Midwives: A Safe, Cost-Saving Alternative

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448. Link

Did you know that almost a quarter of all hospital discharges involves maternity care (mother and newborn)? That six out of fifteen of the most common hospital procedures involve maternity care? That Cesarean section is the most commonly performed surgery? Why are so many procedures being performed on essentially healthy people? ...

None of us would want to stint on the health of mothers and babies if all these procedures produced improved outcomes. But our outcomes are among the worst in the developed world and are not improving. The long-term health problems for women associated with Cesarean section are only now being understood. Maternal mortality is actually increasing. Some of the problem is undoubtedly due to excess interventions, especially those of unproven effectiveness.

The hallmark of midwifery is care with minimal interventions, with a focus on those that are evidence-based. Numerous studies of midwifery care involving low-risk women show lower costs and equal or better outcomes ...

Consider this:

In 2006, in Massachusetts there were 26,141 Cesarean sections (out of 77,670 births.) If we could reduce this surgery by 1% we would experience a cost savings of nearly $1.5 million. Boston ... provides a good example of the magnitude of the potential cost savings: the three Boston hospitals with the most midwife-attended births saved the Commonwealth nearly $3 million ... by reducing Cesarean sections ...

We could also allow low-risk women on Medicaid to choose out-of-hospital birth ...

In 2007 ... a cost-benefit analysis ... on licensed midwifery care ... found that licensed midwives directly save the State ... at least $473,000 per biennium in cost-offsets to Medicaid when women give birth at home or in free-standing birth centers. It should be noted that this was a very conservative estimate which reflects only avoided costs associated with licensed midwives’ lower Cesarean section rates. When facility fees and costly medical procedures such as epidurals and continuous electronic fetal monitoring are factored into the equation, the actual savings to Medicaid biennially are approximately $3.1 million. These savings occur with licensed midwives attending just under 2% of the births ...

... we can use some simple ways to lower costs, increase satisfaction and improve outcomes for our families. Increasing access to midwives ... has just such potential.

Melissa Maimann, Essential Birth Consulting 0400 418 448