Why Birth with a Surgeon?

One of Gov. Huckabee’s ideas that I liked was his emphasis on preventative health measures. The idea is do the things that are healthier and far less expensive instead of waiting for a health problem with an (expensive) cure. The theme is to have a health system instead of a health care system (that waits until things are serious before taking action).

I was often tempted to ask him about maternity care in America on the blogger conference call. I never did because it is not necessarily a presidential issue, but I thought I would post about it now.

I find the maternity care portion of our health care system particularly annoying. In 2006, the US had the 2nd worst infant death rate of any developed nation (followed only by Latvia) according to this CNN article. Our maternal death rate is on the rise (though still rare), according to this 2007 article in the Boston Globe.

And to top it all off, we spend more per baby than most modernized countries. (I couldn’t find a link for that, but in your gut you know it is true.)

Why is this? In my opinion, we would be much better served as women and a country if we stopped going to surgeons for a God-designed function of a woman’s body. OB/GYNs are, first and foremost, surgeons. They spent many years after medical school at a teaching hospital in a surgical residency program and then an OB/GYN residency. If you think that they are prone to not use all of these well honed surgical skills, think again.

I acted as labor support (doula) for a while in Arizona. Every birth I attended was a hospital birth. The doctors often saw themselves as “saving” the woman via all sorts of interventions even when she did not want or need saving. Few doctors knew much about normal childbirth. I say this not to fault them. Their training, after all, is in intervening. So can we blame them when they do? And those services are sometimes necessary. For example, I have a friend who has a condition that makes pregnancy/childbirth very dangerous (her sister almost died in labor because no one new she had it). So my friend is signed up for a c-section at the end of the month.

But most women (around 85-90%) are low risk. Their bodies are perfectly formed to allow a baby to develop and give birth. So why send a healthy woman to a surgeon? All over the developed world there is another, safer, healthier, less expensive system in place. Certified midwives attend most deliveries. Great Britain’s government is even looking for a way to make midwife homebirths (as opposed to a birth center) more accessible. Check out the BBC News article here.

I know that giving birth at home with a midwife raises the image of leftist hippies, but I think that it is really a vertical issue. Both sides of the isle should stand up to the powerful lobby of doctors and usher in a freer, better maternity health care system. At least, we should have a choice. (In some states, women have few legal out-of-hospital choices besides unassisted homebirth.) In Arizona, Medicaid can be used for Certified Nurse Midwives. I can only imagine how many women and babies have benefited from this (I and my son are among them). I can only imagine how many tax payer dollars have been saved. In my case the amount saved was on the order of $30,000, but I won’t go into details on why right now. The average savings would be about $10,000 per delivery.

Along these lines, I stumbled onto a movie called The Business of Being Born. I give it four stars. It did a good job of covering the issue, but the f-word was left in a couple of times. Also for those of you sensitive to it, there was full nudity (in a completely non-sexual birthing way). Here is a link if you would like to see a preview.

UPDATE:
Also, if you would like to learn more about midwifery in your state, go to http://www.birthpolicy.org/default.aspx. They have state by state resources.