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Health Care / Free-Market Reform

Midwives at the Movies

By Sarah Brodsky on Jan 14, 2008

I see on the Ethical Society’s website that they just had a program presented by Free the Midwives and showed a new film about maternity care. You can follow that last link to see snippets from the documentary.

I agree with the director that the legal environment discourages choice. Doctors can charge their patients more because they don’t have to compete with the cheaper midwives. However, from the trailer, it looks like this film is less about extolling the benefits of competition and more about putting down the people who run and work at hospitals.

This strategy could backfire. The trailer says that hospitals just care about money. But most midwives aren’t volunteers, and they have to admit that women who give birth in hospitals enjoy extra security thanks to all the lifesaving equipment hospitals have ready — expensive equipment that patients have to pay for. And while many mothers have been satisfied with their experiences with midwives, there are some high-risk births that midwives will never be able to handle.

It’s also inconsistent to censure hospitals for moving women out of hospital beds too quickly, while praising midwives for helping women stay away from the hospital. Hospitals have good reason to try to get women to go home as soon as possible; there’s the risk of infection, for example.

And some of the complaints about what happens in delivery rooms could be more fairly directed at patients. Women have a responsibility to talk to their doctors about what medications they’ll take and what will be done in case of complications. If they don’t choose to inform themselves when they go to the doctor, they may make the same mistake even with a midwife.

Women should be able to choose midwives if they wish, so I’m rooting for the midwives. But I hope they’ll turn their PR efforts away from exaggerating the extent of their persecution and spreading fear about hospitals, where most babies will be delivered even under the freest laws. Even if hospitals do a good job, and I think most do, women should still have the choice to use a midwife.

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Sarah Brodsky

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