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What Is the Relative Value of a Baby?
Article Number: SIS704615AI220525
22nd May, 2025
Author(s):
Rachel Fleishman, M.D.
Abstract:
This article, written from the perspective of a neonatologist, reflects on a newborn’s struggle to breathe in the first moments of life and the systemic challenges in U.S. perinatal care. The physician describes the baby’s difficult transition from fluid-filled to air-filled lungs, requiring intervention with oxygen and respiratory support. As the parents anxiously watch, the doctor reassures them, acknowledging the uncertainty of the baby’s first breaths.
The essay expands beyond the delivery room, highlighting how hospital closures, restrictive abortion laws, and declining Medicaid reimbursements have led to fewer labor and delivery services, disproportionately impacting marginalized communities. The author describes the financial devaluation of maternal and neonatal care within the relative value unit (RVU) system, which assigns monetary worth to medical procedures, prioritizing high-tech interventions over essential perinatal services.
Ultimately, the article critiques structural violence in U.S. healthcare, arguing that birthing care should not be dictated by profitability metrics, but rather by its fundamental importance to human survival. The physician’s final act placing the now-stabilized infant in his mother’s arms underscores the true value of life beyond economics.