Failing to deliver

Cost of care drives up premiums

Medicaid covers 41% of all annual births for a total annual cost of $20.5 billion. The high cost of this care drives up premiums for both businesses and families. Despite this expense, the United States has one of the highest rates of both infant and maternal death among industrialized nations. With over 4 million women giving birth each year in the U.S., at a total cost of $98 billion (over $268 million per day), childbirth and newborn care is by far the most common and expensive reason for hospitalization.

The U.S. cesarean rate hit 33% of all births in 2009



Why is this and what are the issues?

  1. Unnecessary interventions: high C-section rate (national rate is 33%, WHO recommended rate is 15%),frequency of inductions and other un-indicated interventions.
  2. Health Factors: increased prevalence of obesity, type 2 diabetes and hypertension.
  3. Lack of integrated prenatal care: Fewer pregnancy complications and better birth outcomes could be achieved if prenatal care was more fully integrated (among all providers from the earliest stage).
  4. Technology-intensive care: Results in maternal care being the most costly medical condition for both Medicaid and private insurers. Evidence does not support that this style of care increases safety. We are doing more and accomplishing less.
  5. Social factors: mothers are now older, often having fertility treatments that result in higher risk multiples.
  6. Lack of public awareness: Women do not have an understanding of the impact interventions have on maternal mortality and morbidity.


Maternal Mortality

Deaths per 100,000 live births


According to a study by Merck for Mothers, only 11% of Americans surveyed had heard or read anything about maternal mortality in the U.S. in the past year.


Maternal Mortality Awareness


200%, that is the risk of maternal death in high-poverty areas, twice that of low poverty areas.