Midwife Care

Giving birth is at once beautiful and terrifying. When it’s time to deliver, having friendly faces in the room and trusted professionals working alongside one another helps to ease the process. A recent study from the University of Sydney shows moms-to-be may want to rethink their prenatal care in one important way: by adding a midwife.

The study finds that, with the use of a midwife, a woman can lower her chance of birth complications, reduce her hospital stay, and cut her medical bills. Not bad for just one more friendly face.

While there’s certainly a spectrum of “midwifery,” from the certified nurse midwives observed in this study to the more holistic doulas, a midwife is a trained professional who works with mothers throughout pregnancy, during birth, and afterward to help ease the childbearing process.

Researchers studied what are called caseload midwifery practices, with one midwife for each patient through the entire course of her pregnancy. Midwives were paired with nearly 2,000 mothers in Australia between December 2008 and May 2011.

Mothers with caseload midwifery were less likely to have a medical intervention, less likely to have a cesarean section, and less likely to have an epidural for pain management. Their hospital stays were also likely to be shorter. Moreover, with caseload midwifery, each woman saved an average of AU $566.74, or U.S. $536.25. With a new child on the way, every penny counts.

Add a Midwife and Save Big

“The most significant and surprising finding is the extent to which this way of providing midwifery does not cost more. In fact, it costs significantly less than providing midwifery in the old standard ward and clinic-rostered way,” says study author Sally Tracy, M.D., a professor of midwifery at the University of Sydney in Australia.

In today’s health care climate—especially in the United States—more specialized care just sounds like more money out of your wallet. But because caseload midwifery was found to reduce hospital stays and the likelihood of elective cesarean sections, the actual cost is lower, Tracy says.

Also, by adding a caseload midwife instead of standardized care in which multiple people meet with an expectant mother over the course of her pregnancy, women receive much more personalized service, without compromising safety.

“[Midwife care] is safe for women regardless of the complexity of their pregnancies because it enhances the communication between the patient, the midwife, and the obstetrician,” Tracy says.

Dispelling Midwife Myths

In 2011, nearly 33 percent of all deliveries in the United States were cesarean sections, according to the Centers for Disease Control and Prevention (CDC). That’s at least ten percent higher than both Australian study groups. For the caseload midwifery group, there was a three percent decrease in elective cesarean sections.

Midwifery is standard practice in Australia and the U.K., but before it is adopted on a larger scale in the U.S., there are a few misconceptions that need to be overturned.

Midwifery has to overcome two main myths, Tracy says. The first is that people often assume choosing caseload midwifery means opting out of visiting a doctor.

“This is completely incorrect,” Tracy says. “Having a caseload midwife means that a woman with a complex pregnancy not only has individualized care with a midwife whom she has grown to trust, but a collaboration between her midwife and an obstetrician.”

The second myth is that midwife care is a boutique service, meaning that it will cost far too much and is an unnecessary complement to regular prenatal care.

“This is incorrect also. The midwife is making much better use of her time in responding to the needs of each woman as she is needed. Babies have a habit of arriving unexpectedly,” Tracy says.

As of January 2011, 100 percent of certified midwife care is covered by Medicare, according to the American College of Nurse Midwives. Thirty-three U.S. states also mandate that private insurance companies cover care from certified nurse-midwives. To view coverage in your state, visit the Kaiser Family Foundation’s or the American College of Nurse Midwives’ online resources.

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