August 01, 2003

The financial cost of birth interventions

The cost of unnecessary intervention in birth has finally been quantified and revealed in a brilliant paper that has been published this week in the British Journal of Obstetrics and Gynaecology. A spin off from earlier research that looked at the rates for intervention amongst all the low risk women who gave birth over a two year period in NSW Australia, Sally Tracy and her husband Mark Tracy have taken the extra step to work out how much this meddling is costing both us taxpayers and the health care system.

Some of the highlights:

“The relative cost of birth increased by up to 50% for low risk primiparous women and up to 36% for low risk multiparous women as labour interventions accumulated. An epidural was associated with a sharp increase in cost of up to 32% for some primiparous low risk women, and up to 36% for some low risk multiparous women. Private obstetric practice increased the overall relative cost by 9% for primiparous low risk women and 4% for multiparous low risk women.”

In an Editorial in the same edition of the BJOG, the Associate Editor, Zoe Penn says

“Taken in combination with the evidence base surrounding successful vaginal birth, it [this research paper] debunks the myth that continuous one-to-one midwifery support in labour is expensive. Indeed, it seems that the cascade of interventions from medicalised childbirth leads to high use of epidural anaesthesia and steep increases in costs. Those of us involved in management as clinical directors can now argue that more midwives are a cheap alternative to costly, high intervention medicalised birth.”

She concludes her commentary with these prophetic words: “How ironic if finally the tide of fashion is turned by economics, instead of clinical considerations or the priorities of women themselves!”

I have always thought that the economic argument was our best strategy for promoting midwifery and this paper, a world first, gives us valuable ammunition. Congratulations to Sally and Mark for doing the hard work that proves what we have always known. It will be difficult for politicians to ignore this evidence and for the obstetricians to mount a counter-argument. But I bet they will try.....

The full reference:

Tracy S K and Tracy M B,. Costing the cascade: estimating the cost of increased obstetric intervention in childbirth using population data. BJOG August 2003, Vol 110, pp717-724.

Posted by andrea at August 01, 2003 03:49 PM

Comments

Hi,
My wife is currently 5 months pregnant and I would like to ascertain what the actial cost would be for a normal birth. Also whats the neccessary lenght of time a women should stay in hospital after giving birth ?

Reg,
Sharief

Posted by: Sharief on December 7, 2003 01:40 AM

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