Another reason to not mix work and family: Money makes parenting less meaningful

University of Sydney research has found that pregnant women who see the same midwife throughout pregnancy are more likely to experience fewer interventions during birth, and cost the public hospital system less than women who receive standard shared antenatal care or private obstetric care.

In one online study, American participants reported about how much they typically focus on the present moment, and also read 10 sunk-cost scenarios-such as whether to attend a music festival that had been paid for when illness and bad weather made enjoyment unlikely-and then reported how much they would let go of sunk costs in each of them.

"Most people have trouble admitting they were wrong when their initial decisions lead to undesirable outcomes," says researcher Andrew Hafenbrack, lead author on the new research and doctoral candidate at INSEAD. They don't want to feel wasteful or that their initial investment was a loss. Ironically, this kind of thinking often causes people to waste or lose more resources in an attempt to regain their initial investment or try to 'break even.'"

"This is compared to 48.2 percent of women who chose standard hospital care and 30.8 percent with private obstetric care.
"Caseload midwifery patients were also ten-times less likely to have an elective caesarean than women with private obstetric care," she said.

In the final study, participants also answered questions about the time period on which they focused - that is present, past, or future - and the emotions they experienced. The other group of participants listened to a recording that asked them to think of whatever comes to mind, a practice that is not a form of meditation. Participants then responded to sunk-cost scenario questions.

"Caseload midwifery care works on the premise that women will labour more effectively, need to stay in hospital less time, and feel a stronger sense of satisfaction and personal control if they have the opportunity to get to know their midwife at the beginning of pregnancy.
Paper co-author Dr Donna Hartz, from the University of Sydney, said that despite high quality evidence of the safety and cost savings associated with caseload midwifery care, it has only been introduced in most hospitals as a token service with access to a small proportion of women.


"We found that a brief period of mindfulness meditation can encourage people to make more rational decisions by considering the information available in the present moment, while ignoring some of the other concerns that typically exacerbate the 'sunk cost bias,'" explains Hafenbrack. Across a series of studies, Hafenbrack and co-authors found that mindfulness meditation, which cultivates awareness of the present moment and clears the mind of other thoughts, may help to counteract this deep-rooted bias.

In each, participants listened to a 15-minute recording made by a professional mindfulness coach. For one group of participants, the recording led them through a focused-breathing meditation that repeatedly instructed them to focus on the sensations of breathing. The results revealed that the more people typically focused on the present moment, the more they reported that they would ignore sunk costs.
To test whether mindfulness caused an increased resistance to the sunk-cost bias, the researchers conducted an additional three experiments.

The 2013 Cochrane review of 13 trials involving more than 16,000 women found those receiving midwife-led continuity models of care were less likely to require analgesia, episiotomy, or an instrumental vaginal birth compared to women cared for by different obstetricians, GPs and midwives.

in the journal Pain Medicine, show that sedation before a nerve block significantly increases false-positive results, which means patients are more likely to be sent in for surgeries and other procedures that won't cure the underlying pain. If the nerve block fails to numb pain, surgery or the nerve ablation may not help. Increasingly, physicians have used light or even deep sedation in a bid to ease anxiety and pain while the injection is given.
However, results of the new study, reported online Feb.


"The latest findings help to refute misconceptions that one-to-one midwifery care is expensive or unsuitable to complex pregnancies," Professor Tracy said. The study found that over one financial year there was an average saving of over $1000 per woman for those who chose caseload midwifery care. It is also the first study to calculate the average cost per woman receiving private obstetric care in the public system.
"A previous study published by the same University of Sydney team in the Lancet in 2013, found the median cost of caseload midwifery care was $500.00 less than routine or standard hospital care.

"Childbirth is the single most important reason for hospitalisation and accounts for the highest number of occupied bed days for women, however, the current structure of our maternity system makes it challenging to deliver value for money," she said.

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