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Birth Monopoly

April 21, 2016

What is a monopoly?

A monopoly is a situation in which a single company or group owns all or nearly all of the market for a given type of product or service. By definition, monopoly is characterized by an absence of competition, which often results in high prices and inferior products. (From Investopedia)



Medicine has made a virtual monopoly of childbirth in America.  The facts are starring us right in the face.  First of all more than 99 percent of births in America are done in hospitals.  In 1999, there were resolutions that ACOG (American College of Obstetricians and Gynocologists) that made it highly difficult for women who had previous caesarian sections to birth without an attending doctor.  The guidelines were used inappropriately and caused a spike in the number of repeat c-sections.  In 2010 ACOG altered the vbac guidelines to address this problem.  The meager number of childbirths done outside of hospitals dropped significantly.

Women who had every reason to not want to go back in the hospitals for this labor and delivery were legally forced to do just that.  The very fact that many women who were mishandled in the hospital and would normally seek shelter in birth centers, doctor’s offices or homes to birth their children cited reasons of improper care, the over use of interventions and drugs.

The doctors cited reason of the unsafe condition of women’s uteruses that had been cut during the previous surgical procedures.

pregancy c-section zipper

Inductions after Previous C-section

The truth was that the doctors who often used induction techniques were the one have disastrous outcomes in the very hospitals.  Actually all women have a slight chance of this program when induced.  It is these interventions that cause the problems that the doctors cited were the reasons for women to have to birth back in the hospital.

Now consider what makes a business a monopoly.  Clearly the doctors since the beginning of the 20th century spent considerable time and energy to eliminate the only competition they had in the profitable world of ranch of medicine: childbirth.  Childbirth is the most profitable aspect of medical care.  With over 4.3 million births each year, childbirth is a multi-billion dollar industry.  Obstetricians whose records of customer service and care are poor don’t want to lose business to outside vendors of quality care.

Furthermore, doctors and the AMA have nearly complete control of the licensing of both midwives, certified nurse midwives, and birth centers and they control the boards of all of the insurance providers.  I recently read that a hospital administrator pulled the strings on supporting a birth center back east.  The reasons cited were safety, but really what was prominent was the fact that more and more women were choosing the birth center rather than the hospital across the street.

Birth is a financially lucrative monopoly.

Recent figures say that the average dollar value of a birth in the hospital was over 7600  dollars and the average cost of a c-section was over ten thousand dollars.  The computes to 21,285,000,000 for regular births and 14,190,000,000 for other, coming to a total or over 35 billion dollars.  Midwives and birth centers charge more along the lines of $2500 to $4500.  That comes to $134,750,000 for the CNM, lay and professional midwives, and a handful of doctors who deliver in homes and offices.

money in medicine

Big Money in Childbirth

Relevant Articles and Books:

VBAC: What ACOG Really Says

The Medical Delivery Business: Health Reform, Childbirth, and the Economic Order


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