On TV, babies and mothers are heroically “saved”, hour after hour, on prime-time drama and reality shows like “Baby Story” (TLC), “Birth Day” (Discovery), and “Maternity Ward” (TLC). These programs show highly dramatic births. In TV-land mothers and babies routinely need to be “rescued” by costly medical interventions, including c-sections.

A recent study (Listening Mothers II) found that 68% of mothers watched reality TV birth shows. Troubling is the fact that more mothers learned about childbirth through TV shows than childbirth classes.

Over half of the women who watch these shows say the shows help them understand what it will be like to give birth. These women are led to believe medical intervention is necessary and inevitable.

The Puget Sound Region has the highest rates of c-sections in the state. The statewide c-section rate increased a staggering 60% for low-risk births between 1997 to 2005.

In Washington, around 21,800 women deliver by c-section each year (about 24%). That number should be at least 8,700 women lower than it is (about 15%). Each unnecessary c-section costs at least $9,000 extra per birth. That’s about $78 million extra per year.

But it doesn’t have to be that way.

About 80 percent of women can give birth with minimal intervention and still be comfortable. In Denmark and Sweden most women give birth with a midwife. In those countries birth is seen as normal and natural. It is not a three act drama intended to seize you by the throat. Midwifery care with obstetric backup is a cheaper way to provide maternity care than what we do in Washington State.

Recently, Washington’s Department of Health estimated the cost effectiveness of licensed midwives using conservative calculations. Notably, it assumed that private insurers pay the same rate as Medicaid. As a result its numbers are low by at least a factor of three.

Even with its conservative approach, the study concluded that licensed midwifery saves $1.35 million per year, or about $900 per birth. The real savings per birth are closer to $2700. Only three percent of Washington births are attended by licensed midwives. By offering women incentives to choose midwifery care, the state and private insurers could reduce health care premiums and costs for us all.

In Kirkland we have midwives available to us. The Puget Sound Birth Center provides the option of in-home or a home-like experience. And nurse midwives practice at Evergreen Hospital.

But there are more reasons than cost to consider midwifery care.

Unlike obstetricians, midwives are with a woman throughout labor. A midwife’s steady and comforting presence can make labor less stressful and ultimately less painful.

Substantially fewer low-risk women who start with midwives end with c-sections. Your chance of dying during birth is highest if you are having a c-section, even for low-risk women. And more women than ever are dying in childbirth in this country as our c-section rate climbs.

C-sections also come with higher risks for subsequent pregnancies. Infertility increases after a c-section. So do placental abnormalities that can kill or injure a subsequent child.

It’s time we stop using TV to guide maternity care, and start doing what is right for mothers and for our economy.