MONTPELIER, Vt. — As a rural state with one of the higher rates of home births, Vermont will soon require private health insurers to cover the services of midwives who attend them, joining a handful of states with similar mandates.
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Gov. Peter Shumlin signed the bill into law on Wednesday surrounded by mothers and their babies born at home, saying access to midwifery care and home birth shouldn't be restricted to those who can afford to pay for it out of pocket.
"This law will ensure that all expectant mothers get the coverage and care they want and deserve," he said.
New York, New Hampshire, and New Mexico have similar laws, according to the The Big Push For Midwives, a national campaign pushing to make midwives legal in all 50 states and for Medicaid reimbursement for their services nationwide.
Supporters say the change will save money with home births, estimated to be around $3,500 in Vermont, costing about a third of the cost of an average hospital birth.
Woden Teachout, 41, of Middlesex has had five children at home with a midwife.
"I can say from that experience that this is the best possible maternity care and also this bill will be able to save money," she said.
She figures she's saved about $40,000 in health care expenses.
But the Vermont Medical Society and some insurance companies opposed the bill based on research saying that home births are not as safe as hospital births and that the change could lead to higher costs if a mother must be transferred from home to a hospital because of problems during birth.
"This has the potential in some instances that the patients might not get the right care, in the right time, in the right setting," said Gary Hughes, a spokesman for MVP Health Care.
But advocates argue that because most pregnancies are low risk, why restrict coverage to hospital births. Home births attended by licensed midwives are already covered by the state's health insurance program for low-income Vermonters. Eleven other states provide Medicaid reimbursement for licensed certified professional midwives who practice in out-of-hospital settings.
Still the rate of home births is very low at 3 percent, but the highest rate in the country, according to the Vermont Public Interest Research Group.
Preliminary numbers from the Vermont Department of Health for 2010 show that of the 5,775 total births, 128 happened at home. Of those, 90 were attended by a licensed midwife. A total of 5,640 were hospital births, according to the Health Department.
"We realized that home birth wasn't covered by most insurance companies. So a lot of families were having to make a choice between a home birth or a hospital birth," said Laura Peer, executive director of the Vermont Birth Network. "A lot of families that would choose a home birth, which they find safer, they're more in control of the situation, were having to choose hospital birth for the reimbursement."
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