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

Image from CNN.com

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.

NYT Cross-Post: Birthing in America is Costly!

Josh Haner/The New York Times

As a doula, my job is to sort of come outside of myself, my wishes, my thoughts and my needs to focus solely on a mother as she labors. This means that I support a mother who wants to give birth in a hospital with an epidural as equally and fully as a mother who wants to give birth squatting in her living room. As a woman who's TTC I find this article by the New York Times shocking!

I've been considering a home birth when we, Gd willing, get pregnant. Birthing at home or at a Birthing Center with a midwife and doula insures woman-focused, mother-lead birthing with a caregiver you've had a continuous relationship with, but it's also, quite shockingly, cheaper!

In nearly every other developed country in the world, midwives, not OBs attend births. Why? Because birth isn't a medical "problem" and OBs are trained surgeons. Of course, and I know this because I have fibroids which may put me in the "high risk" area of moms, some births have medical complications where having an OB is necessary. But for women who are healthy, birthing is and should be a natural process. Our bodies were made and are perfectly capable of birthing babies.

It wasn't until the 1950s that birth came to hospitals, before then the majority of American births were done at home. It's also interesting to note that while our births have moved into the hospital and away from the home, we've lost more mothers and babies. In fact, the U.S has one of the worst mother and baby mortality rates.

What are your thoughts on this article? 

From the New York Times: American Way of Birth; Costliest in the World

 LACONIA, N.H. — Seven months pregnant, at a time when most expectant couples are stockpiling diapers and choosing car seats, Renée Martin was struggling with bigger purchases.At a prenatal class in March, she was told about epidural anesthesia and was given the option of using a birthing tub during labor. To each offer, she had one gnawing question: “How much is that going to cost?”Though Ms. Martin, 31, and her husband, Mark Willett, are both professionals with health insurance, her current policy does not cover maternity care. So the couple had to approach the nine months that led to the birth of their daughter in May like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors.When she became pregnant, Ms. Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4,000 to $45,000. “It was unreal,” Ms. Martin said. “I was like, How could you not know this? You’re a hospital.”Midway through her pregnancy, she fought for a deep discount on a $935 bill for an ultrasound, arguing that she had already paid a radiologist $256 to read the scan, which took only 20 minutes of a technician’s time using a machine that had been bought years ago. She ended up paying $655. “I feel like I’m in a used-car lot,” said Ms. Martin, a former art gallery manager who is starting graduate school in the fall.

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