New Study Reveals Midwife-led Birth Centers a Key to Decreased Cesarean Rate, Lower Health Care Costs

With health care costs skyrocketing and approximately one-third of all hospital births resulting in cesareans in the United States, childbirth overseen in midwife-led birth centers is emerging as a safe and cost-effective alternative to hospital births, cites a new study conducted by the American Association of Birth Centers (AABC) and published in the Journal of Midwifery & Women’s Health, the official journal of the American College of Nurse-Midwives (ACNM).

The safety and efficacy of child birth centers has been supported by well established evidence featured in The National Birth Center Study II. Most birth centers utilize midwives as the primary care providers, working collaboratively with physicians, hospitals, and other maternity care professionals in a team approach to maternity care. Midwives are health care professionals responsible for the pregnancy, labor, and childbirth care of the women they serve.

AABC President-Elect and founder of Charleston Birthplace, Inc. Lesley Rathbun, CNM, FNP, MSN describes a birth center as “a homelike facility existing within the health care system with a program of care designed in the wellness model of pregnancy and birth. Birth centers provide family centered care for healthy women before, during, and after normal pregnancy, labor, and birth.”

According to the study, of the 15,574 women receiving care in 79 midwife-led birth centers in 33 states from 2007 to 2010, 13,030 women (84%) gave birth at birth centers, while 2,544 women (16%) gave birth in hospitals.

In 2008, hospitalizations related to pregnancy, birth, and newborn care totaled a staggering $97.4 billion in the United States alone. It stood unrivaled as the health condition contributing most to the overall national hospital costs for that year. Cesareans rose to nearly 33% of all hospital births nationwide in 2010 from just 21% in 1996, garnering approximately 50% more in payments for care when compared with hospitalized vaginal births.

Conversely, of the 15,574 births included in the study, less than 1 in 16 births (6%) resulted in a cesarean birth. Based on current Medicare/Medicaid rates, all 15,574 births in the study may have contributed as much as $30 million in savings for facility costs alone.

“Although cesarean birth is sometimes necessary, due to the condition of the woman or baby, the procedure can lead to complications,” revealed Dr. Cara Osborne SD, MSN, CNM, an Assistant Professor at the University of Arkansas’ Eleanor Mann School of Nursing and one of the study’s researchers.

Many concerned care providers across numerous specialties, including physicians, nurses, and midwives, have aimed to promote lowered cesarean rates. “A growing body of evidence, including findings from The National Birth Center Study II, continues to demonstrate that women who give birth at midwife-led birth centers experience exceptional outcomes and are less likely to undergo cesarean birth compared to those who give birth in hospitals,” Dr. Osborne added.

Dr. Holly Powell Kennedy, a Professor of Midwifery at the Yale University School of Nursing explained that “increasing access to midwives and birth center services would drive down costs in our over-burdened health care system, while also ensuring safe, quality care in pregnancy and childbirth. Midwives, who attended more than 335,000 births in 2010, work collaboratively with a range of health care professionals, such as obstetricians and other physicians, to provide comprehensive care for women, resulting in safe, quality care. Their work as a team with pregnant women and their families ensures a personalized and nurturing birth center experience.”

To learn more and to access the full results of The National Birth Center Study II, visit the Web site for ACNM’s Journal of Midwifery & Women’s Health at: http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12003/full.

For more information on midwives, visit ACNM’s Web site at: www.midwife.org

To learn more about birth centers in the United States, visit AABC’s Web site at: http://www.birthcenters.org/research

Photography by Earthside Birth Photography.