Jennifer Margulis

high There’s a new report, published today, from Truhaven Health Analytics that breaks down the costs of having a baby in the United States.

From the forward:

“One of the greatest opportunities for improving health care value is in maternity care, which impacts everyone at the beginning of life and about 85% of women during one or more episodes of care. Most childbearing women are healthy, have healthy fetuses, and have reason to expect an uncomplicated birth, yet routine maternity care is technology-intensive and expensive: combined maternal and newborn care is the most common and costly type of hospital care for all payers, private payers, and Medicaid.”

There are many ways to lower the cost of having a child in America. We can begin by stopping unnecessary interventions, including labor induction before 40 weeks, unnecessary synthetic hormones to strengthen labor contractions, unnecessary pain medications, and unnecessary C-sections.

Every intervention carries a price tag to the consumer, the insurance companies, and the nation as a whole. Someone has to pay for that epidural medication and the highly trained doctor who inserts it into your spine.

But there isn’t just the financial cost.

There’s the physical and emotional cost as well.

Women request epidurals because doctors rarely help them prepare for the pain of childbirth and view it as something positive. Your body responds to the pain by changing positions, which helps the baby descend the birth canal. Women aren’t told that once they are given an epidural, they will be tethered to the bed and they will not feel their baby being born. No one will look at them. Everyone will look at the electronic monitor that spits out data about each contraction.

Other women are bullied into getting epidurals when they do not want them. I was told by the doctor we had never met before who was the only male in the practice that I was being “selfish” for continuing to labor without Pitocin and an epidural and that I should stop “inconveniencing” my family. The labor and delivery nurses ignored my repeated requests to shut the epidural off. One of my legs was numb for weeks afterwards. Another friend had a headache so bad (from a complication from the epidural) that she could barely lift her head. It was days before she could hold her baby.

We know that epidurals increase the likelihood that women will have a fever during labor and that babies born to moms who have had a fever during labor are more likely to have problems at birth, be given prophylactic antibiotics, and be separated from their mothers.

As this researcher explains, the most scientific birth is often the least medicalized one.

But without an epidural, how can you manage the pain of childbirth?

1) Hydrotherapy: In Scandinavian countries, as in many birth centers in America and in more progressive hospitals, one way is by using hydrotherapy, a fancy term for treatment by water. Many women find that bathing in warm water or taking a shower and directing the spray onto their bellies or back, helps lessen the pain of childbirth. Water costs pennies.

2) Acupuncture: In Scandinavian countries most midwives are trained in acupuncture. I watched a childbirth in Norway. When the contractions started to get really intense and the mom wanted to rest, her midwife dimmed the lights, put in needles, covered her and her husband with a blanket, and had her stay still. The acupuncture helped her relax and get her strength back. This sounds crazy to most Americans who have never heard of it but it is used to great effect in Europe. Training medical professionals to use acupuncture could be a very cost effective way to help women manage pain without other more invasive more expensive interventions.

3) Kind, supportive, caring attention: I attended a panel with a local doctor who does not have room in her schedule to take many pregnant women. “I know that sometimes I’m the best medicine,” she told the audience. “When a woman is having trouble in labor or feels overwhelmed, I come and sit with her. Often that’s all she needs.” Scientific studies have shown without a doubt that having a constant attendant during labor is one of the best ways to decrease the chance of having birth interventions (like surgery) and increase the chance a woman will feel more satisfied with her experience. What is the cost of being loving, gentle, and encouraging to a laboring woman, helping her ride out contractions by massaging her (if she wants to be touched), looking her in the eyes, reminding her to relax her mouth (if you relax your lips, your lady bits relax too), and telling her she can do it?

Jennifer Margulis, Ph.D., is a senior fellow at the Schuster Institute for Investigative Journalism. Her latest book, The Business of Baby: What Doctors Don’t Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby Before Their Bottom Line, will be published by Scribner in April 2013.