Less is More

Jennifer Block has written an article on an obvious solution to part of the “health care problem” — midwife-attended birth. We as a nation are spending entirely too much on birth without getting enough of the good results we ought to be able to expect, were money the sole solution.

In Orange County, Florida, where Jennie Joseph practices, one in five African-American babies were born premature in 2007. In response to these disparities, Joseph also runs a prenatal clinic that turns away no one and coordinates care with the local hospital. Among the women who got prenatal care “The JJ Way” in 2007, less than 1 in 20 gave birth preterm, and there were zero disparities. “It’s not rocket science,” Joseph told me. “It’s really just about practitioners being willing to have conversations with women.” Joseph is perhaps being coy, but whatever she’s doing, we should be studying it very closely.

In short, we don’t have a “wellness model,” but a “sickness model.” And that doesn’t seem to be working very well. In fact, I know it doesn’t work well at all, because pregnancy is not a sickness; and when treated like sickness, all sorts of problems crop up that are not inherent, and could be avoided.

One Response

  1. And then problems from the problems… until suddenly there are so many problems that pregnancy/birth seems like a dangerous emergency to so many moms, and they accept high-risk care for low-risk pregnancies and voila! More problems. And same with care providers – insisting on high-risk care for low-risk birth and… more. problems. Talk about a feedback loop.

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