Hospital Bill- watch those IVs

[Beckylove]

I gave birth about a month ago and requested my itemized hospital bill. Out of $8700 or so total (this is the initial bill, before insurance adjustments) $2500 was IV costs! 1200 in hydration and 1300 is treatment (oxytocin in IV to help shrink the uterus).

I had no problem philosophically with IV hydration before birth or with a little oxytocin to help shrink the uterus after birth, but had I known it would cost 2500 bucks, I would have just drank some more water and let breastfeeding do its job to help shrink my uterus a little slower.

I am not a doctor or health care provider, so discuss your IV options with them before birth. But this is definitely an issue I would have paid more attention to in retrospect and included in a birth plan.

This is just a PSA for those interested.

[daisymommy]

Very good points, except hospital policy is almost always that if you have pain pains, especially an epidural you HAVE TO have a hydrating IV. There is no choice once you go down that road.

[SnuggleBuggles]

I hate IVs so I specifically planned for no pain meds and no induction. I got my midwife on board with no hep lock either. I got lucky and was able to totally avoid it...glad I was able to save some money. :)

Beth

[ashleybama24]

Don't be afraid to call the hospital or your insurance and negotiate a better deal. All hospitals/doctors bill as much as possible knowing that each insurance pays at a different rate. You have every right as a patient to dispute the claims and ask for something more reasonable especially since you probably had that IV in for less than 24 hours!

[BabbyO]

This is really good info to know. I didn't want an IV at all with my last one and the DR insisted that I at least have a port incase something came up last minute during labor and I needed an IV. I had an AWESOME labor & delivery with no drugs. However, afterward they hooked me up to the oxytocin to shrink my uterus before I even knew what happened. I didn't even know they did this because when I had my previous child (16 yrs ago) the nurses massaged my uterus and instructed me on how to do the same to shrink it. I guess that was on thing the doc and I missed in our discussion about my labor.

[Edensmum]

It's good to know. It's good to know after birth they often give pit. Ask about this. Often it's IV but it can be injection. If you don't want some of this remember you have the right to refuse anything.

[hellokitty]

Also, if you DON'T have an epidural, make sure they don't charge you for one. Practically NOBODY at our hospital gives birth w/o an epidural (me and maybe a few other ppl I know, although most w/o epidural, just do homebirth, b/c they are so pro-epidural here, it's a PITA dealing with the establishment). So, they are so used to charging epidurals, that they charge me for one for DS2, when I never got one (stupid CRNA would NOT stop coming into my room asking if I needed, "help," we kept telling him to go away, stopping in my room doesn't count for being able to charge for an epidural!). DH went to billing to complain about the epidural charge. He's an hospital employee, but anesthesia is charged like a doctor's bill, not part of regular hospital services, so it wasn't covered under the hospital part and would have meant a big chunk of change out OOP.

[DebbieJ]

Your insurance company negotiates those costs way down, which is why they are inflated to begin with. DS1 had orthopedic surgery last fall. Hospital bill was ~$15k. Insurance paid ~$1500. It's insane.

[mg1278]

Also, if you DON'T have an epidural, make sure they don't charge you for one.

On the bills for my older daughter, I noticed a charge for "IV oxytocin." I called and disputed that one - I not only did not have an IV, I didn't even have a heplock. There was no way that I received that! My midwife told me that it probably got charted ahead of time and they forgot to take it off the chart. She said that when one of her children was born, she read through her report afterwards and it said something about an IV being started. She hadn't had an IV, but the nurse had written it down out of habit.

[longtallsally05]

On the bills for my older daughter, I noticed a charge for "IV oxytocin." I called and disputed that one - I not only did not have an IV, I didn't even have a heplock. There was no way that I received that! My midwife told me that it probably got charted ahead of time and they forgot to take it off the chart. She said that when one of her children was born, she read through her report afterwards and it said something about an IV being started. She hadn't had an IV, but the nurse had written it down out of habit.

Uh, charted ahead of time? Those charts are legal documents; they aren't supposed to chart ahead of time for convenience! FRAUD.

It is a great idea to ask for an itemized bill, in addition to copies of your chart. My physical therapist said whe she had her baby, the hospital (her employer, no less) charged her twice for newborn care. She asked them where her other baby was, and said when they produced it, she'd pay the bill. They corrected the bill (Oops, just a tiny little error...yeah, right).

My impression is that the reason they want to give IVs so much is 1) They don't have to provide as much intervention to make sure your uterus is contracting as it should after delivery, so nurses can provide one IV injection vs. providing nursing care on multiple occasions...and we all know hospitals are understaffed with nurses. It's cheaper to provide an IV than it is to hire another nurse. 2) A possible complication with epidurals is low blood pressure (they avoid potential liability by increasing your BP via IV fluids). They dump a bunch of fluids in you just in case you have an eipdural. With DD (military hospital), I had an epi and I was so swollen with fluids after delivery that I could barely put my slippers on my feet, forget about shoes. I remember the the dumb-@$$ hospital corpsman told me they usually let all two entire bags of fluids run in before the d/c the IV; I told her to take it out anyway. I had to pump b/c DD couldn't get a decent latch due to all the swelling, which was made even worse after my milk came in (major engorgement). With DS (civilian hospital) I demanded a saline lock, no IV fluids, and I had no swelling either. Go figure.

[o_mom]

My impression is that the reason they want to give IVs so much is 1) They don't have to provide as much intervention to make sure your uterus is contracting as it should after delivery, so nurses can provide one IV injection vs. providing nursing care on multiple occasions...and we all know hospitals are understaffed with nurses. It's cheaper to provide an IV than it is to hire another nurse.

They don't need an IV to administer PP pitocin, though. They can do an IM injection. I had this with both DS2 and DS3 when I didn't have an IV for L&D, but then had PP hemmorhaging issues. I did end up with an IV afterwards with DS3 because they could not get the hemmorhaging to stop, but that was only after the IM injection didn't work and they needed fluids on board.

[ahrimie]

It's good to know. It's good to know after birth they often give pit. Ask about this. Often it's IV but it can be injection. If you don't want some of this remember you have the right to refuse anything.

This was me last week! I refused an IV but they did a hep lock just in case bc of my blood pressure. To deliver the placenta, they did an injection of pit in my leg/thigh.