Creating Value in Childbirth

Costs of Care Creating Value Challenge

In 2007, the Institute for Healthcare Improvement (IHI) proposed a framework for optimizing health system performance known as the “triple aim”. The three components are:

  • Improve the experience of care
  • Improve the health of populations
  • Reduce the per capita costs of healthcare

At Midwife360 we hit the bullseye on all three! Now, where is that friendly OB who wants to play with us?

It’s time to apply the IHI triple aim to childbirth! It is well known that the American childbirth culture is very expensive with very poor performance AND little of what happens to birthing people in hospitals is evidence based. Childbirth for low-risk healthy women (who comprise the majority of people giving birth) benefits from less, rather than more technology. It is, after all, the only physiologic human function that has been relegated to hospital care. Achieving good outcomes usually goes hand in hand with a positive experience of care and this can be done in a very low-tech, inexpensive way by creating teams of home birth midwives and OBs. ACOG approves of home birth under certain conditions – choosing the appropriate client, with a CNM, in an integrated environment. As giving birth is much like making love, it is easier to imagine this happening in an environment where the birthing person feels the most comfortable – whether that be her home, a birthing center, or a hospital. So creating a culture that truly supports choice for birthing people without removing the option of access to a higher level of care can be accomplished by having a care team of homebirth midwife and OB with hospital privileges. Short of that, making hospital labor rooms more homelike – dimmers on the main lights, several options for water immersion (large shower, birthing tubs), small refrigerators in the room, and a second bed for family members or the doula to use – and updating care to reflect the evidence and patient preference are all absolutely necessary to achieve the IHI triple aim.

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  • Jilda

    I didn’t have the pleasure of having Fadwah and her team’s care throughout my pregnancy, but was blessed when she accepted me as a client at 39 weeks pregnant. Throughout my pregnancy I was stressed and sad and worried with my previous midwife, and after she had to reschedule an appointment for the 9th time, I knew my body would not trust her when it was baby-time. Fadwah was a God-send. She immediately saw me for a visit and I was instantly set at ease with the warmth and compassion I felt from her and her staff. She came to my home 3 days later for a home visit, and 5 days after that I delivered my 2nd son. I only had the pleasure of knowing Fadwah for one short week before my baby came, but my 1st home birth was amazing. It was everything I dreamed of and so healing from my traumatic 1st birth. Fadwah and Rosalia were everything one would want in a birth team; knowledgeable, efficient, soothing, calming, understanding, patient, caring, skilled…the list could go on. Although I wasn’t able to experience their care throughout my pregnancy, they were there for me as if our relationship had been 40 weeks in the making. “Thank you” will never be enough to express my gratitude and love for Midwife360.

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