Medicaid pays for about half the births in the United States, at very high cost. Compared to usua... more Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce costs to the Medicaid program. This study draws on information from a previous study of the outcomes of birth center care to determine whether such care reduces Medicaid costs for low income women.
To estimate the effect of a midwifery model of care delivered in a freestanding birth center on m... more To estimate the effect of a midwifery model of care delivered in a freestanding birth center on maternal and infant outcomes when compared with conventional care. Birth certificate data for women who gave birth in Washington D.C. and D.C. residents who gave birth in other jurisdictions. Using propensity score modeling and instrumental variable analysis, we compare maternal and infant outcomes among women who receive prenatal care from birth center midwives and women who receive usual care. We match on observable characteristics available on the birth certificate, and we use distance to the birth center as an instrument. Birth certificate data from 2005 to 2008. Women who receive birth center care are less likely to have a C-section, more likely to carry to term, and are more likely to deliver on a weekend, suggesting less intervention overall. While less consistent, findings also suggest improved infant outcomes. For women without medical complications who are able to be served in either setting, our findings suggest that midwife-directed prenatal and labor care results in equal or improved maternal and infant outcomes.
Schedule H collects expenditures for charity care and "certain other community b... more Schedule H collects expenditures for charity care and "certain other community benefits," including unreimbursed costs of Medicaid and other means-tested programs, as well as expenses for community health improvement, health professions education, subsidized health services, research, ...
Medicaid pays for about half the births in the United States, at very high cost. Compared to usua... more Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce costs to the Medicaid program. This study draws on information from a previous study of the outcomes of birth center care to determine whether such care reduces Medicaid costs for low income women.
To estimate the effect of a midwifery model of care delivered in a freestanding birth center on m... more To estimate the effect of a midwifery model of care delivered in a freestanding birth center on maternal and infant outcomes when compared with conventional care. Birth certificate data for women who gave birth in Washington D.C. and D.C. residents who gave birth in other jurisdictions. Using propensity score modeling and instrumental variable analysis, we compare maternal and infant outcomes among women who receive prenatal care from birth center midwives and women who receive usual care. We match on observable characteristics available on the birth certificate, and we use distance to the birth center as an instrument. Birth certificate data from 2005 to 2008. Women who receive birth center care are less likely to have a C-section, more likely to carry to term, and are more likely to deliver on a weekend, suggesting less intervention overall. While less consistent, findings also suggest improved infant outcomes. For women without medical complications who are able to be served in either setting, our findings suggest that midwife-directed prenatal and labor care results in equal or improved maternal and infant outcomes.
Schedule H collects expenditures for charity care and "certain other community b... more Schedule H collects expenditures for charity care and "certain other community benefits," including unreimbursed costs of Medicaid and other means-tested programs, as well as expenses for community health improvement, health professions education, subsidized health services, research, ...
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