In a message dated 17/07/03 16:42:01 GMT Daylight Time, [log in to unmask] writes:
my hospital in New York City, with a midwifery service starting over 50 yrs ago has just recently said that midwives would no longer be doing deliveries!!
We are 23 midwives working very hard to turn this around, any assistance would be greatly appreciated.
You've certainly got a fight on your hands ... I'll cut and paste some information I've already been sent - it's UK and sterling but I'm sure you'll find it useful.
"The only reference I
have is Petrou and Glazener 2002. For a spontaneous vaginal delivery
overall cost £1698 this includes hospital readmissions birth postnatal
stay midwifery and GO care and HV support.
whereas a caesarean = £ 3.200
An instrumental =£2263
If the C/S rate was reduced by 1% there would be a saving of 5 million
pa. I think you will find that stat in the report entitled 'From Audit
to Action' The rising caesarean section rate and I cant put my hands on
my copy just now. Alternatively you could quote The NCT document
'Reconfiguring Maternity services Veiws of User Representatives 2002
page 24. It says
'Cost effectiveness has bee a major component of the argument for
centralising services over the past decade. This is not supported by
empirical evidence. While there may be some savings in capital costs the
main factor determining the cost of maternity care is staff time.
Midwifery care and support is needed by women in all settings.
Maximising the number of women who have a straightforward normal birth
can save funds by avoiding the need for specialist anaesthetic,
obstetric, and paediatric care. Official estimates suggest that a
caesarean section cost around £1000 more than a vaginal birth. On this
basis, a 5% reduction in the caesarean section rate would save an NHS
trust with 3000 births per year around £150000 per year.'
This was sent to me by Helen Shallow, a consultant midwife here.
Certainly midwifery led care, especially in a birthing unit seems to have a real effect on reducing the caesarean section rate. If you log onto the birth centre group at yahoo, you'll find some evidence from Edgware birth unit in London.
Best wishes
Keep us posted
Sue Dennett