A rant about birth control and the insurance company that apparently wants me to become a Duggar

Now that my uterus is vacant, I really need to think about what type of birth control B and I are going to use this time around. I am absolutely freaking terrified of getting pregnant again. I thought I was terrified of getting pregnant after I had W, but my fear has reach a whole new level now that I've had R. We've all seen that B and I are fertile, fertile people, and I'd like to prevent that whole pregnancy thing from happening to me again.

Let's discuss my options, shall we?

1. Abstinence - This is my option of choice, but B isn't digging it. He seems to think that we need to be having sex. Pshaw, I say! Abstinence is the only foolproof birth control method, you know. And foolproof is what Emily needs right now.

2. Hormonal pills/rings/shots/etc. - These hormonal drugs are no longer an option for me. They make me C-R-A-Z-Y. My feeble little brain does not respond well to my levels of lady hormones being "adjusted" (see, e.g., pretty much every post I wrote during either of my pregnancies), and I really don't want to spend the rest of my pre-menopausal life on antidepressants just to try to keep me "balanced." I've tried tons of different hormonal birth controls over the past 10 years, and I've learned that different hormonal options make me different levels of crazy (NuvaRing = not-so-bad crazy; Depo Provera = off-the-charts-might-as-well-be-pregnant crazy), but none of them let me stay even sane-ish. I'm just starting to get a good grasp on sanity for the first time in two and a half years, and I'll be damned if I'm going to let that get away. Hormonal options are not an option for me.

3. Condoms - We tried this. After we had W. It got us R. Let me lay it out for you: B and E + condoms = babies. As the idea of me using some sort of contraception is to PREVENT babies, going back to condoms is not an appealing option for me right now. I don't trust us to properly and consistently use them. Or them not to let B's effing super sperm through.

4. IUD - This one is the one I wanted. I wanted to get an IUD after I had W, but do you have any idea how much those things cost? Less than a baby, obviously, and in hindsight, we probably should have figured out a way to pay for it out-of-pocket, but it's still a good chunk of change to come up with when you're broke and just had a kid (which seems to be the story of my life). Although my current insurance will pay for my IUD (um, YAY!), there are coverage issues that means I'm not going to be able to get the IUD any time soon (see rant below for explanation).

5. Vasectomy - This is my other preferred option, but B and his balls are not in agreement. Besides, B seems to think that we're going to have another kid some day, which we can't do if his sperm are incapacitated.

6. Tubal ligation - I figure I shouldn't have to have another surgery, since I've had to carry the kids. And B seems to think that we're going to have another kid some day, which we can't do (naturally and cheaply) if my fallopian tubes are incapacitated.

7. Duggarization - This birth control method requires using no birth control at all and having a bazillion kids. No thank you.

Now that we've gone over all my options and seen the issues with all of them, let me rant about my insurance company a bit. My insurance company won't pay for hormonal birth control. That shit is expensive out-of-pocket. My insurance will pay for sterilization procedures, but B wants another kid (and I haven't managed to talk him out of it yet). Best of all, my insurance will pay for an IUD.

You may now be asking yourself, "Emily, if your insurance pays for IUDs, why are you bitching? Just go get the damn thing!" Oh, dear reader, if only it were that simple.

At my six-week check up last week, my doc told me that Mirena recently increased in price. A lot. Insurance companies, including mine, are not increasing their reimbursement rates, though, which has led my OB to refuse to insert IUDs until the company starts paying her more. She has one nurse who is in charge of all things IUD, so she put the nurse on the case. Well, the nurse discovered that my company will actually pay for the IUD (when I called after having W and getting insurance coverage at my new job, they told me they didn't cover it), but she had to call elsewhere for reimbursement rates. I just got the call today that my company reimburses $300 on a $900 product. Which is not enough for my OB. And it means no IUD for me. The nurse told me she'd put me on their waiting list and check back with my company in a few weeks to see if they've increased their rates.

I'm pissed about this. It's bad enough that my insurance won't pay for birth control pills - which, in case you were wondering, are way cheaper than the $18,000+ my insurance just paid for me to have a kid. I'm betting I could 10 years' worth of pills for the cost of one baby. So much for managing costs, right? - but the fact that they're cheaping out on the one non-permanent birth control method they'll cover to the point that doctors won't insert the IUDs is ridiculous.

I understand that insurance companies never pay full price for anything, but only paying 1/3 of the cost of a medical device seems overly stingy to me. Maybe this is the company's way of keeping women from exercising this option: if the doctors aren't getting paid sufficiently for their time and supplies, they won't put the devices in. If doctors won't put them in, women won't get them, and the company won't have to pay anything. Everybody wins!

Except the women who really want to prevent pregnancy, but don't have the ability to take advantage of other contraception options. Like me. I've outline the reasons why other stuff won't work for me and B. I suppose condoms are our best choice (considering that B is anti-abstinence), but they've already failed me once, and we cannot - CANNOT - have another baby. We don't have enough room in our house (that we just bought), we can't afford another one in daycare or diapers, and I don't know that I would be able to make it through another pregnancy. I have legitimates concern for my mental well-being if I have another kid. Not only do the hormones eff with me something fierce, but I don't particularly enjoy being a mother, and I don't want to add another urchin to my list of responsibilities. Besides, three under three is only for the truly disturbed among us.

I know some of the blame also has to lie with the company that makes the IUD for increasing their prices, and with the doctors who won't insert the devices unless they get paid more, but my insurance company is the one that frustrating me most right now. The thing is, I haven't had to personally deal with the company that makes the thing, and I can understand wanting to be fairly compensated for the cost of materials you use in your business. But I don't get a business whose main objective is to spend as little as possible while still meeting its obligations to its customers not paying a little more for something that will save them a whole bunch of money in the long run. An IUD will cost the company $900 (probably less) every five years or so, which works out to about $180 a year. A baby will cost somewhere in the area of $20,000 plus medical expenses as it grows for as long as it's covered by the plan. You tell me which is cheaper. This isn't rocket science, people!

I hate being in this position. I've often described myself as a sexual camel (which B hates) because I can go forever without sex and be just fine. He is not like that. At all. And he's getting handsy. I'm going to have to have sex with him, and it's probably going to be soon. But I'm so scared that I know I'm not going to enjoy it. And I seriously don't know what I will do if I get pregnant again, but I can tell you that it won't be pretty. And that my insurance company will get a very angry phone call from me.

You're looking at one lady who will not, under any circumstances, become a Duggar. No matter how badly my insurance company wants to push the long skirts, bad hair, and perpetually occupied uterus on me.