Monday, July 22, 2013

Another Article About the Cost of Birth in the U.S

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This is the third article this month that talks about the high cost of giving birth in the United States. As I've said before, there are many reasons that women birth in hospitals; familiarity, a sense of safety and more. It should also be noted that, and I'm quoting Ina May Gaskin and a number of birth advocates, birth is not a medical procedure. Sure a c-section is medical, but the natural process of giving birth is quite natural and happens just fine when left alone.

I'm a woman with multiple fibroids in my uterus. Did I mention I'm want to start trying to get pregnant in the fall? I'm well aware that because of my fibroids some midwives and birthing centers will automatically make my pregnancy and me "high risk" which basically means that I might not find a midwife willing to let me give birth at home and the only freestanding birthing center in NYC may not accept me...which means that I may be a woman who births in a hospital.

It happens to even the most determined woman.

But you know what:? It's okay. When we, as women, are knowledgeable about our rights, knowledgeable about hospital norms and express those wants and desires through our partners, doulas, and doctors that listen it's still possible to have a natural birth in the hospital.

Of course, hospitals work on schedules and the odds are stacked against you: You may be hooked up to an IV and unable to move around; You may have to labor and give birth on your back (gravity doesn't work that way!); You may only be able to labor for a set amount of time before they try to induce which may lead to a c-section; They may automatically give you a dose of pitocin (that IV is handy, eh?) to help birth the placenta (the placenta usually will birth itself if the baby is sucking at the breast-oxytocin!); They may cut the cord before it's done pulsing; They may wash the baby; They may not put him directly on you...the list goes on and on. But if you know your rights and the hospital's practice (none of these things are necessary and you can decline all of them) you have just as easy a shot (and a cheaper bill) than if you aren't aware.

My point? Educate yourself. Your doctor isn't smarter or more in tune to your body, because it's your body.

"Newer equals improvement" and "More is better than less" have long been effective marketing themes in American culture. But the problem is that in the case of medical technology, the results don't consistently bear that out.

While other countries have set up elaborate systems to assess new medical interventions for their cost effectiveness compared to existing practices before approving them, until recently that has not been a priority in U.S. medical care. The result is that public infatuation with newer technologies merges smoothly with the medical industry's desire to profit from providing more services.
A prime example of this problem is the failure to take advantage of midwife-led birthing centers. These have been found in the U.S. and overseas to be a safe andcost effective alternative to universal reliance on large hospitals. Freestanding birthing centers (as opposed to hospitals which refer to their maternity ward as a "birthing center") are usually directed by midwives and are affiliated with hospitals that serve as a referral site for transfers. The cost savings stem from less reliance on expensive medications and technologies, a shorter stay (mothers typically return home within 24 hours) and lower personnel costs.
While the numbers of birthing centers have increased in the last decade, less than 1 in 300 U.S. births occur in a center. How come?.... The U.S. needs to seriously rethink how we approach maternity care. The first question that needs to be addressed is: Do more tests and reliance on the biggest, most expensive hospital settings actually improve the health of mothers and babies? When they do, great. But when they don't, we need to overcome the financial, institutional and cultural barriers to use reasonable options like birthing centers.Medical technology has done wonders for our lives, especially in select, high-risk cases. But rising maternity care costs reflects the downside of our societal obsession with newer, bigger and shinier technology.

Read the full article here.

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