Advice on traveling to US for birth of baby

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Hi there,

 

I am a US citizen married to a German and am considering returning to the US for a few months for childbirth. I did a bit of digging around online and haven't come up with much helpful information other than most international health coverage plans do not cover pregnancy related costs if you are already pregnant when you set up the plan. So I am researching now, before pregnancy, so I can weigh my options.

 

Ideally, I would like to spend the first months of pregnancy in Germany and my German health insurance would cover that. Then I would like to go to the States and spend time with my family in the latter months of pregnancy and deliver in the US as well.

 

Has anyone done this and have experience navigating the international maternity coverage marketplace? Is it best for me to just contact the birthing centers and hospitals that I would be interested in and discuss payment plans with them directly?

 

Any advice would be great. Thank you.

 

Best,

 

Anja

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A hospital birth can cost ,600 or more, according to a recent Washington Post article. A C-section costs even more.

 

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And no, you cannot buy pregnancy coverage after you become pregnant. That's not how insurance works. Travel insurance policies exclude maternity benefits anyway, because they're supposed to be for unforeseen emergencies.

 

Perhaps someone in your family can come here for a month or two. Americans can stay in Germany for up to 90 days without a visa.

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Yes, El Jeffo, hospital births in the US are pricey. And I am aware of the issue with insurance.

 

No, my family is unlikely to travel here for health and other reasons. Another piece of why I want to look into options for having the child there.

 

Thank you for your input.

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Remember that airlines determine when a pregnant woman can fly. I think that after the sixth month of gestation you're grounded. Unless you're like a friend of ours and flying with your physician husband - they came to my son's wedding in Germany when she was seven months pregnant.

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There are lots of online forums about people's efforts to negotiate in advance the costs of childbirth in US hospitals and birthing centers, so if you haven't already checked, have a look at those for advice (though, I'm afraid, much of it is sad tales of woe). One piece of advice I've seen repeatedly is to offer to pay a substantial amount of the cost in cash up-front (as part of the concluding prenatal care, I guess), or immediately post-natal. With any sort of pain relief (vag birth), final prenatal care, immediate postnatal care for mother and child (various tests required by state laws, etc.), physicians' and hospital fees - whatever you inquire about, make sure it's soup to nuts and not just bare bones "the birth itself" and not any of the before and after that may be required by the physician, the hospital's policy, or state law. Birthing houses -- or home birth -- would be significantly less, of course (again, assuming straightforward birth, no complications) if that would be an option for you.

 

This recent NYTimes article gives a sense of the landscape in terms of how pricing *may* or may not be determined, depending on the health care institution involved, and of course with all the caveats about these being estimates for a birth without complications. Note that the costs vary considerably by region and precise location in addition to the particular institution involved, so you might get a much better price/payment conditions by being geographically flexible, at least to some degree.

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I've had babies in both places. Even with pretty good insurance in the US, the copays on a hospital birth were in the neighborhood of $2,000. In Germany, it was all covered. The prenatal care in Germany was much more intense, and the options of classes were varied and some covered by insurance. I would really recommend against flying late in a pregnancy. The higher risk is not just the scenario of giving birth on an airplane, but actually you are at an elevated risk of blood clots from early on. Giving birth is stressful no matter where you do it. You may want to look around at the birthing centers and other options here in Germany before deciding. You can take tours at most places. If you live near a big city, there are likely several gynos and clinics where English is a strong second language.

 

This is a good primer Baby

 

The babycenter also has a German website, if you're interested.

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If you end up going back to the US to give birth, you might seriously want to consider shopping around for a less expensive hospital. From an article published just today:

 

 

California women were charged between $3,296 and $37,227 for an uncomplicated vaginal delivery, depending on which hospital they visited, researchers report.

 

In addition, the investigators found that for a cesarean delivery, women were billed from $8,312 to nearly $71,000.

And:

 

 

Hsia and her colleagues found that they could only account for 35 percent of the difference between hospital bills, even after considering such variables as length of a patient's hospital stay, the competitiveness of a market, and the ownership and operation of a hospital.

 

That means 65 percent of what a California hospital charges for a normal delivery is based on nothing the researchers could identify.

Source: http://www.webmd.com/baby/news/20140116/having-a-baby-price-tag-for-delivery-varies-widely

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It's an understandable desire that may be (and probably is) infeasible. But not stupid.

 

edit: although having known several infants who ended up in he nicu, it may be extremely risky, financially.

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Seriously. Stay in Germany for the entire process. Not only are you already paying into the German health care costs, the maternity leave is beyond awesome. We have an 11-month old and my wife is only now going back to work. Fan-friggin'-tastic.

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I think I've talked about Fuenfling's birth on the forum. My fifth pregnancy, everything normal, easy delivery. But on Day #3 I quickly became unable to walk and had a lot of pain in the front of my pelvis with motion. An orthopedist was called into the Frauenklinik where I'd given birth, and he said that due to a few extra pushes of hormones, my pelvic girdle had separated at the symphysis (where the bones join). It was perhaps a centimeter at the most, but it was enough to keep me off my feet. The hospital kept me for four whole weeks, until I was able to walk unaided. They should have transferred me to the Stadtkrankenhaus, but there was no one at home to take care of my baby.

When I returned to the US, I told my old OB about this. He chuckled and said, "Oh, here we just take care of it with steroids." Possibly. My OB was of the old school, who'd "never lost a father yet" and who didn't believe in new-fangled notions like childbirth without drugs.

But anyhow, what I'm saying is that you never ever know what might go wrong, and certainly my four weeks and Fuenfling's care were fully covered in Germany. Despite the horror stories some mothers and fathers have posted on TT - and their experience must have been terrible - overall I would say you and your baby will be better off waiting in Germany for its birth.

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Agree with all of the posters above!

 

Comparing my pregancy (no problems) with my sister (in the US), son born 6 weeks early...

 

I had more prenatal care no charge, free choice of gynecologist, could choose the hospital (we visited 3 until I found one that fit). . .

She had my nephew at the local hospital, she was find after the birth so they wanted to send her home and keep him for observation since he was early for 3 days?! She fought and received a "closet" and could pay $8.000 after birthing process and hospital stay despite quite good insurance.

 

Midwife's, this process I would recommend starting (especially as a not native speaker) already in the 3m of pregnancy. It is important that you understand one another (language) and beliefs. I love living here but do not believe in "holistic" medicine and do not approve of herbal medicines! So this was important for me. The midwife was great and I looked forward to her visit each day (or later in the week) to speak to an adult and she realized our daughter had KISS sydrome (no sleep for 3m) and helped me find an orthopedic doctor for children. She was helpful and motivating (but I speak German) and really helped me continue breastfeeding (but not pushing) when you were about to throw in the towel. She was also open to my ideas (American ideas) and we could discuss things and it was like having my mother here when she could not be.

 

US citizenship, if you or the father is a citizen, no problem but both parents have to go to the embassy. We used this as a good reason to visit Berlin with her aunt when she was 3 months old!

 

For the birth, I would recommend a "family" room as an American. The whole idea of having to share a room with others and newborns after giving birth or worse a bathroom was a big turnoff for me. COst 90-100 EUR a night, which meant, my husband could come and go without disturbing anyone when he pleased, our daughter was directly in our room. Second bed, he could sleep here! He received meals with me (and a bit better than the average hospital food) and even a newspaper. Was a great option for us since we were 3 weeks early and had a dog at home, so he could be in both places at once.

 

Flying, I was traveling a lot for work and never really thought much of it until 7 1/2 m and that flight just to Paris was uncomfortable, to the US, I would think very unpleasant.

 

Better to use the wonderful German parental leave, and if you can afford it, both take several months off. I went back to work after 7m with 80% and my husband took off 3 months with me. That summer we went to the US and spent 3 weeks with family having the baptism so that we could introduce our baby to all family and friends and then 4 weeks in California with just family time for us having a dream vacation! So we really enjoyed this time together but also had the time to relax and vacation as a new family allowing flexibility for the baby as they need it!

 

Just my two cents, but care is for the price top here in Germany -- just look to adjust those few things that are important for you! For the USA, save your time/$$ for a nice family trip abroad (extended) so grandma/grandpa/cousins/aunts/uncles can really enjoy the time with you all! (after you had the chance as a small family to get to know one another). . .

 

best of luck! :rolleyes:

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Maybe you could use the money you would have to spend to go to the USA and get medical care, to bring a member(s) of your family to Germany to help.

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But if the baby is not born in the U.S., he/she can never be president...

 

 

 

Don't tell that to Ted Cruz. :D

 

Anyway, I don't personally have any experience of birth here myself but from friends telling me about it, you are more likely to get better care here in Germany, before and after the birth especially, and you won't have to pay anything extra unless you don't really want to share a room and even then the price is reasonable like paying for a hotel stay. I can understand your desire to have family around for your birth but if, God forbid, anything when wrong, you would be out a lot of money, even potentially go bankrupt.

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I just thought of something that might put things in perspective if all the other helpful comments haven't already. Every so often I look into the "What to Expect" and "The Bump" online forums to see if anyone has a similar thing happening to them during pregnancy. If you want to hear the real cost of things in the U.S. check out those forums. I don't know if you can access this particular post here without registering for the WTEWYE site, but pregnant lady has swelling in her legs, goes to the ER fearing it's a clot, waits 2 hours, gets an ultrasound, is landed with a bill of $1,250.88 (after insurance). Just sayin'.

 

Also TK will send you loads of helpful information once you let them know of your pregnancy and register for pregnancy info. They also cover much of the cost of pregnancy yoga, the majority of the cost of compression stockings, ultrasounds, etc. and so many things that I wouldn't have ever dreamed of in the states.

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