New Reports Show Skyrocketing Costs of Birth, Reality of Maternity Care Liability Claims
Contact: Barbra Elenbaas
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.
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.