URBANDALE, Iowa –Imagine if instead of bringing your baby home from the hospital, you never left home in the first place.
That's what the Browns did. Jenner Brown said, "He was born upstairs in our bedroom on a birthing stool."
They had Vincent in the comfort of their home, just like they did with their two year old daughter Inez. Dad Aj Brown said they researched the idea extensively beforehand.
"We had a plan. If something was to go wrong, if there was to be an emergency, what's the closest hospital, what's the most direct route we're getting there, how are we going to do it," he said.
The only problem: who would pay? "We knew ahead of time most likely insurance would not and we'd be all on our own," said Jenner.
“I think there are a number of families in this community that have struggled to get reimbursed for the perfectly wonderful, safe great outcome," said Certified Nurse Midwife Dana Ericson. She’s the Director of Midwife and Doula Services.
She's attended home births for eight years and hospital births much longer. She charges $5,900 and says it’s difficult to even submit for insurance reimbursement.
“Because there is no code for doing a home birth, and bringing everything and making that home environment that incorporates all the care that home birth midwives provide,” Ericson said.
Iowa Birth Organization Founder Amanda Hardi Hillman said, "The number one reason that people, women, and families cite of where they choose to give birth is insurance reimbursement."
Her group promotes equal access to evidence based maternity care. They know home birth isn't for everyone, but they think it should be an option for women with low-risk pregnancies.
Melissa Schnurr knows cost is a big piece of the puzzle. She said, "I'm one of the fortunate people who has the liberty of choosing where I want to give birth because financially my family could afford to do that. That's not the case for everybody."
Melissa had a Certified Nurse Midwife at both her daughters' births. Ainsley was born in the hospital at no out-of-pocket cost. Melissa said her insurance at the time was billed more than $20,000.
Cora was born at home. That cost $5,500. The parents paid it all. They want to know why it seems some insurance companies prefer the expensive route.
"There are a lot of conflicting discussions about health outcomes and we certainly wouldn't want a woman to make a choice solely because it's less expensive or more expensive. We want to make sure mom and baby are safe no matter what," said Denise Hill, the Director of the Health Law Programs at Drake Law School.
She says women considering a home birth need to weigh the risks and benefits. They should have a birth plan in place in case something goes wrong, the certified nurse midwife needs to have a relationship with a physician, and the birth location needs to be near a hospital with quick transportation available.
"Something that is a very natural occurance, which is birth, also needs to be outweighed by the fact that what seems to be a low risk pregnancy, a woman who would not have risks, can change very quickly," Hill said.
The Browns weighed the pros and cons, and the only thing they would change about Vincent's birth, is how much they were reimbursed for it. "It was just a magical experience," said Aj.
As for the Schnurr family, Wellmark Blue Cross and Blue Shield paid for her second daughter's prenatal care with her certified nurse midwife, but the company did not reimburse her for the cost of the home birth. Melissa said her provider was not in network, but she wanted to try to get reimbursed anyway.
A spokesperson for Wellmark Blue Cross and Blue Shield tells us a home birth is covered, as long as the member uses a certified nurse midwife who is in network. She said it's important for people to check with their insurance plan before having a home birth.