Maternal Health Care With a Human Touch

"There's a misconception that all midwives have their babies in the field and sing 'Kumbaya.' That's not true. There are a lot of midwives that don't deliver. That's not the point. It's to take care of women. But we don't get respected as much here as midwives do in other countries." -- Ebony Roebuck, American midwife.

An issue that has come up repeatedly in the current health care reform debate in the United States is whether Americans use more expensive health services than they really need.

Consider, for example, the cost of having a baby.

Statistics show that delivering a baby without complications at a U.S. hospital costs about $7,000. In a birthing center with midwives but without doctors, drugs or expensive technology, the cost is less than $2,000.

In many developing countries, midwives often are the only people available to assist women during birth. But in the United States, the practice, called midwifery, is poorly understood and many people fear use of a midwife can make childbirth riskier than it needs to be.

Midwives are not just about taking care of pregnant women and delivering babies. Their role is to accompany women throughout their lives, and help them be healthier from head to toe. Midwives encourage proper nutrition, regular exercise and good lifestyle habits, rather than a reliance on drugs or technology.

Critics argue there isn't enough professional oversight for midwives, and that expectant women shouldn't be deprived of the benefits of new medical technology. They also say that in emergency situations, both the mother’s and the baby’s lives could be in danger with only a midwife at the bedside.

Midwifery advocates insist that safety is always their first concern, and that complicated or emergency pregnancies are referred to regular doctors. But in the vast majority of normal cases, they say midwives offer an inexpensive, holistic and time-tested alternative for women who can't afford a doctor's care or women who just seek a simpler, more intimate birthing experience. Should more Americans adopt this less-expensive, more human-oriented care that doesn't rely on doctors, drugs and costly technology?

The D.C. Birthing Center thinks so. In this slideshow, we get to know patients, midwives and the director at the Washington-based center, as they explain their reasons for pursuing midwifery.

Painting For Health Care

"We need a societal shift in thinking and feeling. We need people to care about others. We have to turn people around. And I'm hopeful that my story will do it, because look at me. I don't have a job right now, other than I teach part-time art, but I'm out there. I'm working on it." Regina Holliday, health care reform activist and widow.

Regina Holliday, a 37-year-old widow, part-time art teacher and mother of two, has become a media darling in recent weeks, written about, photographed and filmed by countless journalists. The reason is her story, energy and a colorful mural she is working on in Washington, D.C., at the back of a gas station, across from a pharmacy, not too far from an independent bookstore. In paint on the six-meter high wall, she is recounting her husband's death within the U.S. medical system. He died June 17, 2009, the same day the U.S. Senate started debating health care reform.

Her husband was sent home to die of kidney cancer after doctors refused to try more tests or chemotherapy. For years, he didn't have health insurance, so he didn't take the tests that might have given him an early detection of what was causing his bloody urine and night sweats.

Holliday’s mural has a doctor standing in waste, which symbolizes inefficiency in helping sick people. Another doctor seems annoyed, moving away from his patient, talking aggressively on his cell phone. A nurse types into a computer, but the screen is dark, representing a "loop of information" going nowhere. Data is not transfered from one health center to another. In this artistic rendition, health care is not something that is for patients, it seems to be a money-making, cold monster -- a place where information is not used to help the sick get better, but rather it is compartmentalized to keep costs at high levels and avoid any lawsuits.

Holliday has painted quotes to inspire and engage from Thomas Jefferson to Harry Potter, saying in ways old and new there is a difference between what is right and what is easy.

A girl dressed in the American stars and stripes flag has her legs covered with welts, and a switch to whip her lying at her feet. Holliday says she represents an abuse victim, who thinks she doesn't want change, because she has been conditioned to be afraid.

Holliday was abused for 17 years growing up in her home. Her husband was a victim of poor health, and a society that leaves some of its sick behind. But now she says she is fighting back, with her ladder, paints and brushes.

She believes a government-run health insurance plan can help people like her who don't have a full-time job and benefits. She believes in the long-run it could become better for patients and more efficient than what is currently in place. Her views, of course, are hotly contested by some engaged in the current debate, in which there are many ideas, and many fears of rising costs, less incentive for market-driven innovation and more bureaucracy.

This television report by Carol Pearson shows how one company, grocery giant Safeway, allows employees who work on being healthier to pay less for their private insurance plan.

A Summer of Protests and Rage

"People feel that there are certain things that are going to take place which are not at all factual, so based on false information, this anger has been stirred up unnecessarily and it's a shame because we're not really talking about the issues, and people are just venting," Health Care Reform Protester, in Washington, D.C., August 20, 2009.

Television news, the Internet, town hall meetings and street protests in the United States are currently being dominated by the issue of health care.

People on all sides of the issue are fired up. Public option, or no public option, that seems to be the question. But who can explain what the public option really entails? Basically, it opens the possibility of getting government health insurance, but the unknowns of this proposition riles up opponents.

Loaded guns have been taken to health care-related events, including some where President Barack Obama spoke, as well as plastic guns, loaded with flowers. The words Nazis, socialism, and fascism have been bandied about, as well as "Waterloo", in a reference to the 1815 battle in Belgium which ended the reign of European emperor Napoleon Bonaparte.

Will this health care battle be Mr. Obama's own "Waterloo"? Tensions seem to be much higher than when the previous Democratic Party president, Bill Clinton, tried unsuccessfully to reform America's health care system. How far can this go? Will a real bullet ever be fired at one of these events? Wouldn't that cause a frenzy?

The president himself is safely on vacation now, but pundits continue to weigh in and lawmakers continue to hold town hall debates. The rhetoric is heated, placards are getting torn, and cameras by citizen journalist of all political stripes, pick up the action. Congress will reconvene in early September, with lots of attention now focused on what will happen then.

This report by Kent Klein has the president complaining that the media is giving too much attention to disturbances at protests.

Still, there is a clear divide, between those who want more government involvement in terms of health care, and those who view such a development as outrageous or at least, unnecessary. It seems an important part of America's future hangs in the balance.

Growing Pains of Health Care

"What people don't understand or don't realize … until it's unfortunately way too late, is that you buy into a system that feeds you the notion that it's there for you. You pay so that you are cared for, but in reality, when push comes to shove, and you really need the system, the system is not there for you." -- Sandra Lemaire, a VOA employee, who is trying to get her mother on Medicaid, which extends health benefits to the ailing poor.

"The large majority of the population, who are middle class people, who have worked all of their lives, squirrel money away, and pay insurance all their lives, they don't qualify for anything. Insurance does not pay for long term care." -- Pascale Lemaire, Sandra's sister.

While the debate over health care reform rages on in the United States, many people and families are struggling to pay for their medical needs. Some attention has been given to the nearly 50 million uninsured in America, but those who have been insured all their lives also struggle.

This is the story of the Lemaire family, which has been hit hard by the misfortunes of bad health and rising medical bills. Sandra spends hours every day helping her ailing parents after working full shifts for the English webdesk of the Voice of America. Her father, who also used to work at VOA, suffered an aneurysm last year.

Shortly after he returned from the hospital, his wife suffered from the same severe predicament, a dangerous blood-filled dilation of a blood vessel, and eight months later, she remains in a nursing facility, attached to tubes, unable to speak, and barely able to twitch. Sandra visits her every day, and has hired a lawyer to try to find a way to cut down on monthly medical bills which are in the tens of thousands of dollars, and are quickly decimating the family's savings.

Pascale, her sister, a freelance hairstylist, stays at home with her dad, who also needs full-time assistance to get by. Pascale has had to cut down on her working hours, and can no longer afford health care for herself. She says she feels she is about to have a nervous breakdown.

This is just one family's story and some of their opinions about the state of health care and the need for reform. There are other opinions out there, with many Americans expressing fears the government will spend too much money to reform the system, and tax too heavily to create wider insurance, as Jim Malone's radio report indicates. Opponents of a so-called public option plan, where the government would provide insurance, say that is like socialism. In the U.S. political context, that is almost as bad as terrorism. Those who support a government-run alternative to private insurance say they will be very disappointed if such a plan is not pushed through Congress, as now seems possible.

Town hall meetings were held across the United States in August to discuss the future of health care, erupting at times with yelling and people tearing up each other's placards. Opponents have started showing up at events where President Barack Obama is speaking with guns and rifles in states where this is allowed, making some in the crowd very uncomfortable.

President Obama once said opponents are trying to turn this debate into his "Waterloo," in reference to the town in Belgium where a 19th century battle ended the rule of European emperor Napoleon Bonaparte. But as Kent Klein reports the president is battling with all his might to make discussions civil and avoid his own demise.

A Clinic on Wheels Helps Immigrants

"[The people we help] do not have access to health care. [This job] is very important for me, because we are saving lives." -- Mama Bus worker.

U.S. government data indicates at least 40 million Americans are without health insurance.

Within this vulnerable group of people, a disproportionate number are immigrants who typically receive fewer health benefits than native-born citizens.

This vlog is about the Mama and Baby Bus, run by the Mary's Center, a charitable group which helps individuals and families with limited or no access to health-related services in the Washington, D.C. region.

The bus makes regular stops to provide women with free pregnancy tests and information on where to get free health care. It also gives free health screenings to anyone who drops by, as well as referrals, vaccinations, and dental exams, and guidance on insurance enrollment.

Sometimes even affluent people drive by and park their fancy cars to get a free dental checkup inside the bus.

I caught up with a morning bus crew as they made a stop on the corner of Columbia Road and 14th street, in one of D.C.'s largely Latino neighborhoods in an area in the northwest part of the U.S. capital.

One of those interviewed, outreach worker Chelsea Nycum, followed up with an e-mail, trying to explain in better detail her motivation to do the work she does.

Her words also shed light on a part of the story that my camera was not allowed to capture.

Here is what she wrote: "When someone comes to the bus for an HIV or pregnancy test, the results that will come to light in our 20 minutes spent together have the potential to be life changing. In those few minutes, people usually aren't nonchalant and they don't pretend to have it all together. I am able to be a part of someone's life during something that is honest, vulnerable, and real. Now, I don't pretend to think that after a few minutes with someone that I know their circumstances or understand fully (or even partially) what makes them who they are, but I think that people appreciate being asked about the things that matter to them and they appreciate being heard. Too often, especially in the populations we serve at Mary's Center, people are coping with a lot of pain and tough circumstances and nobody ever reaches out to them to listen to their stories or to let them know that they matter."

Recent Voice of America reports on health care in America, include this radio spot by Gabe Joselow on the White House budget director’s claim that investing in health care is key to creating economic growth.

This radio/television report by Paula Wolfson is about President Barack Obama starting efforts to overhaul the U.S. health care system.