Jade Jymson, who does a little blogging over at the Mama Tao, has written today’s guest post for us.
Since I started writing about the state of midwifery in the US, I have come across many reasons why Natural Childbirth Advocates ™ feel that midwives should not have to or are not able to carry insurance. A few of the main reasons are as follows:
- Why should midwives have to carry insurance when it just means that you want to sue them? Or: We are too litigation happy when all we think about is money when something goes wrong. Or: Money is not going to bring your baby back.
- If the insurance companies were involved then midwives would no longer be able to take women with VBAC, Breech, GD, GBS and a number of other issues.
Let’s start at the beginning, shall we?
Why should midwives have to carry insurance when it just means that you want to sue them? Or: We are too litigation happy when all we think about is money when something goes wrong. Or: Money is not going to bring your baby back.
We all have to carry insurance. I have insurance on both of my cars. Even though I have never been in a wreck, if I should hit someone, I know I would never be able to pay to have their car fixed out of my own pocket. I buy insurance so that I know I can afford to pay for repairs done to others property. If you break something that belongs to someone else, you should have to pay.
In cases like Zen’s we see that the midwives have done serious damage to these people and their lives. Zen’s mother was told to push for over 6 hours because the midwife was sure she could see the baby’s head. It turned out to be a blood clot on her bladder. His mother still needs serious surgery to repair the damage done to her body, but the midwife was not insured. Why should Zen’s mother have to pay to repair the damage herself?
But then again, why should I care? It’s not like I have to pay for it. But hold on a second…what about Sam’s parents? What if Sam’s parents were not able to pay his hospital bills? In such cases almost all children qualify for Medicaid. And what is Medicaid? Why it’s a free insurance paid for by tax payers. When the midwife is not able to pay for her mistakes, we all end up paying for them.
There are no companies willing to offer insurance to CPMs
This is simply not true. Contemporary Insurance Services specifically offers insurance to CPMs and CNMs who attend homebirths. In the past week, we requested a quote for a midwife in California with 3 years of experience and a clean record, and they were perfectly willing to insure her. Not only that, but they’ll insure her even if she has previous claims against her practice at a rate only 10% higher. And this isn’t the only company, either. It was just the first one that came up after 20 seconds of making sweet love to Google.
Midwives don’t make enough money to pay out the insurance premiums.
While I have to admit, my first thought is to say, “Who cares?” The first rule you learn in freshman economics in high school is that to have a successful business you have to make more money than you spend on whatever is necessary to keep your business running . And running safely, I might add. You don’t get to run a restaurant without being able to afford the supplies to keep your kitchen clean or own a climbing gym if you can’t afford harnesses for your climbers.
Considering that many states allow midwives to work uninsured because of this issue, let’s take a deeper look and see exactly what a midwife’s finances must look like.
Faith Beltz, the infamous midwife to the Paperella’s, made $4,200 off of Aquila’s tragic birth. That’s right, she made a mistake that led to their daughter’s death and she was still paid for the job. Let’s pretend that all midwives make as much as Beltz does and take only one birth a month.
Yep. IF a midwife charging what Beltz does only takes 1 birth a month she makes $50,400 a year. But most midwives have more business than that, right? So let’s look at what she would make if she took only two births a month:
Wow! That is more than most people I know make in a year. Pretty impressive. So how much does this insurance cost anyway? Some of the commenters in the last post keep throwing out numbers like $60,000. If that is true then a midwife might have a problem paying her bills if she only takes one client a month.
To make sure that this $60,000 a year number was correct, we contacted the company mentioned earlier as a CPM who had been working for 3 years and had never made a mistake that resulted in the death or harm of a patient. This is what they quoted us:
Wait? Huh? The payments start out at $13,000 and then rise to $22,132 after 5 years. For then on after the rates stay the same to be insured. The policy pays out $200,000 to $600,000. If we are using Faith Beltz and her $4,200 with one birth a month, she still has $28,268 to live on in the fifth year and beyond. Most midwives don’t have a birth center or an office or a secretary to pay – they have little to no overhead. They don’t even buy the materials they use at your birth; that is part of the homebirth kit you purchase yourself.
$28,000 is not a whole lot of money, but it’s also not chump change. If she did two births a month she’d have $78,668 left over.
But $4,200 only one number and most midwives take more than one birth a month. If they only take one client a month and can’t pay their insurance, they need to find more clients.
Finally , one of our readers said that the average midwife makes $60,000 per year. If this is the case then she’d still have $37,868 leftover at the end of the year. Not too shabby.
Again, if midwives have issues making this payment then clearly they have two options, just like every other business in the world. Take more clients or charge more.
If the insurance companies were involved then midwives would no longer be able to take women with VBAC, Breech, GD, GBS and a number of other issues.
I’m going to do something I thought I’d never do. I’m going to talk about something that was said in The Business of Being Born. If I recall, the entire movie they were raving about homebirth and midwife care, but they were always saying one thing I feel is important. Midwifery care should be the norm for LOW RISK WOMEN. You can rant and rave all you want to about how normal breech is and how GD is a myth made up by the man, but in every first world country that uses midwives there is a list of things that risk them out of homebirth. Breech, multiples, large babies, transverse…it goes on and on.
There are situations that should risk people out of homebirth. That does not stop midwives from taking these clients, but they should not be taking them—whatsoever. If having insurance stops midwives from taking high risk clients, then GOOD — it makes midwifery and birth safer for all of us.
I am sorry that this means some of you will make the choice to give birth in a hospital because you want a birth attendant, but we’ll never have the true numbers about the safety of homebirth until midwives stop seeing clients that should never have been homebirth candidates to begin with.