Will “healthcare reform” be better or worse for birth?

It’s hard to watch The Business of Being Born and not find yourself hoping that if we were ever to find ourselves with a healthcare system more like that in the U.K., that maybe we would finally see more natural-birth friendly options here in the States. Not much tops a home birth with a midwife, after all, in terms of cost effectiveness.

Sadly, as I watch the slugfest of healthcare reform play out in the press I’m not feeling optimistic. Not just about having a public health option (or that scary Socialized medicine), but about whether this will mean good or bad things for midwifery access. An article in today’s Times uses Diabetes treatment to show how treatment rules can be influenced by groups looking to profit.

To share some key bits:

Critics like Dr. Hayward have also suggested that pharmaceutical companies influenced the guideline so they could sell more glucose-lowering drugs like insulin.

The main problem is that many guidelines are based not on rigorous studies like clinical trials but on weaker types of medical evidence. And critics like Dr. Groopman have argued that the guideline-setting process is often influenced by industry or by medical ideologues looking to advance their personal agendas.

I know I for one was shocked to see the $15,000 bill paid by my insurance company that arrived at my house after my intervention-free, natural hospital birth. I can only imagine what the price tag is when you factor in epidurals, pitocin and c-sections. On the surface one would think if we’re really trying to curb costs, the $3-5 grand charged by home birth midwives offers a logical alternative for low risk moms. And yet something tells me, there will be intervening forces.

Someone is obviously benefitting financially from today’s obstetric policies. Will healthcare reform give us more of the options we want? Or make things worse?

-Christine