The Cost of Birth Becomes Personal

Originally posted to GlobalShift.org

In a matter of days, I’ll hit my 37th week of pregnancy. Professionals in the field of obstetric and gynecological medicine will tell you that this is a time of considerable growth and importance for pregnant women and their developing fetuses, because it’s generally accepted that a baby born in this window will survive, barring any substantial medical issues.

Yet despite this reassurance of viability, I find myself more afraid than I have been at any other point during the last eight months. Early into my pregnancy, I selected the Women’s Health and Birth Center of Sonoma County to not only provide prenatal care, but to serve as the place where I intended to deliver my baby. This came about after weeks of careful consideration of what kind of birthing experience I wanted.

Once it became clear that this pregnancy would not be going the way of the dinosaurs, I spent a fair amount of time evaluating how to make the experience with the Birth Center as empowering as possible. This should be of no great surprise to any of my long-term readers, as the Feminist angle is my primary motivator for both my career and ongoing personal ideology. Couple that with being a survivor of sexual violence (and, tragically, how the experience of childbirth can re-traumatize those who have been victimized) and you have all the reasoning for why I felt it necessary to create a pregnancy based on empowerment rather than submission.

Choosing the Birth Center was critical to obtaining a peace of mind so that I wasn’t afraid of the journey I was embarking on. Upon my first meeting with Roseanne Gephardt, the head midwife, I laid my frank concerns out on the table. Most importantly, I wanted it understood that a Cesarean section would be permitted strictly as a last resort, and only if it was irrevocably clear that not to have one would mean certain death or deformity for me or my child.

Perhaps, even to those who have been pregnant before, these stances sound extreme. But they really aren’t. Within weeks of discovering I was pregnant, an explosive and comprehensive report about California blew the whistle on so-called maternal health care, finding that the maternal mortality rate is higher than that of Bosnia or Kuwait. That’s correct: mothers are more likely to die in childbirth in the Golden State than in two countries still recovering from brutal civil wars. Adding insult to injury, many of the deaths are preventable with routine postpartum screenings. The growing favor toward C-sections is cited as a major instigator of this climbing statistic.

Across the country, the rate of C-sections is more than on the rise. In many areas, it’s becoming the standard of care rather than a last resort. The World Health Organization suggests the best outcomes for mothers and babies appear to occur with Cesarean section rates of five to 10 percent, while rates above 15 percent seem to do more harm than good. While the US initially met this number in 1967 — the first year such numbers were tabulated — those rates have more than tripled. By 2007, one in every three mothers could expect to have her birth complicated by a Cesarean section, and the other figures aren’t substantiating that each is an absolute medical necessity.

Whether the average American chooses to believe the real culprits are “C-sections on demand” or obstetric surgeons who simply want to get paid, there is a pervasive bias against natural birth options. This explains why, of all the fingers in the small pie that is California’s state-sponsored health care system, birth centers like Santa Rosa’s are being left empty-handed.

When I went into the Birth Center last week for a routine check-up, I was informed that Medi-Cal, the state’s version of Medicaid, would no longer cover my prenatal visits. I would need to receive services from another clinic nearby, a clinic connected to a hospital that I had already researched and concluded was not a place  in which wanted to give birth. And I wasn’t the only one.

“The state’s action is a severe blow to the center, where 85 percent of its patients are covered by the state’s health program for those who cannot afford medical care,” The Press Democrat reports on July 28. “Since last week, Gephart said she’s been forced to lay off four employees and put two others on extended vacation.”

I tried, as best I could, to understand how any bureaucracy could think such a move was possibly a good idea. As best as one of the other midwives could pontificate, the state simply doesn’t understand what birthing centers do. Such isn’t a foreign concept to me — even my fairly granola in-laws reacted with concern when I dismissed the possibility of a hospital birth and discussed my hope of an empowering water-birth.

However, there are a few irrefutable facts. First and foremost, natural birthing institutions like the Birth Center save the taxpayers money. Because pregnant women will always disproportionately make up the numbers of dependents of state-run health care, childbirth will continue to be a major expense taxpayers have to consume. It makes sense, then, to cover low-cost options as equally as those of higher-cost. Natural birth centers, due to their low level of intervention such as C-sections, save an average of $10,000 per birth.

More than the emotions that accompany such a situation, one can only wonder if this state is in any position to refuse options to relieve the financial pressure citizens are under. This week, the Obama administration announced a new initiative to spend somewhere around $63 billion on a “women-centered” global health care solution, but I’m of the opinion that there are plenty of women domestically who could benefit from such an initiative, including me.

While the resolution of this particular situation hasn’t played out yet, it’s unlikely to happen before my scheduled due date of September 21, and I remain unclear as to whether I’ll ultimately have the birth experience that I want. What is clear is that the long patriarchal practice of constructing women’s social preferences so that they appear to be freely chosen has once again launched a moderately successful campaign against what ought to be the most empowering moments of a woman’s life.

With all of the costs, both tangible and not, involved, is that really a price we should have to pay?

Disclaimer: This post was written by a Feministing Community user and does not necessarily reflect the views of any Feministing columnist, editor, or executive director.

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