Why This Is Important

Care for the pregnant woman and her baby in the United States has become increasingly medical. Interventions such as electronic fetal monitors, epidurals and caesarean sections have increased to the point where they are now routine interventions in most births in America. 1998, the CDC's Healthy People 2010 initiative set the goal of a C-Section rate of 15%. Instead, in the first half of this decade that rate has climbed from 17% to 25% in low-risk first time mothers, and from 71% to 90% among low-risk repeat C-section deliveries. [CDC] Of all women delivering a baby in America today, more than one-third of them will end up with this major abdominal surgery and its corresponding increased risk of complications including infection, hospital re-admission, and maternal death.

Why has the C-Section rate increased so dramatically?

Many reasons: An increasingly low tolerance for risk, fear of malpractice suits, the routine use of interventions such as electronic fetal monitoring and epidurals, the inability for a laboring mother to walk around, older mothers, convenience for both the doctor and patient, and, obesity. Conversely, a too-low C-section rate in developing nations is tragic and a clear indicator that women in those countries do not have access to necessary care.

Disparities and Health Outcome

Despite tremendous advances in maternal care, and despite unprecedented application of medical interventions in delivery, infant mortality rates are flat, maternal mortality rates are rising, and preterm birth rates are rising. [CDC] And if you are a black, non-hispanic woman, you are more likely to have poor maternal or infant birth outcome. The midcourse Healthy People 2010 review found that disparities for black non-Hispanic women were increasing for numerous indicators, including neonatal deaths, very low birthweight infants, mental retardation, and cerebral palsy. [Women’s Health Issues, Volume 20, Issue 1, Supplement 1]

The use of evidence-based protocols for birthing women provides better outcomes for mothers and babies. In contrast to the aggressive use of unnecessary medical intervention, these protocols allow women to experience birth as a normal, natural process in which the women’s body and the baby work in symbiotic harmony to bring new life into the world, and in which women experience the power of their bodies in a supportive, nurturing environment.

The article Transforming Maternity Care: Action Steps Toward a High-Quality, High-Value Maternity Care System, explains the high dollar cost of the current maternity-care system.

Maternal and newborn hospital charges exceeded $86 billion in 2006, with employers and private insurers paying for 50% of all births and taxpayers/Medicaid paying for 42% (Russo, Wier, & Steiner, 2009). Although most childbearing women and their babies are healthy and at low risk, the current style of maternity care is procedure-intensive and costly. Women’s Health Issues, Volume 20, Issue 1, Supplement 1