Homebirth is a selfish, unsustainable use of resources


Homebirth advocates, help me out here.

I’m having a problem understanding your math. It’s just arithmetic, so it really shouldn’t be so hard, but I can’t figure it out.

It s widely claimed that there is a midwife shortage in the UK. There aren’t enough midwives to safely care for the women giving birth in hospitals. That’s certainly how the Royal College of Midwives (RCM) rationalizes any and all poor care leading to the preventable deaths of mothers and babies.

Here’s where the arithmetic comes in:

1 midwife in the hospital can take care of multiple laboring women (let’s say 3 for arguments sake, though it is probably more)

but 1 laboring woman at home is supposed to be attended by 2 midwives

If I’m doing the addition correctly that means that 2 midwives can care for 6 women in the hospital, but only 1 woman at home … AND midwives are in short supply.

So, isn’t homebirth a selfish, unsustainable use of scarce resources?

Doesn’t every midwife who heads out to marinate in her own delicious autonomy at homebirth deprive 3 women of hospital based midwifery care?

And how can a selfish, unsustainable use of scarce resources possibly be cost effective?

It can’t, can it? And all the hopping up and down by the RCM and NICE claiming that homebirth saves money is a blatant falsehood since it doesn’t take into account the salaries of all the extra midwives who would have to be hired to provide homebirth services, right?

Let’s put it another way:

If it takes 6 midwives to properly care for 18 laboring women in the hospital, but there are only 5 midwives available, how can it possibly be cost effective, sustainable, or even remotely safe to send 2 of those 5 midwives to a homebirth, leaving just 3 midwives to care fo 18 patients?

The RCM and NICE are like Marie Antoinette who, when told that poor people had no bread, supposedly declared, “Let them eat cake!” Only in their case, when confronted with the fact that a woman often can’t get 1 midwife to care for her in the hospital (whose labor wards are routinely refusing to accept patients when understaffed), declare that she should have stayed home so 2 midwives would come to her.

In a system like the UK, homebirth is selfish, usustainable, saves no money, and compromises the care of everyone except the woman who has a fully staffed homebirth. The only people who appear to benefit from this faulty arithmetic are midwives. Who would have guessed?