From The Big Push for Midwives

PBS Global Health Watch Report: High Rate of Home Birth in the Netherlands Results in Reduced Costs, Superior Outcomes
Report Follows Landmark Dutch Study on the Safety of Home Birth

WASHINGTON, D.C. (October 9, 2009)—In the second segment of PBS' The NewsHour with Jim Lehrer series on health care reform that aired on Wednesday, senior correspondent Ray Suarez reports that “for the Dutch, a huge cost saver starts the day you’re born.” He goes on to note that the majority of Dutch babies are born at home in a nation where the infant mortality rate is 25% lower than in the United States . Suarez’s report is consistent with a recent study of more than 500,000 births in the Netherlands , which found that planned home birth with trained midwives is as safe as hospital birth.


"Reports and research coming out of the Netherlands confirm what those of us in the medical community who pay attention to the evidence have known for many years,” said Stuart Fishbein, MD. “Planned home birth with trained midwives not only reduces costs, but it also results in significant reductions in the cesarean section rate as well as in the rates of low birth weight and preterm births.” Low birth weight and prematurity are two of the leading causes of infant mortality and racial and ethnic disparities in birth outcomes in the United States .

Two types of midwives practice in the United States, Certified Nurse-Midwives and Certified Professional Midwives. While Certified-Nurse- Midwives practice primarily in hospital settings, Certified Professional Midwives are required to undergo specialized clinical training in out-of-hospital settings, including private homes and freestanding birth centers. More than half the birth centers nationwide are owned or staffed by CPMs, who also deliver the vast majority of babies born at home each year.

"What we've learned from the Netherlands and other countries is that expanding access to out-of-hospital maternity care by providers with the type of training that Certified Professional Midwives receive benefits mothers and babies,” said Katherine Prown, PhD, Campaign Manager for The Big Push for Midwives. “The research shows that we could make significant improvements in birth outcomes and in lowering health care costs here in the United States by implementing very basic policy measures, such as closing the gap in federal Medicaid law that neglects to include CPMs as eligible providers.”

David A. Anderson, a professor of economics at Centre College with a research specialization in the costs of out-of-hospital maternity care, calculates that a 5% increase in both the rate of home births and births that take place in freestanding birth centers would result in an annual savings of more than $9 billion. Even at the current rate of 1% out-of-hospital births, simply covering the services of Certified Professional Midwives and freestanding birth centers under Medicaid would result in hundreds of millions in savings to the nation’s health care system each year.

The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating national policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and advocating for including the services of Certified Professional Midwives in Medicaid. Media inquiries: Katherine Prown (414) 550-8025, katie@thebigpushfor midwives. org
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