Transforming the US Birth Experience BETSY MCNAMARA CONSULTANT TO - PowerPoint PPT Presentation

The Transforming Birth Fund Transforming the US Birth Experience BETSY MCNAMARA CONSULTANT TO THE TRANSFORMING BIRTH FUND Grantmakers in Health, March 2014

What is a Donor Advised Fund?  Donor gives money to the NH Charitable Foundation  Has ongoing say in what grants are made  Most administrative and financial operations managed by the NH Charitable Foundation

My role Issue expert Solicit proposals Review proposals Recommend funding Be the face of the Transforming Birth Fund

Vision All women have access to the level of maternity care they want and need, and maternity care systems support them in doing so.

“OUR SYSTEM IS SET UP AS THOUGH YOU HAVE AN ORAL SURGEON PROVIDING ROUTINE TEETH CLEANINGS. ” -DR. MICHAEL KLEIN, OB

Transforming Birth Fund Leverage Points:  Media  Impacting Policy and Practice  Supporting the Movement  Research and its Dissemination  Individual change makers

Elective Inductions

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Elective Labor Inductions: Less than 39 Weeks Gestation 35% 30% Elective Deliveries 25% 20% 15% 10% 5% 0% Jan '01 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan '02 Feb Mar Apr May Jun Jul Source: Intermountain Health Care Institute for Health Care Delivery Research

Commonwealth Fund Case Study: Intermountain Health Care Improved Changes in Data Outcomes & Practice Lower Cost

Our maternity model costs us Payers of Maternity Care Medicaid 43% 57% Private Insurers or Consumers

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US Maternity Costs Are Rising Commercial Insurance Payments for Birth by Type 2004 & 2010 $30,000 $25,000 $20,000 Vaginal Birth $15,000 Cesarean Birth $10,000 $5,000 $- 2004 2010

Enforce Evidence-Based Practices Adhering to Evidence based practices lead to the triple aim  Improve outcomes  Improve quality  Lower cost

Grantee Highlights

Grantee: Yale University School of Nursing Decreasing Cesarean Section Rates through Promoting Primary Vaginal Birth Holly Powell Kennedy, PhD, CNM, FACNM, FAAN YALE Department of OB/GYN Grand Rounds January 17, 2013

Obstacles to First-time Vaginal Birth  Perception that cesarean is “normal”  Cost and quality of Childbirth Education  Fear of litigation  Time & patience  Lack of respect for woman’s decisions  Inconsistent respect and/or power differentials among clinicians

Supports to First-time Vaginal Birth  Women’s confidence & desire for vaginal birth  Childbirth Education is an expectation & affordable or free  Patience  Women’s sense of power  Strong respect, collaboration and teamwork among clinicians

Study Conclusions

Grantee: Childbirth Connection

No More Elective Inductions before 39 weeks

Cesarean Rates have stopped growing but still too high

Grantee: MAMA Campaign

Cost Comparison  2011 Birth Center Vaginal Birth Cost: $2,277  2011 Hospital Vaginal Birth with No Complications Cost: $10,657

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