In 2009, my year of shadow and light began. In this chapter, we’re fully in 2009, in the spring, when we began growing things in earnest: an orchard, a garden, a baby…and frustrations.

 

You can watch my YouTube video (link below) or read chapter 5 below.

5. Growing Things

If you have a garden and a library, you have everything you need.

—Cicero

When we learned that my contract job would not be renewed again, I floated the idea past Misha that a good option might be for me to freelance full time. To my surprise, he agreed, no hesitation. (To say I was blown away by how easily he accepted this would be an understatement. It was not really in character for my anxious husband.) The owners of the publishing company that was my main client said they would make it a priority to keep me as busy as I wanted to be. I was excited to leave my contract job, which had definitely run its course. I was so disillusioned with the company and with many of my coworkers that I had begun counting down the days to the end of the contract.

I took two weeks off after the contract ended, spending time with my husband, getting things around the house and property in order, and relaxing. I hadn’t had a break of more than three days in a row in a year, and I wanted to start my new job fresh.

Of course, with my husband unemployed and me self-employed, we had a difficult time finding health insurance. We had done without while I was in the contract job, but we knew we were tempting fate, and we wanted to be covered. We were contacted by a couple of fellows from a company that insures a lot of farmers and other self-employed people, so we sat down with them. Mike was immediately eligible for coverage, but because of my weight, I was uninsurable. I would have to lose something like sixty pounds before they would insure me, so I started trying even more earnestly to lose weight. We were still following as best we could the guidelines in The Fertility Diet, and now that I was home all the time, Mike and I began exercising even more, working together to help make it more enjoyable and to support each other. I kept looking for insurance, looking into the plans offered by the state. Those were not at all within our means. A woman of childbearing age—18 to 60 years—had to cough up $400 to $600 per month for very basic coverage. If I would get pregnant, it would cost more. We decided to forego such “public assistance.”

Our garden started off slowly, but Mike had put his months of unemployment to use and researched how to use companion planting and several other “tricks” to get our poor soil to produce better results than our nearly disastrous first year here. We even managed to can and had a very good haul, considering our relative inexperience. Our squash went crazy, and so did our beans. Our bell peppers and hot peppers provided a very modest crop, but we learned the hard way that growing spicy peppers next to sweet peppers is not a good idea unless you want all the peppers to become spicy. We had a huge haul of cucumbers. Our tomatoes did beautifully, and we managed to can salsa, ketchup, pasta sauce, and more—not enough, given our prolific propensity toward consuming tomato products, but it was enough to help with the grocery bill.

Mike and I thrived in our new capacities. Mike was the most peaceful I’d ever seen him, tending to the garden and orchard all day and spending time with me in inclement weather. I was at peace. We were both spending much more time in nature than life had allowed us to for several years. This recharged our batteries. We felt good.

And then finally, we conceived. We’d been trying for three years, and finally, it happened. The spark of life had been ignited in my womb. One day, as had become so common in the preceding years and months, I decided to take a home pregnancy test. I waited with bated breath, as usual. But then…it was positive?! I rushed to find Mike, who was outside in the garden. Without a word, I grabbed his hand and led him inside, back to the master bathroom, and showed him the test, just to make sure my eyes and hopes weren’t deceiving me. I was shaking all over. Mike looked at the test, then he looked up at me. His eyes were full of tears. I fell in love with him all over again in that moment.

We had been trying and expecting to get pregnant for so long that we had known we’d be overjoyed. It turns out, we hadn’t realized that “overjoyed” would be a gross understatement. We were ecstatic. We were walking on clouds. We awoke with smiles every morning and went to bed with smiles every night. We’d wake up in the morning, put our hands on my belly, and croon, “Good morning, Baby.” Then we’d give each other goofy smiles and kiss each other good morning. At bedtime, it was just as syrupy and sweet: “Good night, Baby,” and loving kisses.

Life wasn’t worry-free, of course. Mike was still unemployed, I still had no health insurance, and we had no idea how we would manage to pay for the necessities of caring for a baby, as we were barely paying our bills. Now that I was pregant, trying to figure out how to pay for that child became nearly a full-time job on its own. The challenge, in a nutshell, was this, as I told my friends and family in my blog at the time:

Most private insurances like this require that a woman be enrolled for a year BEFORE pregnancy is covered. So, obviously, there must be some insurance out there that would take me despite my weight? Sure, maybe, for a very high premium. But still, pregnancy not covered unless you’ve been enrolled for a year. Hmmm… And even if they HAD decided to cover me despite my weight? Pregnancy is a preexisting condition, and private insurance…well, they tend to frown upon preexisting conditions. …

But Medicaid in [Indiana] has a plan for pregnant women–premium-free healthcare coverage. And the minimum monthly income is greatly increased–largely, I believe, because of the abominably damned difficult time pregnant women in this state have getting care. But still, we make in this household just a bit more than that monthly allowance. Ah, but in the fine print, I see a note saying that for self-employed people, 40% of their income is automatically removed in calculating eligible income. This means that only 60% of our monthly income is calculated in determining my eligibility. I do the calculations and find that we’re still awfully close, and depending on just how they figure, we may still make just a SMIDGE too much for us to be covered. But it’s worth applying. So I print out an application from online and prepare to submit it. But what’s that I see? Proof is needed. Proof of income. A little difficult because of my self-employment, but I keep detailed records, and that shouldn’t be a problem. A letter from a healthcare provider stating when the pregnancy began. Of course. They don’t want to provide pregnancy coverage for a woman who’s not actually pregnant.

So I begin calling around to see who can administer a pregnancy test (I’m fairly certain that taking in my own pee stick to the social services office doesn’t count as a letter from a healthcare provider). What am I told? “Congratulations on your pregnancy! We’ll be happy to take you in as a new patient. What insurance do you have? None? I’m sorry, but I can’t schedule an appointment with you if you don’t have insurance.” Well, this complicates things…I can’t get insurance without a letter verifying the pregnancy from a HEALTHCARE PROFESSIONAL, and I can’t see a [healthcare] professional without [having] insurance. … So I ask the woman on the other end of the line if she knows WHERE I might be able to get such a pregnancy test and a letter confirming my pregnancy so I might be able to get some public assistance. …

Well, the Women’s Resource Center might be able to help me. Hooray, a lead! Yes, they can certainly give me a test and provide me a letter. Free of charge. … Yes, I went in. They administered a pee test. Yup, just like the ones I took over and over, but this one was administered by a nurse who volunteers at the center, so I was able to get a letter. …

Okay, so, with my letter in hand on a Monday morning, I call the social services office to ask what I need for proof of income now that I am self-employed and my husband unemployed. I gather these things together and go down to the office to apply in person. I am handed a form, fill it out, give it back, and am asked if I would be available at 10 AM the following Thursday for a phone interview with a case worker. No, I didn’t need my proof of income or proof of pregnancy at that time. Well, folks, had I known that ahead of time, I could have applied two or three weeks earlier and gathered all my information in the meantime. But that’s okay, it’s all gathered.

Now for all the hard work. Oh, yes, there’s more. So much more. …

I called my OB/GYN in [a city an hour away] and asked to get an appointment set up. Self-pay. … I had to have $700 to step through the door the morning of my appointment. Let’s stop there and consider that a moment, folks.

$700 before I can sit down with anyone in the business office and work out a payment plan. And that’s with the 20% cash discount. But really, it’s explained to me, only $200 of that goes toward the care for me and the baby. $500 is for lab fees because so many tests are done on that first visit. And at any visit when a lab will be done, I have to pay for the test before I get to see the doctor. … I could expect to spend about $900–$1200 on labs throughout the pregnancy.

Then there’s the $2400 charged by the doctor for the delivery fee. This covers all my visits and a normal vaginal delivery, but not hospital costs. The doctor offers a cash discount, so the cost would only be $1920 if I’m paying cash. What a bargain. But it’s due in full at 24 weeks. Well, at that point, I was already 10 weeks along. Hmm…that’s not … promising. And they can set up a payment plan, but if they do that, well, there’s no discount. Hm. So we’re back to $2400 because I can’t just come up with $1920 in the next 14 weeks. It may seem simple, but I can’t remember the last time we had expendable income adding up to $137 a week. Oh, and if I would happen to get the Medicaid insurance…[this office] would not accept that. And then there would be the hospital fees. I would be able to choose one of two hospitals in the [city] to deliver at. Either one accepts [the Medicaid plan]. For either, fees for a normal vaginal birth for a 2-day stay would be $6000–$8000 paid up front or $10,000–$12,000 not up front. Not including anesthesia if I would so choose to partake. Not including any extra fees if something would go wrong or a C-section were needed. All for the privilege of delivering in their hospital.

All that, on top of both the doc and the hospitals being a good hour’s drive from where we live. Not feasible. So I begin researching in our area again. I call various departments in our local hospital, various doctors, the Women’s Resource Center, [the closest] Planned Parenthood, and the neighborhood clinic. … The Women’s Resource Center does not provide prenatal care. Planned Parenthood does not provide prenatal care. The neighborhood clinic does not provide prenatal care. … When I speak to someone at the hospital, they say they do not provide prenatal care, but they tell me to speak with the OBs who practice at the hospital. The number they give me is the number of the practice I called when I was informed they couldn’t even schedule an appointment if I didn’t have insurance.

Oh, the joy.

Finally, I send an email to the hospital seeking further information. Anything, I say, will be helpful, but I need information. How can I get care if I don’t have insurance? A few hours later, I was informed that I needed to call that practice again and speak with the business manager. They do, indeed, provide care to people without insurance, but there are special requirements. Here we go again. …

 

$2400 for vaginal delivery and all prenatal care. With a 20% discount, it comes out to $1920. Well, this all sounds familiar. I am not heartened. But only $420 is due at the first visit, and then there are 6 monthly payments of $250. Okay, I feel a little better. Relieved, even. This works out to everything being paid in full around the time of delivery. Much better than at 24 weeks. Ah, but there’s more. … That doesn’t include any labs, ultrasounds, or hospital fees. Ah, there’s the kicker. She can’t really tell me the cost of these things because they are billed directly from the lab to us. But she gives me the telephone number and billing extension for the lab so I can ask about the cost.

 

Oh, and yes, they do accept Medicaid, but until that coverage goes through, I would be treated and have to pay as a cash patient. Then, if the Medicaid goes through, I will be refunded all the money I have paid. Well, it’s promising, and I understand completely. …

Next, I call the lab and ask what they charge for standard prenatal tests. Well, they can’t tell me for sure without the specific names of the tests because every doctor orders different tests, and there are just too many, apparently, for them to list all to me with prices. I will have to have specific names in mind….Yes, they do offer payment plans. … There are no set payment plans in order, I am told. They LIKE to have everything paid off within 4 to 5 months. But, by the lady’s tone, I can tell, this is not a requirement. I am really taking heart. Further, they offer a cash discount if the fees for the labs are paid within 10 days and they don’t have to bill insurance (in other words, if they don’t have to deal with insurance and you pay quickly, you’re saving them money). I am substantially relieved, but I still don’t know how much they charge for all their labs. … But being able to work out payments rather than pay for labs before I even have the labs done? Well, that’s a load off my mind. …

Now, to call the hospital. … The cost for a 2-day stay for a normal vaginal delivery is $9500. Am I insured? No. Oh, well, then I can pay $4750 one month before the delivery, and then the hospital will write off the cost of the baby’s stay and care. I waited for further details. To hear what was due after the birth. There were no more details forthcoming. “Okay,” I say, “I want to make sure I understand this correctly. If I have paid $4750 a month before the baby is due, I don’t have to pay a single dollar more, if the delivery goes well and I don’t need anesthesia or anything like that?” That’s correct, this angel on the other end of the line tells me. And all I have to do is contact the hospital ahead of time and tell them I’m a prepay. I can even set up payments. All I have to do is call and pre-register and get an account number, and then I can send in payments whenever I like. All up to $4750, so long as I’ve paid it all a month before the baby is due. “Is that something you’d be interested in?” she asks. “Of course it is!” I want to shout in joy. A 50% discount. But I slowly say, “I think so, but I have to discuss things with my husband. I’ll call back to pre-register later.”

So, what have I (and M, to a lesser extent) learned from this journey?

1. I have not made the money I need to earn in these past two weeks because I have been too busy calling what feels like every agency set up to help the poor and/or pregnant in a 50-mile radius just to find care for my unborn child.
2. Obama’s healthcare plan won’t go into effect soon enough to help me. …
3. We are far less worried about the costs of providing a good life for our baby than [about] the costs of bringing our baby into the world.
4. If the social services caseworker I speak with this week does not feel I qualify for Medicaid for prenatal care … we have to come up with about $8200 to have a baby through the traditional means, with nothing going at all wrong. It’s a good thing I already planned to have as natural a childbirth as possible.

I was doing all that amidst the great first-trimester fatigue. But we had hope. As Mike told his mom one day, we didn’t have any problems a million dollars wouldn’t fix. That helped us keep things in perspective with all the challenges we were facing. We were healthy, we had no relationship problems, our house was 99.99% sound and problem-free, our time was ours to do with largely as we pleased, and we had the love and support of our family and friends.

***

Thank you for allowing me to share this part of my journey with you. Please let me know what you think so far and if you want to hear/read more of my story.

 

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