 years ahead; part of addressing it is changing the conversation around pregnancy in one's late 30s and even early 40s. From watching TV shows it would seem by age 35 your shot is shot.
Spooky23 5y ago
You pay for a nurse or aide to be ready to intervene if there’s an issue in a post-caesarean situation. In our case, the hospital my wife delivered in pushed skin to skin heavily, but after a minute or two, I ended up holding our son, skin to skin for the next 10-15 minutes becuase their policy didn’t allow mom to hold the baby while they sutured and did their thing. Once they were done in the OR, back to mom. Usually this sort of absurdity on the billing front is based on ways to increase Medicaid reimbursements. Since Medicaid patients are usually less likely to have good primary and pre-natal care, they have a high complication rate and typically are a money loser for the hospital. In an extreme case, an opioid addicted baby costs >$1M to deliver and discharge, a tragic story all around.
- prionassembly 5y ago
  > You pay for a nurse or aide to be ready to intervene if there’s an issue in a post-caesarean situation. We had a pediatrician in the room (which is also a perfectly opportunistic for the ob/gyn to score a referral). OR theater was main OB/GYN (which we chose), his assistant (also ob/gyn, younger and oddly published), anesthesiologist, instruments clerk and pediatrician. I don't think we had a nurse at all.
  - drknownuffin 5y ago
    What country were you in? In the US, a nurse is highly standard. If you're not getting a c-section, the usual array is: OB/GYN, plus or minus a resident or assistant, doing the delivery and doing any post-delivery laceration repairs; and a nurse who brought in instruments and is on hand to assist with repositioning the mother, getting more equipment, etc. In most places it's 1-2 nurses. If everything is expected to be, and remains, stable a pediatrician will swing by at some point to check in. This isn't generally a major source of referrals for the pediatrician - (a) many people have already established a relationship with a pediatrician in anticipation of the birth, and (b) in many reasonably sized hospitals the guy who drops by is either a hospitalist or a neonatologist, and they don't have an outpatient practice. Anesthesiologist may drop by to start an epidural, but otherwise isn't present on a continued basis. If in the OR for a c-section, you'll have the OB and a resident or an assist; one nurse just looking after scrub and tools; a second nurse on hand for additional assistance and to receive the kid for the initial clean-up; an anesthesiologist handling your anesthesia; plus/minus a med student or two either holding instruments for the OB or speaking with the anesthesiologist. If everything is and remains stable, peds will swing by. If the kid is unstable or things go sideways, peds +/- their resident will be on hand for the delivery - a neonatologist if the hospital has one. I've seen some variation in different places of course, but that's pretty much par for the course. (When I was in the latter part of med school I had a brief fling thinking I'd do OB/GYN, so I did sub-I's in a few different hospitals around the country. Thank god that idea passed.)
gambiting 5y ago
Wait, you have to pay to have a baby in the US? The wealthiest country in the world cannot even pay for the birth of its own citizens? I can understand arguments for private healthcare etc....but making people pay to give birth is insane.
- rootusrootus 5y ago
  Tell me where it is completely free. And I don't mean paid for via taxes.
  - gambiting 5y ago
    No offense, but that's such a weird way of looking at it. Even in the US every reasonable adult would say that driving on public roads is free, right? But roads are maintained from taxes so how dare you call them free!!! It's the same thing here - other countries just pay for their citizens giving birth from taxes. The cost to you as a citizen is zero. No it's not free, someone pays for it. But I never used the word free anywhere, so I feel like you want to have an argument for the argument sake.
    - rootusrootus 5y ago
      > every reasonable adult would say that driving on public roads is free, right? No? I certainly don't. I'm constantly aware of how much we don't spend on roads. Any conversation trashing the US for not having healthcare that is free-at-point-of-sale is meaningless without discussing the larger system. What can I say, I get tired of Europeans trashing the US using singular metrics as if they're a meaningful reflection of policy. You want to get into a more interesting conversation, let's talk about how the US citizenry is essentially subsidizing the universal healthcare that many other countries enjoy. That's not some political talking point, either, it's legitimate.
      - gambiting 5y ago
        >>No? I certainly don't. I'm constantly aware of how much we don't spend on roads. Let me ask this then - is there anything in the world you would call free, or do you avoid the word out of principle? >>Any conversation trashing the US for not having healthcare that is free-at-point-of-sale is meaningless without discussing the larger system. I think you are purposefully trying to drag me into a discussion about a point I didn't make, I merely expressed surprise at the fact that United States of America, the wealthiest nation in the world, cannot even pay for the births of its own citizens. No statement anywhere about healthcare as such. If you want to read into it in my comment, then that's on you. >>You want to get into a more interesting conversation, let's talk about how the US citizenry is essentially subsidizing the universal healthcare that many other countries enjoy. Let's have that discussion then, please, I'm curious to hear your thoughts.
rootusrootus 5y ago
Could we put aside the politics? Jeez.

Medical is probably the single most regulated industry in the US. The US landed at the worst possible system where the government mostly only pays for medical for old people (where the returns on expenditures are very low), but simultaneously interferes a lot with hospitals and insurance in ways that make the process very punishing for everyone. You can get much better service for way less money if you avoid the red tape and do a home birth.

aidos 5y ago
We’ve had 2 home births now. And the 1st birth was nearly a homebirth too. They’ve all gone well for us, so I recommend them from that point of view, but on the other hand, I don’t recommend them because I’d hate to have any hand in a situation that went wrong for someone else. Our last we actually delivered on our own because the midwifes didn’t get to us in time.
- choeger 5y ago
  While home birth is certainly possible and apparently can be a very nice experience, I strongly suggest going into a hospital for birth (you should be able to choose a hospital of your liking after talking to the nurses/doctors/midwifes working there). Birth is safe in most cases, but complications do happen. While the probability is low, the possible damage is extreme. Please consider the availability of experienced medical professionals as a safety net for mother and child! I witnessed an "emergency" C-section after 18hours of labor without any prior indications and was extremely happy that professionals were literally in the next room when this became necessary.
  - jmkd 5y ago
    As a counterpoint, home births are in general very safe if recommended prerequisites have been met. Typically: 1) low-risk pregnancy 2) within X minutes of suitable hospital 3) higher level of monitoring in late pregnancy and perhaps two midwives at birth Birth - a natural process - has been commercially medicalised, especially in Brasil (C-section rate >60%) and the US (>30%). If giving birth at home was normalised, we'd see a huge growth in natural birth and an increased availability for medical staff to support in emergencies if required. But the rates of emergencies would actually decline too.
    - bredren 5y ago
      Point 1 is a big point. Lots of things make a birth not “low risk.” Otherwise I think it’s an awesome idea and encourage people to consider it. Birthing centers are also a great alternative. I do not especially like the idea of hospitals as default places of birth, but acknowledge the potential value when needed.
  - souprock 5y ago
    I probably wouldn't have most of my family if I'd gone to a hospital. My twins would have been a C-section, and then the scar would have led to another C-section and to troubles with the placenta invading the scar. Before long the uterus just plain wouldn't work OK, and would endanger the lives of future babies. Avoiding a C-section is really important for having a large family. My 13th is due in 6 weeks.
    - captainredbeard 5y ago
      Congrats on your family!!
- okprod 5y ago
  Very interesting. A coworker hired a professional doula and their home birth went well. I'm not sure yet what we would do.
PragmaticPulp 5y ago
> You can get much better service for way less money if you avoid the red tape and do a home birth. My wife had unexpected complications that would have been disastrous, possibly fatal if we had been at home rather than a hospital for delivery. I can’t imagine trying to rush her from home to the hospital mid-delivery. I’m forever grateful for the medical care we received at the hospital during delivery. It’s simply not possible to deliver the same care at home.

neofrommatrix 5y ago

Yes. For caesarean they do. https://www.cbsnews.com/news/doula-explains-why-hospital-charged-parents-39-to-hold-newborn-baby-in-viral-post/ https://www.cbsnews.com/news/doula-explains-why-hospital-cha...

frankenst1 5y ago
“During a caesarean, many people become shaky, nauseous, uncomfortable, even faint,” Grant explained. “These are normal physiological reactions. In order to facilitate skin to skin in the OR, an extra nurse needs to be available to assist.”
- tobr 5y ago
  I don’t understand how that is a “mic drop” as they put it in the article. If these are normal physiological reactions, why would you charge extra for it? It must be the request to hold your newborn child that they consider not to be normal, then?
  - dboreham 5y ago
    Normally the baby is whisked quickly out of the OR to a place that's not a tightly controlled clean environment, where skin to skin contact is facilitated without charge (to the father/non-birthing-close-relative, obviously, since mother is still in recovery). Source: two sons born this way in the US.
- deleted 5y ago
  [deleted]

tialaramex 5y ago

Sure https://www.vox.com/2016/10/4/13160624/medical-bills-birth-delivery https://www.vox.com/2016/10/4/13160624/medical-bills-birth-d... "Skin to Skin after C-Sec" $39.95 [C-Sec here means Caesarean section, a relatively safe surgical procedure to delivery a baby via an incision in the mother's abdomen. Although mostly safe, and certainly preferable to situations where vaginal delivery would incur an undue risk to mother or baby, C-Section is undesirable because it increases the rate of complications both that time, and in any subsequent pregnancy. But it's very common in the US, for a variety of reasons.]

agumonkey 5y ago
facepalm how long until they try to give everyone the best service according to their budget. one arm holding 30$, two arms 40$, full cuddle 70$
prionassembly 5y ago
I think the whole rhetoric about C-sections needs to be adjusted for a time where many older women are having babies. There's a kind of narrative about optimal pregnancy/childbirth/early care that seems to make sense for 27-year-olds who will sneeze and squeeze out their baby and shoot milk at the thought of their baby. But that's increasingly not the norm. More generally: declining birth rates are one of our top-ten societal problems if we think 50-100 years ahead; part of addressing it is changing the conversation around pregnancy in one's late 30s and even early 40s. From watching TV shows it would seem by age 35 your shot is shot.

Spooky23 5y ago

You pay for a nurse or aide to be ready to intervene if there’s an issue in a post-caesarean situation. In our case, the hospital my wife delivered in pushed skin to skin heavily, but after a minute or two, I ended up holding our son, skin to skin for the next 10-15 minutes becuase their policy didn’t allow mom to hold the baby while they sutured and did their thing. Once they were done in the OR, back to mom. Usually this sort of absurdity on the billing front is based on ways to increase Medicaid reimbursements. Since Medicaid patients are usually less likely to have good primary and pre-natal care, they have a high complication rate and typically are a money loser for the hospital. In an extreme case, an opioid addicted baby costs >$1M to deliver and discharge, a tragic story all around.

prionassembly 5y ago
> You pay for a nurse or aide to be ready to intervene if there’s an issue in a post-caesarean situation. We had a pediatrician in the room (which is also a perfectly opportunistic for the ob/gyn to score a referral). OR theater was main OB/GYN (which we chose), his assistant (also ob/gyn, younger and oddly published), anesthesiologist, instruments clerk and pediatrician. I don't think we had a nurse at all.
- drknownuffin 5y ago
  What country were you in? In the US, a nurse is highly standard. If you're not getting a c-section, the usual array is: OB/GYN, plus or minus a resident or assistant, doing the delivery and doing any post-delivery laceration repairs; and a nurse who brought in instruments and is on hand to assist with repositioning the mother, getting more equipment, etc. In most places it's 1-2 nurses. If everything is expected to be, and remains, stable a pediatrician will swing by at some point to check in. This isn't generally a major source of referrals for the pediatrician - (a) many people have already established a relationship with a pediatrician in anticipation of the birth, and (b) in many reasonably sized hospitals the guy who drops by is either a hospitalist or a neonatologist, and they don't have an outpatient practice. Anesthesiologist may drop by to start an epidural, but otherwise isn't present on a continued basis. If in the OR for a c-section, you'll have the OB and a resident or an assist; one nurse just looking after scrub and tools; a second nurse on hand for additional assistance and to receive the kid for the initial clean-up; an anesthesiologist handling your anesthesia; plus/minus a med student or two either holding instruments for the OB or speaking with the anesthesiologist. If everything is and remains stable, peds will swing by. If the kid is unstable or things go sideways, peds +/- their resident will be on hand for the delivery - a neonatologist if the hospital has one. I've seen some variation in different places of course, but that's pretty much par for the course. (When I was in the latter part of med school I had a brief fling thinking I'd do OB/GYN, so I did sub-I's in a few different hospitals around the country. Thank god that idea passed.)

gambiting 5y ago

Wait, you have to pay to have a baby in the US? The wealthiest country in the world cannot even pay for the birth of its own citizens? I can understand arguments for private healthcare etc....but making people pay to give birth is insane.

rootusrootus 5y ago
Tell me where it is completely free. And I don't mean paid for via taxes.
- gambiting 5y ago
  No offense, but that's such a weird way of looking at it. Even in the US every reasonable adult would say that driving on public roads is free, right? But roads are maintained from taxes so how dare you call them free!!! It's the same thing here - other countries just pay for their citizens giving birth from taxes. The cost to you as a citizen is zero. No it's not free, someone pays for it. But I never used the word free anywhere, so I feel like you want to have an argument for the argument sake.
  - rootusrootus 5y ago
    > every reasonable adult would say that driving on public roads is free, right? No? I certainly don't. I'm constantly aware of how much we don't spend on roads. Any conversation trashing the US for not having healthcare that is free-at-point-of-sale is meaningless without discussing the larger system. What can I say, I get tired of Europeans trashing the US using singular metrics as if they're a meaningful reflection of policy. You want to get into a more interesting conversation, let's talk about how the US citizenry is essentially subsidizing the universal healthcare that many other countries enjoy. That's not some political talking point, either, it's legitimate.
    - gambiting 5y ago
      >>No? I certainly don't. I'm constantly aware of how much we don't spend on roads. Let me ask this then - is there anything in the world you would call free, or do you avoid the word out of principle? >>Any conversation trashing the US for not having healthcare that is free-at-point-of-sale is meaningless without discussing the larger system. I think you are purposefully trying to drag me into a discussion about a point I didn't make, I merely expressed surprise at the fact that United States of America, the wealthiest nation in the world, cannot even pay for the births of its own citizens. No statement anywhere about healthcare as such. If you want to read into it in my comment, then that's on you. >>You want to get into a more interesting conversation, let's talk about how the US citizenry is essentially subsidizing the universal healthcare that many other countries enjoy. Let's have that discussion then, please, I'm curious to hear your thoughts.

rootusrootus 5y ago

Could we put aside the politics? Jeez.