Miriam Perez on why home births may be better for women — and better for government’s pocketbook — than hospital births:
Michelle Bartlett is not the typical Washington high-stakes health-care player. She’s probably not even on the radar of anyone in Congress or the Obama administration. Bartlett is a midwife in Idaho, but in the last few years, she’s been trying her hand at lobbying. This came after a night spent in jail for using medication during a home birth she attended in 2000. Bartlett was the second midwife to be charged for this type of practice in Idaho, and thanks to her efforts, she will be the last in her state. “I’ve done a lot of hard things in my life, and giving birth was one of them,” Bartlett says. “But giving birth to a law was really hard.”
On April 1, Gov. C.L. “Butch” Otter of Idaho signed legislation allowing certified professional midwives (CPMs) like Bartlett to administer medication during births. Unlike certified nurse midwives who are able to practice in all 50 states and generally work in hospital settings alongside obstetricians, midwives like Bartlett are referred to as “direct entry” midwives, and practice exclusively outside of hospitals, mostly in homes or birth centers.
Childbirth is among the top five causes for hospitalization, and the No. 1 cause for women. According to Childbirth Connection, Cesarean section is the most common operating-room procedure, and in 2009 the C-section rate hit an all-time high according to the Centers for Disease Control and Prevention, at 31.8 percent of all births. These rates account, in part, for the increasing cost of maternity care in the U.S. — maternal and newborn charges totaled $86 billion in 2006, 45 percent of which was paid for by Medicaid. The federal government is already footing a huge portion of the U.S.’ maternity-care bill, and these midwives think they can help reduce costs significantly, and not just for low-income women.
