Pushing Forward Childbirth in America

Pregnancy and childbirth costs more in America than anywhere else on in the world and the pricetag is more than just a little obscene. The June 3oth New York Time’s article  American Way of Birth, Costliest in the World  reported that:

” From 2004 to 2010, the prices that insurers paid for childbirth — one of the most universal medical encounters — rose 49 percent for vaginal births and 41 percent for Caesarean sections in the United States, with average out-of-pocket costs rising fourfold, according to a recent report by Truven that was commissioned by three health care groups. The average total price charged for pregnancy and newborn care was about $30,000 for a vaginal delivery and $50,000 for a C-section, with commercial insurers paying out an average of $18,329 and $27,866, the report found.”

Out of pocket costs have risen fourfold at a time when many Americans are struggling to stay afloat financially, meaning that expecting women and families have to worry about how they are going to afford the pregnancy on top of everything else that comes with bringing a new life into the world.

Dr. Howard Vogel, Third From Left, Is Assisted...

America’s pathology-oriented medical model of childbirth keeps the lights on in hospitals, but it hasn’t lead to better care during pregnancy and birth.  In 2010, 33 countries had lower maternal mortality rates, 37 countries had lower neonatal mortality rates, 65 countries had lower rates of low birth weight than the United States. Perhaps it is time for us to shift the way we approach maternal care.

We need a high-quality system that keeps costs within reason, while at the same time promotes wellness for the woman and her baby. In most countries with excellent maternal and newborn health outcomes and affordable care, midwives lead maternity care and refer high-risk and complicated cases to specialists. Perhaps reserving high-tech, expensive diagnostic tests for high-risk women or women presenting with worrisome symptoms serve women and their families best.

A midwife measures the height of the mother's ...

Starting next year, under the Affordable Care Act, birth centers and midwife care will be mandatory Medicaid services. More women utilizing midwife-led birth centers before, during and, after pregnancy, could produce significant cost savings for the US health care system and simultaneously improve health outcomes.According to the study by The American Association of Birth Centers and the American College of Nurse-Midwives:

“Women who receive care at midwife-led birth centers incur lower medical costs and are less likely to have cesarean births compared to women who give birth at hospitals. The rising number of cesarean births in the United States (32 percent in 2010 ) has generated concern due to the many short and long-term health implications for women, their newborns, and future pregnancies. The study, which included more than 15,500 women who received care in 79 midwife-led birth centers in 33 US states from 2007 through 2010, found that fewer than one in sixteen (6 percent) of participants required a cesarean birth compared to nearly one in four (24 percent ) similarly low-risk women cared for in a hospital setting.

A shift is needed. Pregnancy and childbirth approached from a medical model that treats these events like illnesses doesn’t work. We need a wellness model that provides accessible, affordable, high-quality care. This means increasing the availability and viability of women to choose to give birth at home or in birthing centers with the support of a midwife. While it might not be the right choice for every woman, it is a safe and low-cost alternative that women should have the option to choose.

What do you think? Send us your comments and be sure to check in next week to read local women’s  stories and perspectives of the maternal health care system in system in Baltimore.

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Shannon is an advocate for social change. Her passion for systemic, holistic approaches to the health of individuals and communities has taken her to cities across the US and to Guyana. Read more.

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