New Reports Show Skyrocketing Costs of Birth, Reality of Maternity Care Liability Claims

Contact: Barbra Elenbaas
Office: (240) 485-1822
E-mail: [email protected]


SILVER SPRING, MD
* Maternal and newborn care represent the most common reason for admittance to
hospitals in the United States, and 2 reports released this week from
Childbirth Connection identify 2 persistent problems negatively affecting the
current US maternity care system: medical liability and the rising cost of
birth.


The Cost of Having a Baby in the United
States addresses the rapidly-increasing price tag weighing down a
maternity care system in which cesarean births occur at more than double the
World Health Organization's recommended rate. Decreasing the rate of more
expensive cesarean births from the current 33% of all births to the recommended
15% alone would cut national spending on maternity care by $5 billion. Significant variation in costs between states
and regions for cesarean and vaginal births indicates that there may be more
opportunities for savings. The report found that regardless of type of birth,
the largest share of all costs associated with combined maternal-newborn health
care go to hospital or other facility expenses, and that total maternal and
newborn care costs are highly concentrated in the hospital stay for children.


The second report, Maternity Care and Liability: Pressing
Problems, Substantive Solutions, takes
the first comprehensive look at medical liability in maternity care in 25
years, and finds that widely held beliefs about the areas of dysfunction in
care and about most promising solutions are not supported by new research. The
report holds several surprising findings, including that costs of liability
premiums are a comparatively small, declining portion of clinician practice expenses
and defensive practices motivated by fear of liability occur at only a modest
rate in maternity care. Traditional liability
system reforms, aimed, for example, at reducing liability premiums, have failed
to prioritize the needs of childbearing women and newborns. About
three-quarters of paid maternity-related claims have consistently been found to
result from substandard care, and mothers may experience negligence in care at
several times the rate that newborns do, according to the report. The
highest-rated prevention strategy, according to Maureen Corry, MPH, report
co-author and Executive Director of Childbirth Connection, is rigorous quality
improvement programs for care providers, which have been shown to lead to
better care and maternal-newborn health and reduced liability claims, payouts,
and premiums.


The necessary changes to the maternity care system in the
United States implied by the reports would create a need for providers that
certified nurse-midwives (CNMs) and certified midwives (CMs) are poised to
fill. The tough issues raised in the reports could be addressed by an increase
in high-quality care from healthcare providers with low rates of intervention -
a hallmark of the midwifery model of evidence-based care. "We have a real
opportunity to improve the wellbeing of mothers and babies in the United States
while lowering cost burdens," said ACNM President Holly Powell Kennedy, "and we
can do it by following the evidence." ACNM looks forward to engaging with
policymakers on strategies to implement the recommendations in these two
important reports.


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For more information,
contact Barbra Elenbaas, ACNM Communications Assistant, at (240) 485-1822 or
via e-mail at [email protected].


About the American
College of Nurse-Midwives


The
American College of Nurse-Midwives (ACNM) is the professional association that
represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the
United States. With roots dating to 1929, ACNM sets the standard for excellence
in midwifery education and practice in the United
States and strengthens the capacity of midwives in developing countries.
Our members are primary care providers for women throughout the lifespan, with
a special emphasis on pregnancy, childbirth, and gynecologic and reproductive
health. ACNM reviews research, administers and promotes continuing education
programs, and works with organizations, state and federal agencies, and members
of Congress to advance the well-being of women and infants through the practice
of midwifery.