Monday, June 02, 2008

Insurance Companies Rejecting Women Who've Had C-sections

I received this from ICAN (International Cesarean Awareness Network)
and wanted to pass it along... it's sad how the effects of C-sections can go on and on, impacting every aspect of life.


Insurance Companies Rejecting Women with History of Cesarean
Some Companies Require Surgical Sterilization for Coverage;

Trend Gives New Imperative to Learn Ways to Avoid Unnecessary Cesarean

Redondo Beach, CA, June 1, 2008 – As reported in today's New York
Times, ICAN has begun tracking an alarming new trend of insurance
companies refusing to provide health insurance for women with a
history of cesarean surgery. In some cases, women are being rejected
for coverage outright and in other case they are being charged
significantly higher rates to obtain the same coverage as women
without a history of cesarean. With over a million women each year
undergoing this surgery, this practice has the potential to render
large numbers of women uninsurable.

This trend surfaces as the rate of cesarean surgery, including
unnecessary cesareans, continues to rise. In 1970, the cesarean rate
was 5%. In 2007, it was 30.1%. Experts often cite the incentives
within the health care system for driving up the rate of cesarean
unnecessarily, including physicians' medical malpractice fears,
better reimbursement for surgery, and lifestyle conveniences for care
providers and staffing efficiencies in having more '9-5' deliveries.

'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,' said Pam Udy, President of the International Cesarean
Awareness Network (ICAN).

The trend is highlighted in the cases of women like Peggy Robertson
of Colorado. When she applied for health insurance coverage with
Golden Rule, her husband and her children were accepted, but her
application was denied. After multiple inquiries directed to the
insurance company, she was finally told that she was denied because
she had delivered one of her children by cesarean. 'It was shocking.
I assumed that as a woman in good health I would be readily
accepted,' said Robertson. 'When I finally found someone who would
explain why my application was denied, they had the audacity to ask
me if I had been sterilized, stating that this was the only way I
could get insurance coverage with them.'

As the incidence of cesarean increases, the evidence of the
downstream medical complications for women and babies, and the
associated medical costs, becomes increasingly apparent. Risks of
cesarean in later pregnancies include increased incidence of
infertility, miscarriage, fetal deformities, overgrowth of scar
tissue leading to bowel problems, and potentially deadly placental
abnormalities in subsequent pregnancies.

And though most women with a prior cesarean are being encouraged and
often coerced into having repeat cesareans by their doctors and
hospitals that have banned vaginal birth after cesarean (VBAC), a
pair of recent studies done by the National Institute of Child Health
and Human Development Maternal–Fetal Medicine Units Network
demonstrates that women who deliver vaginally after a cesarean fare
significantly better than women who deliver by repeat cesarean.
(Obstetrics & Gynecology 2008;111:285-291, Labor Outcomes With
Increasing Number of Prior Vaginal Births After Cesarean Delivery,
Mercer et al, and Obstetrics & Gynecology 2006;107:1226-1232 Maternal
Morbidity Associated With Multiple Repeat Cesarean Deliveries, Silver
et al.)

'Most women are looking to avoid cesareans. But physicians often make
surgery difficult to avoid by insisting on non-evidence based
practices,' said Udy. Practices that fail to improve the outcomes for
mothers and babies and increase the risk of cesarean section include
inducing for going post-dates, inducing for suspected large baby,
requiring fasting during labor, requiring women to be confined to bed
for continuous fetal monitoring, and failing to offer continuous
support to a mother in labor. 'These care practices serve the system
well, but not mothers and babies' Udy added.

In fact, women and their babies may be paying a higher price than
being denied health insurance. Last August, the Centers for Disease
Control reported that, for the first time in decades, the number of
women dying in childbirth has increased.

Experts note that the increase may be due to better reporting of
deaths but that it coincides with dramatically increased use of
cesarean. The latest national data on infant mortality rates in the
United States also show an increase in 2005 and no improvement since
imdeaths05.htm Internationally, the U.S. ranks 41st in maternal
deaths and has the second worst newborn death rate among
industrialized nations.

Women who are seeking information about how to avoid a cesarean, have
a VBAC, or are recovering from a cesarean can visit www.ican- for more information. In addition to more than 90 local
chapters nationwide, the group hosts an active on-line discussion
group that serves as a resource for mothers.

Women who want to reach their lawmakers can visit Women who want to reach their state
insurance commissioner can visit .

About Cesareans: ICAN recognizes that when a cesarean is medically
necessary, it can be a lifesaving technique for both mother and baby,
and worth the risks involved. Potential risks to babies include: low
birth weight, prematurity, respiratory problems, and lacerations.
Potential risks to women include: hemorrhage, infection,
hysterectomy, surgical mistakes, re-hospitalization, dangerous
placental abnormalities in future pregnancies, unexplained stillbirth
in future pregnancies and increased percentage of maternal death.

Mission statement: ICAN is a nonprofit organization whose mission is
to improve maternal-child health by preventing unnecessary cesareans
through education, providing support for cesarean recovery and
promoting vaginal birth after cesarean. There are 94 ICAN Chapters
across North America, which hold educational and support meetings for
people interested in cesarean prevention and recovery.

Contact: Gretchen Humphries (734) 323-8220

Write your state and national representatives about this:

U.S. Congress Representatives:


State Representatives:

State Insurance Commissioners:


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