National health spending is expected to reach $2.5 trillion in 2009, accounting for 17.6 percent of the gross domestic product.

More is spent on health care in the United States on a per capita basis than in any other nation in the world.

Childbirth is the leading reason for hospitalization in the US

Childbirth in the US is over medicalized. The current style of maternity care is procedure-intensive, and six of the fifteen most commonly performed hospital procedures in the entire population are associated with childbirth.

Cesarean section is the most common operating room procedure in the country. US C-section rate in 1970 was 5.5%. The US C-section rate in 2007 was 31.8%. According to the World Health Organization recommendations about optimal cesarean section rates the best outcomes for mothers and babies occur with cesarean section rates of 5% to 10%. Rates above 15% do more harm than good.

Maternal and newborn hospital charges ($86 billion in 2006) far exceed those of any other condition. Private insurers pay for 49% of births; Medicaid covers 43%.

The United States newborn mortality rate ranks 29th the second worst rate in the developed world

The United States ranks behind at least 40 other nations in maternal mortality rates; the highest in over 20 years.

Eighty percent of pregnant women are considered low risk.

The Truth About Birth Centers

Both the American College of Obstetricians and Gynecologists and the American Medical Association have stated that accredited freestanding birth centers are a safe setting for birth.

Birth centers have a proven history of reducing low birth weight and preterm birth, the main causes of neonatal death in the U.S.

Birth centers provide innovative approaches to maternity care that reduce disparities for low income and minority women, lower cesarean section rates, and reduce health care costs.

If only 100,000 births were attended in birth centers, annual savings have been estimated to be up to $314 million.

Should the birth center model be applied to all Medicaid births, a potential for a saving of almost $12.9 billion exists.

The Congressional Budget Office has evaluated the Birth Center Medicaid Reimbursement Act (HR 2358 and S1463) and says it could save 47 million dollars over the next 10 years.

There are approximately 200 birth centers in the United States and the majority are owned and operated by certified nurse midwives and certified professional midwives.

The Truth About Midwives

The percentage of countries providing universal prenatal care that have lower infant mortality rates than the United States: 100%

The percentage of US births attended principally by midwives: 5%
The percentage of European births attended principally by midwives: 75%

Number of midwives practicing in the US is growing. In 2008 the number of certified professional midwives was 1400. In 2005 306,000 births were attended by 7,000 certified nurse midwives.

Number of midwives needed in the US to meet European levels: 120,000.

The World Health Organization (WHO) states that the preferred location for most births is outside the hospital, either at home or in a birthing center, and that out-of-hospital birth should be implemented and maintained as the basic standard for all midwifery education and training programs.

Several systematic reviews have summarized the evidence for midwifery care relative to physician-led care and have shown midwifery care improves birth outcomes for both mothers and babies at a cost savings to our health care system.

Two important cost savings acts passed in the Health Care Reform Bill and signed into law by President Obama:
Equitable reimbursement for Certified Nurse Midwives
Medicaid reimbursement for Birth Centers
New legislation to improve maternity care and safe health dollars:
Congresswoman Lucille Roybal-Allard has introduced the Maximizing Optimal Maternity Services for the 21st Century Act (a.k.a. ”MOMS for the 21st Century Act” (H.R. 5807) which places a national focus on evidence-based maternity care practices to help achieve the best possible maternity outcomes for mothers and babies.