The Economics of Midwifery
The Saint Louis Post-Dispatch reports on the raging controversy over liberalizing laws that now bar midwives from delivering babies without the supervision of licensed doctors:
Missouri has one of the most restrictive laws in the nation, allowing only certified nurses to become midwives, in partnership with doctors. The bill would allow so-called direct-entry midwives to also practice, provided they meet certain certification requirements.
Currently, direct-entry midwives in Missouri can face felony charges for assisting in births. In most states, including where many of Grisamore’s children were born, that’s not the case.
“This is about giving families a choice in the direction of their health care,” he said.
On Wednesday, Grisamore joined an unusual coalition of legislators, Mennonites, Amish and advocates of home birthing to push for the bill.
Doctors raise concerns about the patient safety, but these aren’t fly-by-night midwives we’re talking about. The legislation would require midwives to either have 2 years of training and experience with 20 births, or have been a practicing midwife for five years. It’s possible that giving birth with a midwife is a little bit riskier than giving birth with a doctor, but in a free country, an expectant mother should be allowed to assess the risks and make a choice for herself.
The big effect of the midwife bill that medical associations don’t talk about is that opening up the market will increase competition and reduce the salaries of doctors. Although doctors might not like that, it would be a good thing for the rest of us. The United States has millions of patients who are unable to see a doctor at all due to soaring health care costs. If midwives can deliver babies nearly as well as doctors at a fraction of the cost, it makes sense to have doctors tend to more patients who really do require the services of doctors, while midwives deliver more babies.