Thursday, 24 May 2012

A very simple calculus

Financial cost of a pack-a-day smoking habit over the course of a pregnancy:
$13 * 266 days = $3,458.

Financial cost of a Sky Sport package over the same term: $731.

Financial cost of the best obstetrician team in Christchurch: you'll have to ask them, but Ira cost $2k in 2008 and Eleanor cost $2500 in 2010.

Cost of having a midwife-only birth under New Zealand midwife training standards: potentially unfathomable.

If you or somebody you care about is pregnant, recommend a shared-care option with a good obstetrician. It is damned cheap. One person in the extended family quitting smoking for the duration pays for the best obstetrician in town. Four friends giving up Sky for the duration works too. Even among the poorest deciles, is there really nobody who cares enough about an expecting mother to give up smoking for long enough to cover an obstetrician's fees?

I expect the main problem is that, in the low decile groups, folks tend to figure that whatever the government gives them must be good enough. It really isn't. High social capital rich folks know to call around immediately on finding out they're pregnant (or even earlier) and snap up the midwives with proper nurse's training. Low-decile folks wait 'till they're several months along and take what's left, not knowing that there are differences in qualifications among midwives and that the bottom tail of the distribution is abysmal.

Update: @harvestbird gives an updated price schedule:


  1. As you know, we're about to have our first very soon. We have opted to go midwife only, but are going to deliver at Chch Women's (assuming nature doesn't decide otherwise of course) in case we need additional expertise and resources. We have chosen a very experienced and well-trained midwife, and had no problems finding one. We are outside the city proper though, and are getting our LMC through the Lincoln maternity unit, so this may have accounted for the relative ease of finding a suitable midwife. I have no qualms about not employing a specialist obstetrician. But we will have the hospital's house one on tap should we need it.

    1. That is a pretty safe route. If you've got one of the good LMCs, then you're likely fine. The duty obstetricians are generally decent; the obstetrician for whose services we paid also works as duty obstetrician. But there is absolutely no way we'd consider birthing outside of a facility that can provide an emergency caesarean.