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Birthing Classes: HSA Eligibility

Birthing Classes: requires a Letter of Medical Necessity (LMN) to be eligible with a Health Savings Account (HSA)
Birthing classes are partially eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Only the portion of the class that relates to the process of childbirth is eligible and a Letter of Medical Necessity may be required to indicate what part of the expense is medical and therefore eligible. Examples include: breathing techniques, stages of labor, labor & delivery procedures, birthing positions, vaginal & Cesarean delivery, so it's vital to check with a benefits administrator to see how these classes are reimbursed. Birthing classes are not eligible for reimbursement with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

The following portions are ineligible: general health of the fetus & newborn, newborn care, breastfeeding & bottle feeding.

Private Letter Ruling 89190009

What are birthing classes?

Birthing classes, also commonly called Lamaze classes, are designed to teach women a series of controlled breathing techniques that both facilitate labor and provide a degree of confidence and comfort to cope with the stresses of giving birth. This technique is named after the French obstetrician Ferdinand Lamaze, and has been used throughout the United States since the late 1950s to cover a wide range of topics that allows women and their partners know what to expect when labor begins (American Pregnancy Association).

Lamaze classes are as much about instilling a philosophy behind childbirth as they are about preparing women for the experience. The doctrine behind Lamaze classes is that childbirth is a natural, healthy process that is purely under a woman's control, which includes the right to give birth free from medical interventions. The breathing techniques associated with birthing classes like Lamaze are not only designed to provide comfort and confidence for pregnant women, but also a degree of self-awareness to be able to make vital medical decisions based on informed consent, rather than on pure emotion (BabyCenter).

What do birthing classes cover?

Birthing classes feature hands-on instruction that will prepare pregnant women for the experience of labor, but also a wealth of helpful information that can help new parents be prepared for common issues that can occur before and after labor. Lamaze classes typically feature smaller class sizes to provide individual attention to couples, and women are advised to begin these classes as they start their seventh month of pregnancy. Some of the topics that are discussed during birthing/Lamaze classes include via Parents.com:

  • Breastfeeding
  • The signs of labor/the normal progress of labor and birth
  • Partner support during labor
  • Pain coping techniques
  • Focused breathing techniques, body positioning, relaxation strategies
  • Understanding the early postpartum period
  • Communication with healthcare teams/possible complications to prepare for
  • Epidurals and other pain management options
  • How to perform early interactions with the newborn

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