12.Nov.2010 The Economics of Birth are Killing Us

I’ve just returned from the Midwives Alliance of North America Conference where we spent a lot of time discussing maternal and infant mortality.  What is clear from the data is that what we midwives do is the safest for mothers and babies. And it is also clear that what the US medical industry does to healthy women and children is causing death.  The world health community was present at MANA this year with the plea — help change US birth culture. Right now more babies die in Memphis than Sri Lanka, more mothers die here than in 40 other developed countries (and the CDC estimates that we under count maternal deaths by a factor of 3). (The workshops on maternal death in the US were chilling.)

Why does the world health community care what happens in the US? Because the US provides 50% of all international aid dollars.  By doing so, we export our model of care around the world. And our model of maternal and infant care is dangerous.  Why was the world health community at MANA?  Because we Certified Professional Midwives are the experts on physiologic birth. We don’t have access to inductions, augmentation, epidurals, vacuum extraction, c-section, etc.  We have become experts in how women’s bodies give birth. And we have documented our findings through the MANA statistics project. (See the CPM 2000 report in the British Journal of Medicine, for example) (And huge kisses to all of my clients who have consented to be part of the data collection project. Thank you. The world is watching.) [And here’s a little article from the Huffington Post that shows that mainstream Americans are watching too. http://www.huffingtonpost.com/tabby-biddle/women-speak-out-about-wha_b_781205.html?ref=fb&src=sp#sb=370053,b=facebook

MANA, the Canadian Association of Midwives, the Internation Confederation of Midwives, ACNM, along with support from the American Public Health Association and the World Health Organization are working jointly on public policy to improve maternal and infant health. And MANA has issued the 2020 challenge. By 2020 in the United States we need 20% more midwives and we need to be attend 20% of all births. It will take that level of saturation of the birth market for the midwives model of care to impact the US health care industry — and that’s when we will see a dramatic reduction in maternal and infant death rates.

The MANA 2020 challenge is very doable. Breaking it down to achieveable goals: each midwifery preceptor needs to take on 2 students and each midwife needs to do 45 births a year. We can do this.  Other countries have made this change to improve maternal and infant outcome.  Canada legalized direct-entry midwifery about the same time Monana did. Canada has the advantage of having a health care system as opposed to a health care for-profit industry. And now in Quebec there are more midwives than OBs. And direct-entry midwives are integrated into the health care system. They attend births in home, birth center, and hospital. In the same time frame, New Zealand made the same changes. We have bigger battles than either country because of our profit-based health care industry. But I know that 2 students and 45 births a year are doable. I am already doing it.

If you have ever considered midwifery as a possible career now is the time to act. Midwifery schools are accredited. Federal policy is changing. Science and the international health community are on our side. The women who brought midwifery back from the brink of extinction here in the US  have positioned us to succeed. Now we need to step forward and move midwifery into the mainstream. Mothers and babies need us.

For more information on Midwifery Education, here the Midwifery Education Accreditation Council

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