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Czechs could save money with midwives
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June 20th, 2007 issue

Consumers are demanding more natural healthcare options all over the world, from the United States and Europe to the Czech Republic.

Delivering babies should be no different.
Using a midwife to deliver a baby at a birthing center or at home, rather than going to the hospital, is getting trendier among expectant mothers.
It also appears to be a lot cheaper. With the country spending more on health care per capita than any of its neighbors apart from Slovenia, according to 2004 statistics from Eurostat, saving a little extra money by using midwives and making mothers happier is the right way to go.
Czechs spent 6.7 percent of the country’s gross domestic product on health care in 2004, compared to Poland, at 3.8 percent, Slovakia at 5 percent and Hungary at 6 percent, according to Eurostat, the European Union’s statistics collection office. Slovenia spent 7.8 percent of its GDP on health care. 2004 is the most recent year for which statistics are available.
More specific figures aren’t available across the spectrum because member states are responsible for making policy decisions on issues such as midwives and giving birth at hospitals, said Natalie Vlkova, from the Representation of the EC in the Czech Republic.
Czech midwives are pressing the issue. If other member states allow them to be “autonomous care providers,” then the Czech Republic should also, says Zuzana Štromerová, vice president of the Czech Confederation of Midwives.
Štromerová and her colleagues have filed a complaint with the European Commission to gain the right to practice independently. Štromerová opened the country’s first birthing center in 2005 but is not licensed to assist births because there’s no on-staff doctor or required medical equipment similar to that found in a hospital, according to the Health Ministry.
Instead, At the Stork, or U Čápa, focuses on checkups and prenatal classes. The center has three midwives.
Mothers have been delivering babies since the beginning of time, with or without hospitals. If the government wants to save money in the healthcare system, this would be an easy place to do it.
In the Netherlands, about 70 percent of women choose midwives to help them deliver and 30 percent give birth at home. In fact, many Dutch women never see a doctor during their pregnancies, according to the Dutch Health Ministry. Scandinavian countries have similar patterns.
It’s no surprise that the government wants to regulate the profession. Most European countries also still require midwives to practice alongside a doctor in the hospital, according to the World Health organization. In the United States, about 80 percent of women deliver their babies at a hospital, with or without a midwife present.
Nonetheless, midwives are the “most appropriate primary healthcare provider to be assigned to the care of normal birth,” according to the World Health Organization, which monitors countries’ health care.
It might be the poorer countries that use midwives more often, because mothers can’t afford doctor care, but about 85 percent of all pregnant mothers in the Czech Republic could also use them, Štromerová says.
Safety is important, and national infant mortality rates are tied with Finland, Iceland and Norway as the second-lowest in the world.
U Čápa is only seven minutes from the hospital, Štromerová points out.
There are 5,500 licensed midwives here. Let’s let them do more work and hopefully save some money in the government budget as a result.


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