American Nurse Practitioner Midwives Can Save Lives while Dramatically Reducing Costs
The United States pays far more per delivery than other countries and we have a maternal mortality rate 5 times that of Germany, Norway, and the Netherlands. That is the very definition of low value healthcare—much higher cost for much worse outcomes. From start to finish, the cost of maternal care in the US averages $30,000 per baby. If the woman has a caesarean section, the cost is $50,000. That is on the high end, but the most conservative estimates show a big difference. “a standard delivery in the U.S. cost $11,200 in 2017 while a c-section had an average bill of $15,000. By comparison, costs for a standard and c-section birth in the Netherlands only average $3,600 and $5,300 respectively with insurance typically covering everything.”
Part of the reason for this lies in the fact that midwives play a much bigger role in Europe than in our country. We have 4 midwives for every thousand births. Germany has 25 per thousand and Sweden has over 60. Our births are managed by physicians which are more expensive.
It has not always been this way. Prior to 1860, almost all deliveries in the United States and Europe were done by women for women. Midwives performed almost all deliveries. They continued to play a major role in Europe and improve their educational background to do this work. But something very dark happened in this country. “In the late 19th and early 20th centuries, American obstetricians sought to overtake the entire field of childbirth and declare major war against the traditional midwives in the United States. Midwives wanted an education, but obstetricians fought hard against this idea.” In an instant it was all different in the United State. We went from women taking care of women in this most womanly of healthcare issues to a system run by men for men. It his not worked out well, producing much higher cost along with higher rates of infant and maternal mortality.
American nurse practitioners are working to fill this gap with training programs for Women’s Health Nurse Practioners (WHNP) These programs address the healthcare needs of adult women including pregnancy and childbirth. I have told you repeatedly how nurse practitioners provide better care in chronic cardiovascular and related diseases. This is another area where they can improve health at lower cost.