Uninsured Women Lose Access to Midwives in South Carolina

On September 30, the five midwives providing services at the prenatal program at North Central Family Medical Center in Rock Hill, SC, will be out of work, and the uninsured women and families they serve will lose access to midwifery services. The clinic is planning to end the prenatal program because it has become too expensive.

Specifically, North Central says it is too expensive to renew their contract with the midwives’ employer, Piedmont Medical Center. Studies have shown that midwifery care saves money—and lives—through reduced risk of prematurity and low birth weight. So, why wouldn’t North Central want to pay for it?

A big part of the problem is that midwifery services for uninsured and underinsured women and families are paid through Medicaid, which does not foot the entire bill. Medicaid does not always reimburse midwives for the full cost of their services, and it does not cover legal immigrants who are a large part of the patient population at the clinic. If the situation continues as is, North Central says they will be an estimated $200,000 in the hole by next year.

Ending the prenatal program is, at best, a stop-gap solution. No matter what a woman’s insurance status, she won’t just stop being pregnant. She needs care. As one heraldonline.com reader so eloquently commented:

“If North Central says it will lose $200,000 each year if the current midwife contract arrangement were to be continued—all it takes is ONE very premature, low birth weight baby to be born to a local mother who goes with NO PRENATAL CARE, and you're talking about a $200,000 to $300,000 intensive care nursery bill at Palmetto-Health Richland Hospital in one fell swoop!!!”

Simply put, eliminating midwifery services will magnify and shift the bill to someone else’s budget—the hospital and the tax payers who ultimately pay for Medicaid.