MaternityCare_2.0 ~ Mother-Baby-Father-Friendly Care for Normal Childbirth that all Americans can be proud of!
Today’s blog is the final installment about an ABC article reporting on the increase in maternal mortality in the US (published by ABC on March 4th, 2010, excerpts embedded in the March 8th of this blog (Normal-Birth.blogspot.com).
We know that what has been happening is the US is wrong - the false idea that Cesarean surgery makes birth safer. Now we need to figure out how to correct this problem -- how do we transform our maternity care system? And in particular, how do we end the mindless medicalization of normal birth - the overuse and misuse of induction of labor and elective Cesarean - in healthy women and replace it with evidence-based, cost-effective maternity care. This is the best way to (a) reduce preventable maternal mortality and (b) to provide an effective and efficient system that is highly rated by childbearing families as "satisfying" and highly rated by health care officials as affordable and accessable.
The science-based model of maternity care for normal childbirth protects and preserves maternal-fetal wellbeing, while providing access to appropriate obstetrical intervention for those women or babies with complications or if medical interventions are requested by the mother. This serves the needs of healthy families far better than our expensive and inflexible high-tech model, which costs two to ten times more than it needs to.
Billions of health care dollars can be saved every year by lowering the direct cost of maternity care and reducing post-operative, delayed and downstream complications associated with Cesarean surgery.
MaternityCare_2.0 is a big first step on our national path to a safe, effective, affordable, accessible healthcare system that we Americans can to proud of -- HealthCare_2.0
Adopting evidence-based standards for normal childbirth will require legal and legislative changes that move us away from the mistaken idea that it is "substandard" for a physician to provide physiologic (i.e. non-medical) care, since childbirth is legally defined as a surgical procedure by the medical profession. We also need regulations to end the perverse incentives that pay for doing things *to* the mother (often risky, invasive or painful procedures) but don’t compensate a physician for spending time *with* the mother. Under the current surgical billing code for normal birth, medical providers are paid per procedure. This makes more interventions more profitable.
What we need is a new, non-surgical billing code for physiologically-managed childbirth that allows birth attendants to be protected from outmoded policies and inappropriate litigation, while at the same time being fairly compensated for their time and rewarded for preventing complications. This will also reduce long-term problems that burden the family and are expensive to the healthcare system.
Maternity Care 2.0 – a science-based model for the 21st Century:
For an essentially healthy population, the most efficacious form of maternity care is always the method that provides “maximal results with minimal interventions”. This is defined as a *beneficial ratio of interventions to outcomes* for each childbearing woman.
The ideal maternity care system *seeks out the point of balance* where the skillful use of physiological management and adroit use of necessary medical interventions provides the *best outcome* with the *fewest number* of medical/surgical procedures and *least expense* to the health care system.
This is the right way, the only way to eliminate preventable maternal mortality and morbidity and eliminate unnecessary suffering of the children, fathers and families left behind.
Faith Gibson - former L&D nurse, California licensed professional midwife, ratifier of the Coalition for Improving Maternity Services (CIMS) “Mother Friendly Childbirth Initiative”