The Hidden Costs of Maternity Care: Why the System Needs Reform
In this episode of The Mama Making Podcast, I had the pleasure of chatting with Avital, a passionate advocate for maternal health and author of an upcoming book that explores the realities of the maternity care system. As a mother who experienced both the joy and challenges of childbirth, I resonated deeply with many of the topics we discussed, especially how costly and broken our healthcare system is when it comes to pregnancy, birth, and postpartum care.
Maternal care in the U.S. is shockingly expensive, and the truth is that many of us don’t fully understand how the system works—until we’re in the thick of it. Avital shared a powerful story about her own personal experience and how this fueled her desire to shed light on the flaws in our healthcare system.
The Financial Burden of Childbirth
We all know that childbirth can be expensive, but when it’s your own baby who needs additional care, the financial burden can feel overwhelming. As Avital and I discussed, my son had a NICU stay and a transfer to another hospital, which resulted in hundreds of thousands of dollars in medical bills—even though we had good insurance. It was shocking, to say the least, and that’s the reality for so many families. Even with insurance, the cost of giving birth is high, and the financial consequences can be dire for those who are already struggling.
What struck me during our conversation is how much more common these financial burdens have become. It’s not just a rare scenario anymore. Health insurance doesn’t necessarily mean you’re off the hook, and even with insurance coverage, many families are still faced with mountains of debt after a birth, particularly if any complications arise. Avital’s comment that “it’s cheaper for women to die” really hit me hard. What she meant is that, in many cases, it’s more financially viable for the insurance companies to cover the cost of a woman’s death—whether that’s through maternal complications, surgery, or long-term medical treatment—than it is to provide adequate preventive care.
This stark reality has made me think a lot about why the system remains the way it does. If we could focus on preventing complications through better prenatal care, better access to specialists, and more affordable medical services, the financial burden on families and healthcare providers could be drastically reduced.
The System is Broken: How Did We Get Here?
One of the most alarming statistics Avital shared with me is that 84% of maternal complications could be prevented. Think about that—84% of complications are preventable with better care. And yet, our system continues to fail us. According to Avital, the maternal care system is one of the worst in the developed world, despite the U.S. spending more on healthcare than almost any other country. In fact, during the pandemic, while other countries managed to reduce their rates of maternal mortality, the U.S. saw those rates increase.
I don’t think most people realize just how deep this problem runs. The U.S. has the most expensive birth costs in the world, yet some of the worst outcomes. We’ve normalized this level of dysfunction, and it’s hard to see a way forward. But Avital is hopeful. She believes the change is going to come from the people—those working on the front lines of maternal care.
The book Avital is writing, though filled with sobering facts, offers a ray of hope. One chapter focuses on the people and organizations who are stepping up to fill the gaps. From traveling midwifery services to birth justice networks in underserved areas, there are countless individuals working tirelessly to create a better future for maternal care. It’s easy to get discouraged, but when you hear about the good work being done by people like Dr. Stephanie Mitchell in Alabama, who is working to open one of the first freestanding birth centers in an area with limited care options, it helps you realize that we aren’t completely powerless.
The Intersection of Maternal Health and Reproductive Justice
Another key theme that we discussed was the intersection of maternal health and abortion care. Avital pointed out that the states with the strictest abortion laws tend to have the worst maternal health outcomes. And that’s no coincidence. When women’s reproductive rights are restricted, it doesn’t just affect those who want to end their pregnancies. It affects every part of reproductive healthcare, from fertility treatments like IVF to access to basic care during pregnancy.
Since the Dobbs decision, many states have seen their maternal health systems unravel as doctors and providers have fled states with restrictive laws. Medical students are opting out of OBGYN rotations in those states because they can’t get the comprehensive training they need, especially in abortion care. And, as a result, many states are experiencing maternal care deserts—areas where pregnant people can’t access basic services.
There’s also the issue of the overuse of C-sections. In some states like Louisiana, fear of being wrongly accused of performing an abortion has led doctors to perform more C-sections than necessary, because they know they can’t be accused of performing a procedure that might be interpreted as an abortion. The result is that women are undergoing more invasive and potentially unnecessary procedures because of these political restrictions.
What Can We Do to Help?
In Avital’s book, she encourages readers to take action. While many of us feel overwhelmed by the magnitude of the problem, she reminds us that we all have a role to play in improving maternal health. Whether you’re currently pregnant, planning to have children, or simply a concerned ally, there are many ways to support change.
For starters, educating yourself and others is key. One of the most empowering things you can do is have informed conversations with your friends, family, and providers about maternal care. We also need to find and support organizations that are already doing the hard work—those fighting to improve access to care, offering resources for at-risk communities, and advocating for legislative change.
A lot of change will come from grassroots efforts, which is why I am hoping to start sharing resources on my podcast and website. If we all find the organizations and individuals doing meaningful work and support them financially or with our time, we can help push this movement forward.
Conclusion
It’s clear that maternal health care is in crisis in the U.S. The system is broken, and while it’s easy to get discouraged, the truth is that we all have a part to play in creating a better future for families. The work of Avital and others like her gives me hope that, through education, activism, and grassroots movements, we can make a real difference in the lives of pregnant people and their families.
If you’re passionate about supporting better maternal care, I encourage you to check out Avital’s work, and consider what you can do to help. Whether it’s donating, volunteering, or simply having a conversation, every effort counts. Together, we can help build a future where everyone has access to the care they need, no matter their background or circumstances.
Stay tuned for more updates on Avital’s upcoming book, and thank you for being a part of this important conversation.
Resources
If you’re looking for ways to get involved or support those doing the work in your community, here are a few suggestions:
Southern Birth Justice Network: A group that offers accessible midwifery care to underserved areas.
Dr. Stephanie Mitchell’s Birth Center Project: Supporting the creation of freestanding birth centers in areas with limited maternal care options.
The National Women’s Health Network: Advocating for better healthcare policies for women, including reproductive health rights.
Find organizations near you that are working to improve maternal health care and consider donating your time, money, or skills to help create lasting change.
TL;DR
We talk with writer, author, and activist Avital Norman Nathman about her book The Good Mother Myth and her upcoming release The Perfect Birth Myth. Avital shares her personal pregnancy and birth experience, including the incredible she encountered with midwifery care, emphasizing her decision to cornerstone the importance of reproductive justice and the need for accessible, supportive care for all mothers.
Jessica and Avital discuss societal pressures surrounding the idea of a “perfect” birth, the impact of quality (or lack of) on maternal care, and the connection between maternal and abortion care.
How to connect with the guest:
IG: @themamafesto
Website: www.themamafesto.com
Extras: Read The Good Mother Myth or more writing from Avital
Mom podcast, Motherhood Podcast, Motherhood Journey, Postpartum Mental Health, Pregnancy, New Mom Support, Avital Norman Nathman, The Good Mother Myth, The Perfect Birth Myth, motherhood, reproductive rights, midwifery care, pregnancy, birth, diverse voices, reproductive justice, societal pressure, perfect birth, maternal care, birth stories, book structure, white supremacy, abortion care, support, advocacy, intersectionality
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