My Daily Domestic Clips 09/10/2010 (p.m.)

• Melissa Cheyney: Why Home Births Are Worth Considering – Annotated tags: birth childbirth homebirth
  • The United States is already the butt of jokes in the international public
    health community. We spend more on health care than any other high-income
    nation, while simultaneously serving the lowest percentage of pregnant women, as
    several of our key health indicators continue to decline each year. According to
    Eugene Declercq of the Boston University School of Public Health, the U.S. now
    has the highest number of maternal deaths relative to all other high-income
    nations, and we also rank second worst for perinatal deaths.
  • The U.S. has not reported a significant decrease in maternal mortality rates
    since 1982, and the Center for Health Statistics indicates that the rate of
    cesarean section in this country is now at a whopping 32 percent, marking the
    11th consecutive year of increase. As the incidence of cesarean section rates
    rise, so do medical complications for mothers and babies, along with associated
    health care costs. The World Health Organization recommends a cesarean rate of
    no more than 10 to 15 percent, so our rate is two to three times higher than it
    should be.
  • We know that 99 percent of women in the U.S. are giving birth in hospitals,
    yet the United States has one of the highest infant mortality rates of any
    developed country, with 6.3 deaths per 1,000 babies born. Meanwhile, the
    Netherlands, where one-third of deliveries occur in the home with the assistance
    of midwives, has a lower rate of 4.73 deaths per 1,000.
    While maternal mortality rates decreased among our peer nations between 2000
    and 2005, they increased by more than 54 percent in the United States during the
    same time period. The two major differences between the U.S. and other nations,
    which have superior maternal and infant health outcomes, are that the latter
    offer universal health care and rely more extensively on cost-effective midwives
    as a public health strategy.
  • Consider the economics of the situation. The cost of a cesarean in the United
    States is about $15,000 and an uncomplicated vaginal birth averages $8,000
    (without prenatal or postpartum care), while homebirth midwives charge $2,000 to
    $4,000 — a fee that includes care from conception through the postpartum
    period. Exploring the option of home and birth center birth with midwives for
    low-risk women should be at the core of national health care reform and
    research. Instead, several generations of high-tech, low-touch birth and a
    pervasive cultural belief that birth is imminently dangerous — even in healthy,
    low-risk women — has led to powerful cultural blinders that limit options for
    women.
    In anthropology, we say that “normal is simply what you are used to.” The
    power of socialization and the dominance of biomedicine have kept us from
    systematically examining a variety of birthing environments and providers as
    viable alternatives to the expensive and interventive hospital delivery that has
    become the norm in the U.S.

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