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http://www.usatoday.com/news/health/2008-10-08-childbirth-costs_N.htm
	Becky Orchard, a midwife in training and a certified doula, performs a check-up on 3-week-old Cody Drake as his mother, Kelly Routt, watches at Dayspring Midwifery Services in Hayden, Idaho, in May. The authors of a new report recommend increasing low-cost approaches such as the use of doulas and decreasing expensive techniques for healthier and less costly childbirth.
HIGH PRIORITY	Childbirth outranks pneumonia, cancer, heart failure, bone fracture and stroke as reasons for hospitalization in USA. Source: Agency for Healthcare Research and Quality 2008

"Everybody recognizes that our health care system's in trouble," says Childbirth Connection's Maureen Corry, co-author with colleague Carol Sakala. "But when it comes to maternity care, no one talks about it."

Yet, she says, with 4.3 million babies born annually, nearly one in four people discharged from U.S. hospitals are new mothers or newborns. On the outpatient side, only checkups, follow-ups and coughs rack up more visits than maternity care.

In 2005, the average hospital charge for an uncomplicated vaginal birth was $7,000, compared with $16,000 for a complicated C-section, Corry reports. "I think a lot of people have no idea about the cost," she says.

The University of Wisconsin's Douglas Laube, a former president of the American College of Obstetricians and Gynecologists, blames "very significant external forces" for the overuse of expensive technologies in maternity care.

"I don't like to admit it, but there are economic incentives" for doctors and hospitals to use the procedures, says Laube, who reviewed the new report before its release.

For example, some doctors might get bonuses for performing more labor inductions, which adds costs and increases the risk of C-sections, which, in turn, increase hospital profits because they require longer stays.

In addition, some doctors order unnecessary tests and procedures to protect against malpractice suits, Laube says.

Bonnie Jellen, head of the American Hospital Association's maternal and child health section, hadn't seen the report. She says women's preferences and doctor's malpractice concerns have helped raise the C-section rate.

Says Corry: "A lot of people think pregnant women are accidents waiting to happen. It's just crazy."