Wednesday, May 07, 2014

The Evidence Says................US maternity care is at a dangerous crossroads!

US cesarean rate is 32.8%.

WHO reports that women dying during childbirth is up 136% since 1990.

Hospitals are reducing or eliminating staffing for childbirth education classes.


Statistical data on maternity care points strongly at racial disparity. African-American women are four times more likely than white women to die of childbirth related causes. The infant mortality rate among African Americans is three times that of whites, and pre-term and low birth weight rates are double. (2010 report from Amnesty International "Deadly Delivery")

Midwifery care continues to be held down.

Obstetricians are retiring early or switching to gynecologic care due to increasing malpractice costs.

A woman birthing in America has decreasing options.

Water labor/birth safety is again questioned and in many facilities, tubs are being uninstalled due to lack of use.

The number of babies exclusively breastfeeding at 3 and 6 months is low.



In short, US maternity care providers generally (there ARE exceptions) do not practice evidence based care.   Yet according to The Pregnant Elephant in the Room: The US Maternity Care Crisis, a typical birth in the US costs upwards of $35,000.  A typical birth in the Dutch health care system is approximately $6000.  Author Laurie Foster CNM, MSN asks some very vital questions: "In light of the changes taking place in the American health care system, what is being done to improve the quality of care, cost, and outcome of the most important medical event in human life?"  She goes on to ask: "Why do American women routinely get major abdominal surgery? What is driving the maternity care crisis in the US?"

Who is afraid of the answer?  And just what is the answer?  I agree with Foster: "The US must improve outcomes and decrease costs.  There is a clear solution: increase the percent of births attended by midwives and employ the midwifery model of care as the evidence-based standard."

The evidence in the research shows this to be true.

Don't just celebrate midwifery, doulas or childbirth education for one day, one week or one month.  

Do it every single day!

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