In the the last post, I wrote about the exorbitant cost of US healthcare. If we pay 4 times as much for healthcare, our care should be much better—right? But that is the craziest thing. We pay more for care that is much worse. The value of a product takes into consideration cost and quality. Our healthcare system is high cost and low quality which is the very definition of low value.
Pregnancy is not really a disease. It is a normal bodily function that involves healthcare to protect the mother. Our healthcare system does a terrible job of protecting the mother. If your wife, sister, or daughter becomes pregnant in the United States, she is 10 times as likely to die as a young pregnant woman in the smaller countries of New Zealand or Norway. Seven hundred women die in pregnancy in America every year. That is like crashing two jumbo jets full of young mothers into the side of a mountain annually. Nine out of ten of these deaths are preventable. What a hole that leaves in the family, and it is totally avoidable.
As with chronic disease, women dying in pregnancy is a systems problem related to lack of primary care.
“The U.S. has an overall shortage of maternity care providers relative to the number of births.
Midwives in many countries are key care providers trained to provide a wide range of services. Among these are helping to manage a normal pregnancy, assisting with childbirth, and providing care during the postpartum period. Placing a priority on natural reproduction processes and relationship-building, midwives also can help address the social and personal needs of mother, baby, and family. Ob-gyns, meanwhile, are physicians trained to identify and intervene in abnormal conditions that come up before, during, and after pregnancy. They typically provide care in hospital-based settings.
Midwifery-led care models have been shown to provide care that is comparable to, or sometimes even better than, that provided by obstetrician-gynecologists, or ob-gyns (see box).
The U.S. and Canada have the lowest overall supply of midwives and ob-gyns — 12 and 15 providers per 1,000 live births, respectively (Exhibit 3). All other countries have a supply that is between two and six times greater.”
Nurse practitioners are being trained as midwives in the United States, but our financial models of care do not support them adequately. With extensive reform of our system, we could protect more wives, daughters, and mothers now. Will we? Or will we continue to tolerate healthcare for American women that does not meet their needs?
Another sign of the total destruction of our profession in America. Very sad!
The ob-gyn I had quit to become a functional medicine doc. She is my doc now. She is much happier now she remarked. I understand that it’s much riskier to be an ob doc now with our litigation society and treatment tyranny from the hospitals. Medical boards. The pediatric sector is off the rails as well.