Monday, September 28, 2009

How the United States Ranks

There are precious few situations in life where the cheaper alternative is also the better alternative – and maternity care is one. If we eradicated the unjustified obstetric monopoly in the United States, with its extreme medicalization of birth, and replace it with a humanized maternity care, we can vastly improve the care of women and babies, lower death rates for both women and babies, and save vast sums of money at the same time. A few facts:
  • Percentage of gross national product spent on health care:
1966: 6 percent
1992: 12 percent
  • Percentage by which U.S. health care expenditures exceed those of:
Canada: 40 percent
Germany: 90 percent

Japan: 100 percent
  • The twenty-two countries with lower infant mortality rates than the U.S.: Japan, Sweden, Canada, Singapore, Hong Kong, Netherlands, France, Ireland, Germany, Denmark, Norway, Scotland, Australia, Northern Ireland, Spain, England and Wales, Belgium, Austria, Italy.
  • Percentage of countries with lower infant mortality rates than the US that provide universal prenatal care: 100 percent
  • Percentage of US women who receive little or no prenatal care: 25 percent
  • Chances that a woman with little or no prenatal care will give birth to a low-weight baby(less than 5.5lbs) or premature baby(less than 37wks): 1 in 2
  • Factor most closely associated with infant death: low birth weight
  • Percentage of infant deaths link to low birth weight: 60 percent
  • Average cost of long-term care(through age 35) for a low-birth-weight baby: $50,5588
  • Average cost of long-term care (through age 35) for a baby of average birth weight: $20,003
  • Cost of newborn intensive care for one infant: $20,00 to $100,00
  • Cost of prenatal care for thirty women: $20,000 to $100,000
  • Percentage of births attended principally by midwives (CNM’s and CPM’s): United States: 10 percent; European Nations: 75 percent
  • Percentage of countries with lower infant mortality rates than the US in which midwives are principal birth attendants: 100 percent
  • Average cost of a midwife-attendant birth in the US: $1,200
  • Average cost of a physician-attended vaginal birth in the US: $4,200
  • Health care cost savings obtainable by using midwifery care for 75 percent of pregnancies in the US: $8.5 BILLION per year
  • Cost per year of using routine electronic fetal monitoring during every childbirth: $750 million
  • Number of well-constructed scientific studies in which routine electronic fetal monitoring (EFM) during every birth has been proven more effective than the simple stethoscope to monitor the fetal heart: zero
  • Health care cost savings obtainable by eliminating the routine use of electronic fetal monitoring in every birth: $675 per year
  • US C-section rate: 1965: 5 percent, 2004: 29.1 percent, 2007: 33.3 percent
  • Cesarean section rate targeted by the World Health Organization (WHO) and the US Department of Health and Human Services (HHS): 12 percent
  • The eighteen industrialized nations and states with lower C-section rates than the US: Czech Republic, Japan, Hungary, Netherlands, England and Wales, New Zealand, Switzerland, Norway, Spain, Sweden, Greece, Portugal, Italy, Denmark, Scotland, Bavaria, Australia, Canada.
  • Percentage of women in the US with C-sections who undergo repeat c-sections today: 91 percent
  • Ratio of women dying from C-section to women dying from vaginal birth: 4 to 1
  • Average cost of a C-section birth: $7,826
  • Health care cost savings obtainable by bringing the US C-section rare into compliance with recommendation from WHO and the federal Department of Health and Human Services: $1.5 billion a year
Source: Born in the USA by Marsden Wagner,M.D. , 2006

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