Midwives and the medical monopoly; solving the problem of the high cost of childbirth and getting insurance to pay for midwife deliveries.

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Midwives and the medical monopoly; solving the problem of the high cost of childbirth and getting insurance to pay for midwife deliveries. Quite a bit has been said in the media lately about the cost of childbirth in the United States. The cost of childbirth in the US is the highest in the world, between hospital charges, epidurals and the medicalization of a process that is natural and has gone on for centuries with the use of midwives. In most countries, midwives deliver most of the babies. In our country, it has been seen as a medical procedure, with high costs tied to it. For those who remember it, there used to be a clinic in Princeton called Family Borne, which was staffed by Midwives and had an arrangement with RCHP Healthplan. Unfortunately, when RCHP went under, this cost effective facility went under as a lower cost and a more natural alternative for women to give birth. The medical establishment has mad it quite difficult for midwives to prosper in the United States, assuring the monopolization of childbirth in the hospital systems, with the associated high costs. Insurance covers the cost in 33 states as Midwives act as physician extenders. The NY Times examines this dilemma and explores Portland Oregon, an area where midwife births are the norm in the U.S. Read about it here
Medical doctors deliver more than 85 percent of American babies, and the overwhelming majority of births in the United States take place in hospital labor and delivery wards. But in many European countries, midwives attend to most pregnancies, often in clinics, resulting in maternity charges that are a fraction of those in the United States. At a time when the United States is looking for ways to rein in its runaway medical spending, a surprising glitch is preventing American women from choosing the low-cost option: Many insurance plans do not have midwives in their provider networks, or do not cover midwife care at all. Dozens of readers expressed their frustration on this topic in response to a New York Times article on the high costs of maternity care in the United States, "American Way of Birth, Costliest in the World." One said that her insurer at first refused to pay for her midwife delivery as an "unauthorized service," though it later relented after she fought back. Another, in Kansas City, said that her insurer, UnitedHealthcare, had no birth centers in its local network. Another, in New York, relayed that her "comprehensive medical insurance" wouldn't cover her childbirth at a birthing center at all, and she noted: "If I had used a medical doctor, medications and had a C-section with a hospital stay of one week, my coverage would have been 100 percent." Susan Pisano, vice president for communications at America's Health Insurance Plans, a trade group, said that care for midwife services varied widely among plans, adding: "If this is a feature that is important to you, you have to ask before you enroll." Thirty-three states require private insurers to cover nurse-midwife services, according to the American College of Nurse-Midwives. But access to coverage is often further limited in practice by whether midwives can get privileges to treat patients at local hospitals, whether freestanding birthing clinics are permitted and local medical custom, Ms. Pisano said read more