By Jeff Levin-ScherzJuly 23, 2026
Levin-Scherz is a senior managing director and population health leader of the North American health and benefits practice at WTW. He is an assistant professor at Harvard Medical School and the Harvard T.H. Chan School of Public Health.
The approach to paying obstetricians and midwives is changing. These changes will likely raise the cost of childbirth, with no guarantee of better maternity outcomes.
The American Medical Association (AMA), at the recommendation of the American College of Obstetrics and Gynecology, will eliminate the global payment codes for deliveries used by obstetricians and midwives at the end of this year. The AMA will replace these global fees, where health plans paid for professional services based on a single bill after delivery, with fee-for-service, or pay-as-you-go, codes for prenatal and postpartum visits, fetal monitoring, and various procedures.
Professional global maternity codes were instituted in the 1990s, and it’s hard to argue that they have led to vast improvements in maternity care. During this time, cesarean section rates have increased from 22.9% in 2000 to 32.5% from in 2025. U.S. maternity mortality rates and severe maternal morbidity rates are the highest among wealthy nations. Earlier prenatal visits are associated with better pregnancy outcomes, but global billing codes don’t capture the timing of prenatal visits.
