Maternity care consumer advocacy group (ASAC: Association for Safe Alternatives in Childbirth) releases maternity care cost report. | December 15, 2016

Midwifery consumer advocates are pleased to release the findings of an in-depth maternity care cost analysis report.  Key points of the report outline potential savings to Alberta’s Ministry of Health through decreasing cesarean births and utilizing (underfunded) midwives to their full scope of practice.  Since midwives became publicly funded in 2009 there has not been a cost analysis of this nature.

Albertans have been campaigning for increased access to midwifery care for many years, with a heightened focus in the spring of 2016 after Hon. Sarah Hoffman announced an incremental increase to midwifery funding (to $11M) over the course of the next 3 years.  Consumers across the province have been contacting their MLAs to raise concerns about inadequate access to midwifery care.

“Courses of care” (CofC) allocations to midwifery practices by Alberta Health Services (AHS) for the 2016-2017 fiscal year took place on March 18th, 2016, upsetting midwives and consumers alike.  Despite the rising demand among Albertan women, many midwives remained with a number of CofC that put them again in a part-time work situation; and some new midwifery practices (in St. Albert, Cochrane, and Calgary) anticipated closing their doors altogether because of insufficient courses of care being allocated to them. A database administered by the Alberta Association of Midwives (AAM) has over 1,900 women listed who desire midwifery care but currently do not have access to a midwife. Some pregnant women under the care of a midwife were told they would no longer have that care.

Representatives from AHS, AAM, Alberta Health (including a visit from Minister Hoffman), Mount Royal University’s midwifery program, as well as consumer representation met for a “summit” on April 7th and 8th, 2016 to begin the process of reviewing the existing funding framework for midwifery in Alberta, and working toward an amended, sustainable framework.

In response to concerns over increased healthcare spending on midwives, the Association for Safe Alternatives in Childbirth (ASAC) undertook a cost analysis report, comparing the costs of maternity care provided by different providers (i.e., physicians and midwives). ASAC president Dana Weatherhead and VP Finance Cynthia Hnatko met with Health Minister Sarah Hoffman in February, along with Associate Health Minister Brandy Payne in April, to present the report outline and preliminary findings of the cost analysis to ensure all key data the government needed to address concerns around costs was included.

ASAC is excited to now publicly release the key findings of the report, which indicate a $2055 cost savings for maternity care provided by a midwife when birthing outside of hospital, as compared to maternity care provided by an OBGYN:

  • Childbirth is the #1 reason for hospitalization and cesareans the #1 surgery in AB.
  • Cost of maternity care, when birthing out of hospital (in home or birth centre) is $4,600.
  • Average cost of maternity care ending in vaginal birth in hospital with OBGYN is $6,655.
  • Hospital costs are the biggest portion of total costs at approximately two thirds or $4000 – $4600/birth.
  • When birthing with a midwife out of hospital maternity care costs 58% less than cesarean birth ($4600 vs. $10,989).
  • 7% of pregnancies are considered high risk. OBGYN and midwife cesarean birth rates are 29% vs. 7% comparatively.    
  • Cesarean birth (OBGYN) costs $10,989, with a rate of 81% for repeat cesarean births.
  • 76% (OBGYN) and 79% (Midwife) of VBAC attempts are successful presenting $45.9M in potential VBAC savings.
  • Decreasing cesarean birth rate from 29% to 20% offers a potential $14.5M savings in hospital costs. The WHO recommends an ”ideal” rate of 10-15%.
  • Midwives currently only attend 5% of births in Alberta compared to BC and Ontario that are between 16-20%.
  • If the 1900 women were taken off the waitlist, based on a 48% (home) and 52% (hospital) birth location rate, approximately $1.92M could be saved.
  • Breastfeeding and Associated Health Outcomes costs were also looked at presenting over $150M in potential savings. 

The Association for Safe Alternatives in Childbirth (ASAC) was formed in Edmonton in 1979. For decades now, women in this province have been asking for choice in maternity care. After this report, Albertans can no longer be told there isn’t any money considering there is upwards to $220M in potential cost savings. It is time to address the concerns regarding maternity care in our province by removing the funding cap on midwives to allow women to birth where, how and with whom they choose. Doing so will not only have a short-term impact on the financial health and well-being of Albertans, it will have a lasting impact with savings for years to come; all the while creating a healthier Alberta.

Link to full report, highlights and infographic:


ASAC President Dana Weatherhead, 780-887-0725,

“What is Midwifery?” video created by ASAC:

“Transformation to Parenthood” TV series, sponsored by ASAC: