What are homebirthers trying to sell me?

I figured that there had to be something behind the scare tactics and aggressive marketing of the homebirthing/ natural childbirthing movements.  I’ve figured out what it is….

Money.

For about $60 a month (the cost of public heath insurance in BC, Canada) I had a hospital birth.  That covered the cost of prenatal care, my own labour and delivery nurse (handholding, cheerleading, encouragement during the birth, postpartum monitoring, breastfeeding help afterwards), a physician or midwife at the delivery, a Caesarian section should I need it, pain management before and after, ICU care should I need it, NICU care should my baby need it, a pediatrician’s assessment of my newborn, testing for inborn errors of metabolism and bilirubin, meals, linens, menstrual pads, ice packs etc.  The only things not covered were nominal costs such as parking at the hospital ($10-20 a day in an urban center) and the morning latte my husband was nice enough to get me ($4.50).  In addition, a public health nurse visited me in my home after discharge from the hospital to check up on how I was recovering, weigh and measure the baby and help us with breastfeeding.  That’s right…this free covered by public health insurance nurse is also a lactation consultant.

So, lets say I’d bought into the hype, wanted to follow in the footsteps of vocal celebrities and supermodels, and opted for a natural home birth…

Well, in BC the cost of a midwife is covered by the provincial insurer, including prenatal care and attendance at the birth, whether it be in the hospital or at your home.

But wait, since I won’t have access to anesthesia and I’ve heard it might hurt (or be orgasmic, it’s confusing), I should probably hire a doula.  After all, my husband couldn’t possibly understand or help me through the pain.  He’s a he and we all know birth is some sort of mystical woman’s work.  Plus, he hasn’t taken a weekend course (16 hours of instruction), read five books about birth, gone to a prenatal class, paid DONA money, been trained in lactation or attended 3 births.  So he’s pretty useless right?  Average cost of a doula: $500-750 for two prenatal visits, attendance at the birth and the postnatal visit.

Since I can’t just ask for cop out and get an epidural I should probably also obtain some instruction in alternative pain management.  Candles ($9), a couple essential oils ($21), a hypnobabies course ($400), a massage roller ($35), and a microwaveable heat pack ($25).  Total cost: $490 (source, amazon.ca, hypnomommas.com).

Now, I’m going to be gushing and bleeding and pooping all over the place when my water breaks and I push the sucker out…so I should probably take some steps to protect my mattress/ floors.  For $20 I can get a waterproof sheet protector but its only 34 x 36 inches so I should probably get two.  I think that if I use a drop cloth from the hardware store ($20) and some old towels (free) I should be good.  Total cost for floor/ bed protection: $60 (more if you don’t have a stash of old towels).

Did I forget anything?  Oh, tons.  Check out this link…what the heck is the DUCT TAPE FOR??????????????  I am NOT adding duct tape to my home birthing budget!  Lets budget another $50 for large garbage bags, rubbing alcohol, and extra bed sheets.

I’ve also heard that a water birth is where it’s at.  I’m feeling a bit squeamish about pushing my baby out into tepid fecally-contaminated water but I hear it really helps with the contraction pain.  I suppose I could birth in my bathtub, but it’s really rather narrow and not very deep.  If I got on my hands and knees to push, my baby would come out above the water.  So I need to rent or buy a tub to birth in.  Rental: $200-300 (source: http://www.birthingbuddies.com/birth-pools).  The good news is that this pool rental now comes with a fish net!  Wow, I can have the birthing in a koi pond experience I’ve always wanted…no, wait a minute, I bet the fish net is to fish out the turds…ew.

The cost, if I wanted to buy my own birth pool is about $250 + shipping.  If I can commit to more than one home water birth I would come out ahead if I bought my own pool.  So lets say $200 for the pool.

Because I am a good natural birther/ homebirther, I’m also going to want to encapsulate and consume my placenta.  Cost: $200 (http://www.placentalove.ca/service.html)

Total cost for my home birth: $500 (doula) + 490 (pain management) + $60 (floor and bed protection) + $50 (other supplies) + $200 (birthing pool) + $200 (placenta encapsulation) = $1500

Comparing home to hospital birth:

So $1500 – ($60 x 9) = $960 or a lot of diapers, professional baby photography sessions, cute onsies etc etc.

Of course, this isn’t a fair comparison because I have to pay monthly premiums for health insurance…so the $60 a month is mandatory whether I get pregnant or not.

So $1500 – $0 = $1500 or a whole lot of diapers, professional baby photography sessions, cute onsies etc etc.

There were a lot of births in Canada in 2009-2010.  383 595 of them.  At $1500 a birth that’s potentially $575 392 500 to be made…that’s right…close to 600 million dollars!  Wow!  I’m totally in the wrong business.

Canada is a small market, what about the US?  In 2009 there were 4 130 665 births.  Potentially $6 195 997 500 to be made…..6 billion dollars…and that DOESN’T include midwifery care.

Since only 0.67% of births in the US occur at home this is a MASSIVE and LARGELY UNTAPPED market.

No wonder the HB/ NCB movement uses aggressive marketing tactics.  Lets do the math:

Currently 0.67% of 4 130 665 = 27 675 births x $1500 each for birth services not included midwifery care = $41 512 500

vs

90% of 4 130 665 (assuming “high risk pregnancies” account for 10% of the total) = 3 717 598 x $1500 = $5 576 397 000

Of course, why exclude high risk pregnancies if that would result in a loss of 500 million dollars?  After all, the great US of A was built on rampant capitalism wasn’t it?

The next time you hear someone tell you that evil doctors perform “unneccessary” procedures just to pad their wallets, remember, babies are big business…no matter where they are born.

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9 comments

  1. Yep. You just got added to the old blogroll. Keep up the most excellent work.

  2. Snorkel · · Reply

    Oooh, I love this blog post!

    Natural birth is one big payday for some painfully under trained women.

  3. LOVE LOVE LOVE your post. I was just saying these exact words this weekend..birthing IS BIG BUSINESS..duh!!

    I am a Certified Nurse Midwife – with 12 years experience including having been on a University faculty service. I left that position two years ago to open a homebirth practice. Not to become rich – although I do enjoy making my own hours and doing what I love to do – practice midwifery in the home setting. You may go to my website to see a list of my fees. It’s not cheap but costs much less than what clients often end up paying for a hospital birth here in the U.S.A. (even those with insurance plans).

    Glad you wrote this ! It needed to be said ;).

    1. Unfortunately in the US, hospital birth care is a big business too. Anytime you look at a patient as a source of revenue you have a deep and troublesome barrier to the provision of good care. Score 1 for “socialized” medicine!

  4. Charity · · Reply

    LOVE this, you are right on.

  5. You totally rock! And I am jealous of your socialized medicine!

  6. Fantastic!

  7. sarahsahara · · Reply

    Great post.

  8. That was great. Though for me in the U.S. my first hospital birth cost about 1400 dollars with insurance. That was co-pays for visits, lab tests, ultrasounds, and hospital stay. Interestingly enough, Midwife services here cost 2-3 thousand. At least in my area. So still more expensive than hospital birth by a considerable amount. The only way home birth is cheaper is if you have no insurance. Except that you can get on pregnant medicaid which is what I had to do for my second kid, and then it’s completely free. I didn’t pay a dime for the second one. So really home birth is only cheaper than what your insurance pays for a hospital birth. Not what you pay.

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