Tag: vaginal birth after cesarean

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c-sections Current Events Mothering Pregnancy & Birth

Insurers Denying Coverage to Women Who’ve Had C-sections

If you have read my blog for a while, you know that I write frequently about c-sections.  It is my opinion that Cesarean sections are over performed in this country.  Previous posts I have written, discuss many of the complications that can arise from c-sections.  Despite the many risks and complications associated with c-sections, the c-section rate continues to rise.  Last year in the US, it was 31.1 percent of births.  That is a little more than one in three births.

The New York Times had an article on Sunday reporting that many insurance companies will no longer accept mothers who have had a previous c-section.  The thinking behind this is, once a woman has had one c-section chances are, she will have another one.  Because VBAC’s (vaginal birth after cesarean) are banned and prohibited in so many hospitals, the only choice basically left for women birthing another baby after a c-section, is another c-section.  Because so many c-sections are not medically necessary, the insurance companies don’t want to pay for them. 

Insurance companies are rejecting these mothers coverage, and some insurers even consider having a c-section, a pre-existing condition.  What makes this even scarier, is once someone has been denied coverage and rejected by one insurance company, they have to disclose that to subsequent insurance companies they apply to.  Once an insurance company sees the mother has been rejected, a red flag goes up, and makes it even harder to get coverage.  If they do get coverage their premiums are extremely pricey and expensive.  In Colorado it was estimated some premiums would be 140% more than standard rates. 

The article quoted Pamela Udy, from the nonprofit group, International Caesarean Awareness Network, (ICAN) whose mission is to prevent unnecessary Cesareans.  “Obstetricians are rendering large numbers of women uninsurable by overusing this surgery.”

There are a few “exceptions” some of the insurance companies are making, where they will cover a woman who has had a previous c-section, such as:  

  • If the woman has been sterilized after the cesarean section
  • If the woman is over the age of 40 AND at least two years had past since the c-section
  • If after five years, there has not been a complicated pregnancy AND another c-section

These hardly seem like fair options.  You can only get coverage after a c-section if you have been sterilized? 

This is definitely a fall out from c-sections being performed unnecessarily.  The article mentions that women are caught in the middle of this mess between insurance companies and doctors. Pamela Udy says,  “Women are caught in the middle of a dysfunctional system. Doctors are telling them they need surgery, even when they don’t, and insurance companies, who are tired of paying the bill for so many frivolous surgeries, are punishing women for the poor medical care of doctors.”

This situation should be alarming for every woman in their child bearing years.  Even if you have no intention what-so-ever of having a c-section, in the rare case that you did need a medically necessary one, you can be denied insurance coverage now, because the procedure has been over performed.

Doctors and hospitals must start allowing VBAC’s, and return to delivering breech babies, in order to lower the ever rising c-section rate.  If nothing else, c-sections should be reserved for true emergency situations.  Something has to change- now more than ever, our very health depends on it. 

Categories
c-sections Cole Mothering Parenting Pregnancy & Birth

Two Years Old

Cole is two years old today!  I have been thinking a lot about this week about my labor, delivery, and his birth.  He was technically born on the third Monday of May, and on Monday I was remembering the time line of his birth.

Having had a c-section with Ryan, I was attempting a VBAC (vaginal birth after caesarian with Cole.)  I have been through a c-section birth before, but with Cole, it was obvious my first time being in labor.  I remember after 42 hours of labor, and a successful VBAC, I finally was holding my brand new baby boy, and I couldn’t believe how small and tiny he was.  I had forgotten what a newborn looked and felt like.  The tiny toes, the tiny fingers, the microscopic finger and toenails, the way his body just nestled into mine and Joe’s- like that space existed just for him.  I relished those first few days and weeks- knowing in a blink of an eye, my newborn would be gone forever, and in its place, I’d have a baby, toddler, and then a little boy.

Two years later, a little boy has replaced my sweet newborn.  His toes and fingers are no longer tiny.  He doesn’t fit ‘just so’ in my arms, and in a sense I have forgotten again the details of a newborn.  However, two years ago, I could not even begin to imagine how much I am in love with the little boy Cole is.

While he is no longer a baby, he is such a special little boy.  His smile lights up a room.  He loves trying to make us laugh, and he succeeds every day.  From playing peek-a-boo with the kitchen towel, to trying on all of our clothes and shoes, and parading around the house, with the biggest smile on his face. 

Cole thrives on touch, hugs, and kisses.  I will never be lacking a child to hug, kiss or cuddle with.  As he turns two, Cole is learning to talk quite well, with his favorite words being, “mama,” “dada,” “me,” “eat,” and of course, “Ryan.”

Cole loves his big brother to pieces, and has to do everything just like him.  The other day, Ryan’s foot was hurting, and after I was done inspecting it, Cole came running up to me, lifting his foot up too, “whining.” 

While he tries to be just like Ryan, he is also very much his own person.  I love seeing how his personality is changing and growing.  I like to see him develop his different skills, outside of Ryan.  One thing I have noticed is how mechanical he seems to be, and can already put anything back together that he takes apart.  He also loves babies.  Everywhere we go, when he sees a baby, he yells “Baby!” and starts waving hello. 

Two years ago, I had a newborn placed on my chest, and while I knew his name, weight, and eye color, for all practical purposes, he was a blank canvas- I knew absolutely nothing about him.  Today, on his second birthday, my little boy’s portrait is being filled in with the most brilliant and vibrant colors.  Every day I discover a new color that is added to his portrait.  While I know the canvas is always a work in progress, I am so privileged and blessed to be Cole’s mother, and to see his essence being painted.

Happy Birthday, my darling Cole.  I love you so very, very much.  

                       

Categories
Books / Reading c-sections Current Events Pregnancy & Birth

Excellent Article on Disturbing C-Section Trend

The other day, while browsing through my local newspaper, I came across this excellent article on the alarming c-section rate (more on that in a moment) from Jennifer Block, author of “Pushed: The Painful Truth About Childbirth and Modern Maternity Care.”

I have never heard about this book before, and after reading the review of it on Amazon, it sounds fascinating!  I will definitely have to read this- here are a few lines from the review:

“…the United States has the most intense and widespread medical management of birth” in the world, and yet “ranks near the bottom among industrialized countries in maternal and infant mortality.” Block shows how, in transforming childbirth into a business, hospitals have turned “procedures and devices developed for the treatment of abnormality” into routine practice, performed for no reason than “speeding up and ordering an unpredictable…process”

Back to the article that was in my paper- it was originally published in the LA Times, and I do not get that paper, so it was nice to see that other newspapers are picking up and actually running these kinds of stories.  The title of the article is: The C-Section Epidemic.

I loved this article and in my opinion, Ms. Block is right on, regarding the sad state of C-section rates.  In my case, I found her words to be unfortunate, but true, regarding hospitals and doctors use of repeat C-sections instead of promoting VBAC’s (vaginal birth after cesarean), when she writes (bold print mine),

“Too many caesareans are literally medical overkill. Yet some U.S. hospitals are now delivering half of all babies surgically. Across the nation, 1 in 4 low-risk first-time mothers will give birth via caesarean, and if they have more children, 95% will be born by repeat surgery. In many cases, women have no choice in the matter. Though vaginal birth after caesarean is a low-risk event, hundreds of institutions have banned it, and many doctors will no longer attend it because of malpractice liability.”

My local hospital, which is all but five minutes away, has banned VBAC’s.  I wrote the administration, doctors on staff, and the board of directors there, questioning why they will not allow women to choose VBAC’s, and it came down to the insurance factor. 

Women’s lives are being put in danger, needlessly.  I have written before urging anyone who may be faced with a c-section to do your research, and realize that it is major abdominal surgery, with risks of complications and infections, much higher than normal vaginal birth.  Don’t get a c-section, merely for the convenience of the hospital and or doctor’s if it isn’t medically necessary.   Once you have had a C-section, it is becoming increasingly hard and in some places, nearly impossible, to have a VBAC birth, with subsequent pregnancies. 

I liked Ms. Block’s article so much, I am going to post the entire article at the end of my post, so you don’t even have to click a link to read it. Every woman should read this article. It might not relate to you directly, but you can share it, if you have a sister, a daughter, a cousin, a daughter-in-law, a granddaughter, a son (yes, we need to start educating our sons on this subject as well), or a friend facing a possble C-section.  It is valuable information, which could save her life.

I think these new statistics from the CDC should be a huge wake-up call to the medical community, and everyone-really, which proves C-sections that are not medically necessary, are hurting women, and in some cases killing them.  This disturbing trend must change!  What will it take?  If not now, when?

The C-Section Epidemic

More women are dying in childbirth thanks to the high numbers of doctors and mothers who opt out of normal delivery.

By Jennifer Block
September 24, 2007

Pre-term births are on the rise. Nearly one-third of women have major abdominal surgery to give birth. And compared with other industrialized countries, the United States ranks second-to-last in infant survival. For years, these numbers have suggested something is terribly amiss in delivery wards. Now there is even more compelling evidence that the U.S. maternity care system is failing: For the first time in decades, the number of women dying in childbirth has increased.

The Centers for Disease Control and Prevention last month released 2004 data showing a rate of 13.1 maternal deaths per 100,000 live births. For a country that considers itself a leader in medical technology, this figure should be a wake-up call. In Scandinavian countries, about 3 per 100,000 women die, which is thought to be the irreducible minimum. The U.S. remains far from that. Even more disturbing is the racial disparity: Black women are nearly four times as likely to die during childbirth than white women, with a staggering rate of 34.7 deaths per 100,000.

These high rates aren’t a surprise to anyone who’s been investigating childbirth deaths. Physician researchers who have conducted local case reviews across the country consistently have found death rates much higher than what the CDC has been reporting. In New York City between 2003 and 2005, researchers found a death rate of 22.9 per 100,000; in Florida between 1999 and 2002, the rate was 17.6. Other reports by CDC epidemiologists have acknowledged that deaths related to childbirth are probably underreported by a factor of two to three.

What’s to blame for the poor U.S. showing? True, we are the only industrialized country without universal healthcare. But when it comes to childbirth, we basically have it. Ninety-nine percent of women give birth in a hospital with access to all the bells and whistles — high-tech machines that continuously monitor the baby’s heart rate, drugs that can control the speed of contractions like the volume on a stereo, instruments that can coax a reluctant head out of the birth canal, and surgeons at the ready to perform the mother of all interventions, the caesarean section.

The C-section, now used to deliver 30% of American babies, is such a norm these days that, in some places, doctors and women have taken to calling it “C-birth” or even just “having a ‘C.'” Pet names aside, the procedure is major surgery, and although it saves lives when performed as an emergency intervention, it causes more harm than good when overused. Here’s why: Caesareans are inherently riskier than normal, vaginal birth. They also lead to repeat caesareans. And repeat caesareans carry even greater risks.

Placenta accreta is one of them. The placenta embeds into the uterine scar from a previous surgery, causing a catastrophic hemorrhage at the time of delivery. Most women with placenta accreta lose their uteri; as many as 1 in 15 bleed to death. In 1970, accretas were so rare that most obstetricians never encountered one in their career. Today, according to a University of Chicago study, the incidence may be as high as 1 in 500 births. And that is all because of caesareans and repeat caesareans.

Obesity plays a part as well because obese women are more likely to have health problems that make a caesarean more likely, and more likely to suffer surgical complications. Still, it all comes back to the “C,” which could easily stand for “culprit.”  

According to a sweeping 2006 study by the World Health Organization, published last year in the medical journal Lancet, a hospital’s caesarean rate should not exceed 15%. When it does, women suffer more infections, hemorrhages and deaths, and babies are more likely to be born prematurely or die.

Too many caesareans are literally medical overkill. Yet some U.S. hospitals are now delivering half of all babies surgically. Across the nation, 1 in 4 low-risk first-time mothers will give birth via caesarean, and if they have more children, 95% will be born by repeat surgery. In many cases, women have no choice in the matter. Though vaginal birth after caesarean is a low-risk event, hundreds of institutions have banned it, and many doctors will no longer attend it because of malpractice liability.

American maternity wards are fast becoming surgical suites. We’ve become dangerously cavalier about it, but the caesarean rate should be a major public health concern. Universal care alone won’t solve the problem; what pregnant women need is entirely different care. They need doctors and hospitals that promote normal labor and delivery. Of course, reducing obesity belongs on the healthcare agenda, and so does curtailing the scalpel.

Jennifer Block is the author of “Pushed: The Painful Truth About Childbirth and Modern Maternity Care.”