Insurance and the Expense of Home Birth
We had read that home birth tends to cost more out of pocket than hospital birth, primarily because a great many insurance companies don't cover midwife services or home birth expenses. There's also the reality that, even if your insurance company *does* cover midwife services, your midwife may not accept your insurance. Insurance aside, we had read that home birth in the United States is *crazy* expensive, and I was gearing up to be disappointed by the reality that we simply couldn't afford to give birth at home.
My fears proved unfounded. There may indeed be places in the U.S. where home birth will cost you your first-born (pardon the expression), but at least in Kentucky, or perhaps just with the midwife we interviewed today, this is not the case. We, at least, will end up paying less out of pocket for a home birth than we would to give birth in a hospital. Unfortunately, we will need to maintain a relationship with our current OB in case I go into labor early again and need to deliver at the hospital (I delivered 12 weeks early with my first pregnancy), and this will mean a bit more expense over all. But if the midwife we choose has a fee as reasonable as the midwife that we interviewed today, this shouldn't be too much of a problem.
Husband as Primary Birthing Partner
My strongest desire regarding labor and delivery is that my husband be allowed to fill as active a roll in the process as we both desire and he can cope with. My husband is my best friend, hands down, and no one knows me as well as he does. Granted, there will be plenty of moments in labor and delivery when a trained professional will know better than my husband what my body needs, but it's not her face I'll be looking for in my moments of distress, and if it's my husband I want (and I foresee that it will be), everyone in the room had darn well be ready to get out of the way and let him through.
I want very much to avoid unnecessary interventions--epidural, forceps, suction. This desire is near the top of my list of reasons for wanting a home birth. Specifically, I want to avoid an episiotomy. I'd rather tear naturally. I'd rather not tear at all. I know there are no guarantees, but I've read about (and observed) a great many techniques for avoiding tearing, and I wanted to know that the midwife we choose is versed in these techniques and ready to employ them.
Finding a Relational Fit
The one issue I *had* thought about was how my husband and I would mesh with each of the midwives we interview. What I have been told is that, with a home birth, it is absolutely essential that the midwife and laboring mother have a positive, trusting relationship--not simply a luke warm, I-guess-I-can-live-with-this-person kind of relationship. I assume that it's helpful if the midwife is also a good relational fit with my husband. In this respect, I feel I was very well prepared to interview. It doesn't take long to figure out if I can manage to mesh with someone. We got answers to important questions (most of which were brought up by my husband, God bless him), but I also talked with her about my first experience with labor and delivery, and was able to gauge her responses to my anxieties and desires for my next experience. I felt heard and affirmed, and I think this is one of the most important things (for me, anyway) that came out of the interview.
These were some of our questions and anxieties--the information we considered key in our process of choosing someone to attend us in the birth of our baby. Your questions and concerns may differ from ours, but thinking through them ahead of time--even writing them down--will help you get the most out of your interviewing process.