Tuesday, July 27, 2010

Why I Care

Some time ago I wrote a post about medical control as acceptable, in which I pondered the question of why do we care about birth, if many birthing women themselves don't really seem to care? Why do we make it any of our business what other women choose to do with their births?

Well, I've been doing some thinking and here is my list of why I care:

  • Because women are suffering--birth trauma is real--see organizations like Solace for Mothers--and postpartum mood disorders are very common.
  • Because babies are suffering--late pre-term births are increasingly common, many babies experience at least some post-birth separation from their mothers (which is not their biological expectation), and many babies spend time in the NICU. Infant mortality rates, especially for minority babies, are higher than in other industrialized countries.
  • Because breastfeeding is suffering and thus public health is suffering (see my previous article on the birth-breastfeeding continuum)
  • Because the physical costs of our current birth model are high--morality and morbidity rates are higher than necessary due to high volume of cesareans and many physicians and hospitals do not practice evidence-based care--continuing to deny laboring women food and drink and continuing to use Cytotec for inductions for example.
  • Because the financial costs of our current birth model to society are high--birth is a multi-billion dollar a year industry. Some maternity care facts from CfM:
    • Over four million births in the US each year (26.4 births per 1000 women aged 15-44 years in 2004).
    • Second most common reason for hospitalization of women.
    • Care for mothers and babies combined rank 4th for hospital expenses.
    • Hospital costs for deliveries mounted to more than $30 billion in 2004. More than 30% of births by cesarean section. ranking seventh highest total on the "national bill" for procedures (over $17 billion per year).
    • Of all births, 99% take place in hospitals, 90% are attended by obstetricians.
    • Over 6 million obstetric procedures are performed – the most common category of surgical procedures.

"The percentage of births paid for by Medicaid varies from state to state but can be as high as 50% or more in some states. Coverage by all insurers (Federal government, Medicaid, private, HMOs, etc.) varies; many will not reimburse for OOH births, and when midwives are covered, the reimbursement rate is only a percentage of the rate for physicians. We all pay for births, including unnecessary interventions and preventable complications and injuries, through our taxes, health insurance withholding, and individual policies."

  • Because women's birth memories last a lifetime (see Simkin, Not just another day in a woman's life).
  • Because women deserve better.
  • Because I know in my heart that birth matters for women, for babies, for families, for culture, for society, and for the world.
CfM Blogger


Chloe said...

The financial aspect is a huge one. It's easy for average people to think this issue doesn't affect them because they are "done" having babies. But everyone who pays taxes and insurance is "paying" for the over-medicalization of birth, which creates additional problems that then require more medical care to address.

In additional to being annoyed at paying ever increasing insurance premiums (for decreasing benefits), I am livid that I have had to pay for all my maternity care out of pocket because my private insurance refused to pay for my home birth with a licensed midwife.

Anna said...

Thanks for posting this...I've been interested in this discussion for years and really enjoyed your first post on the subject. Lots to think about...and lots to do!

Lani said...

Love this. Thank you.

Sarah--Well Rounded Birth Prep said...

Thank you for articulating something I've felt for a long time and didn't know how to put into words. I love this post.

The Deranged Housewife said...

I'm glad a few people made it their "business" to inform me (tactfully, wisely, and knowledgeably) that I had other choices. Some women just don't know; some don't care. It shouldn't be perceived so much as birth advocates thinking "it's their business," but rather a duty to possibly help another person avoid something that they themselves went through. If I have information, I want to share it the best way I can to help others - it may be received well and it might not.

Because a few have chosen to inform me, I became a stronger person and a huge birth advocate as a result. It truly changed my life.