Archive for the ‘Advocacy’ Category

New Research: Doula Support Reduces Odds of Cesarean Section by 40%

February 22, 2013

A new study entitled Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries” was released online last week in the American Journal of Public Health and is creating quite a stir within the childbirth community nationwide.  Paired with National Birth Center Study II, released last month by the Journal of Midwifery and Women’s Health,  it seems that the movement toward more choices in maternity care is gaining strength.  The National Birth Center Study provided evidence for increased access to midwifery care and birth centers by showing that women who receive care at midwife-led birth centers incur lower medical costs and are less likely to have cesarean births compared to women who give birth at hospitals.

The new study on doula care compared childbirth outcomes of women insured by Medicaid who received doula support to those who did not.  Researchers at the University of Minnesota School of Public Health found that doula support reduced a woman’s odds of giving birth via Cesarean section by more than 40%.  They also found a decrease in preterm births of almost 20% in the doula supported group.

Past research has shown that doula support results in other positive birth outcomes, such as:

  • Increased initiation and duration of breastfeeding
  • Shorter labors
  • Less need for anesthesia or analgesia
  • Fewer vacuum and/or forceps births
  • Higher APGAR scores
  • Better mother-baby bonding
  • Less postpartum depression

The study goes on to discuss the possible cost savings to Medicaid programs if they were to provide reimbursement for doula services, since Cesarean sections are approximately 50% more expensive than vaginal births.  The researchers are hesitant to provide concrete numbers because costs and associated benefits would vary widely by state.

But since blogs aren’t held to the same high standards that research articles are, we decided to come up with a very approximate estimate, just for curiosity’s sake.

Number of births in US per year
Estimated Percent of US births covered by Medicaid
Estimated Number of US births covered by Medicaid
US Cesarean section rate (2010)
Estimated number of Medicaid-covered Cesarean sections in US
Percent of Cesarean sections prevented with doula support
Number of cesarean sections preventable through doula utilization
Difference in cost between Cesarean section and vaginal birth
Resulting savings to Medicaid programs per year
3,999,386
46%
1,839,718
32.8%
603,428
40.9%
246,802
$4,500
$1.1B

This very rough sketch of the money that Medicaid programs would save if every mother had access to doula support doesn’t take into account the considerable cost of providing that support.  If Medicaid reimbursed for doula care at $500, and offered support to every mom, the cost would be about $920M.  That would still yield a net savings, after reimbursement, of nearly $200M.  Not to mention all those better outcomes for mom and baby.

This seems (to us) to be one of those wonderfully poised, win-win initiatives that leads to both happier, healthier moms and babies and cost savings for a taxpayer-funded program.  What would happen if there was a campaign in every state to bring this issue to the forefront and get doulas for all women?  And are you willing to help?

Watch CiC’s Executive Director, Elan McAllister, discussing doula care on Huffington Post LIVE

Article Citation:

Backes Kozhimannil, K., Hardeman, R., Attanasio, L., Blauer-Peterson, C., & O’Brien, M.  (2013). Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries. American Journal of Public Health. e-View Ahead of Print.  doi: 10.2105/AJPH.2012.301201

Bearing the Burden of Choice: A Young Feminist’s Perspective

January 25, 2013

By Meagan Fuller, guest blogger

feminist camp-0109-054723

Group of Feminist Campers Winter 2013, photo credit: Carly Romeo of Two Spoons Photography

I came to NYC to participate in the ultimate feminist vacation, conference, and networking event, Soapbox, Inc.’s Feminist Camp. A week packed with visits to social justice organizations from foundations to grassroots activist groups, Feminist Boot Camp was an opportunity for aspiring social justice advocates to discover modern activism and what feminism can look like in professional practice. One of our stops was at Choices in Childbirth.

Here are some notions with which I walked into Choices in Childbirth’s office:

Based on personal observation, choices concerning women’s reproductive health are heavily concentrated in preventative action – what are the best practices to avoid pregnancy?  Consequently, prevention inspired language lends to a negative association with child bearing. It is something to prevent rather than embrace.

Language surrounding abortion lends to the same effect. Public health initiatives emphasize preventing pregnancy through the use of contraception, but when spontaneity clouds the campaigns and the unplanned happens, how does one tackle the heaviest choice of all?

Throughout the week long journey, the controversial plight of feminism, the legal right to have an abortion, was a reoccurring topic. Abortion is one of those issues that seems to leak into every “women’s issue” whether initially intended or not. Needless to say, we talked about abortion to the point of exhaustion. Not to take away from the weight of abortion to the feminist cause, I began to recognize a gap in our reproductive justice discussions. I found myself asking the question:

What about the women who choose the path of childbearing?

Following an intense viewing of the documentary entitled, The Business of Being Born: Classroom Edition, filled with intervals of happiness, anger, laughter, and even tears, I, along with my fellow feminists, learned how choices in the realm of prenatal, postpartum, and maternity care have been institutionalized. Who would have thought the phrase “turnover rate” would be used in the context of maternity care? The interviews from the film resonated throughout subsequent meetings, bringing to light to what extent choice is a heavy word, heavy in the sense that it comes with great responsibility and repercussion, but also, limitation. Choices are saved for the privileged, ostracizing populations of women who do not have access to the resources which would allow them to make individual decisions about their pregnancy. As social justice advocates, feminists like me seek to challenge the essence of privilege that dictates the amount of choices one has. Feminists are the defenders of choices in reproductive health, extending this privilege to every person, regardless of their demographics. Perusing pamphlets listing countless resources and venues through which women can access their preferred maternity care, I found my prior questions answered in the humble work of Choices in Childbirth.

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Launch of the NEW Guide to a Healthy Birth!!

September 21, 2012

Choices in Childbirth is so excited to announce the launch of the 2012/2013 edition of The Guide to a Healthy Birth. Click here to order today!

Wednesday Night (9/19) was our first official launch of the 2012/2013 Guide to a Healthy Birth! Many providers and members of the birth community visited our office in NYC to pick up their guides and mingle. If you weren’t able to make it, don’t worry! You can easily order them online by clicking here! Together we can help foster environments that inform mothers and families on their rights and options in childbirth.

We are incredibly grateful to every editor, writer, and contributor to the Guide. We could not have created it without such amazing skills, time, dedication, and collaboration from our volunteers! Many thanks to every one who helped create this educational tool! Our hope is that mothers and families will feel more empowered to make decisions about birthing options, support, and care after reading the guide.

There are TWO versions of the guide:
1. National                                
  • State c-section rates
  • General resources (care providers, agencies & organizations offering services to birthing women)
2. NYC Metro             
  • NYC Metro area hospital c-section rates
  • Directory of local Mother-Friendly providers: from doulas to midwives to acupuncturists, Gynecological care, obstetric care, nutrition, fitness, prenatal/postpartum counseling, breastfeeding support, childbirth education classes, advocacy, lesbian and gay parenting support, and much more!

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