Sunday, June 01, 2008

Caesareans Cause Insurance Problems

The vast majority of Caesarean sections are unnecessary, invasive surgeries. To add insult to injury, many women are finding themselves un-insurable after a Caesarean. Insurance companies don't want to cover women of child-bearing age. Period. It's expensive and the insurance company's goal is to make money. The insurance company's goal is not to make sure you get well. That is your job. The doctor's job is to help you.

It is helpful to remember these roles when you're making health care decisions.


MaxedOutMama said...

I see you really ARE feeling better!

The problem for a woman is that she doesn't have the expertise to know whether one is necessary or not, and when you are in labor it is hard to get a second opinion. After the first, one can shop around to see if one can find a provider willing to try a second natural delivery.

There are no easy answers on this one. I think the operation is overdone because of the potential liabilities if a problem develops in a somewhat stressed delivery. Maybe tort reform is necessary to really change this dynamic?

Melissa Clouthier said...

Well, I'm feeling somewhat better. I think I was more optimistic this morning. Ugh.

As for c-sections: 1. A huge percentage (varies by state and even city) of sections are elective. For a first-time birth this is unconscionable.

2. A huge percentage of "emergency" c-sections are because of liability. For example, a dip in heart rate makes the doc nervous and rather than switching the position of the mother, the doc goes to c-section. Women still labor in the supine position which puts pressure on the blood vessels that feed the uterus. It's stupid and causes problems. In addition, once a woman has had an epidural she cannot move and there is a correlation between epidurals and c-rates.

3. Another cause for c-rates increasing is a decrease in doctor skill. A breach baby will force a c-section, when just a generation ago the baby would safely be delivered by a skilled ob/gyn.

Doctors like c-sections. They get paid more. They require less skill than delivering a big, or misaligned baby. Now, doctors want to vaginally birth "perfect" candidates. Also, doctors routinely break the water which forces a birth within 24 hours due to fears of infection. So, so many interventions require the c-section and it's the doctor's not the woman's fault.

And in the midst of everything, a woman will do ANYTHING to protect her baby. She will die for that child and when she sees a panicked look on her doctor's face, she is as submissive as any physician could hope for. It is abusive, in my opinion.

That isn't to say that c-sections are life saving operations. They can be absolutely necessary. A friend of mine nearly lost her baby due to a chord prolapse and her baby was saved due to a c-section. So I'm not anti-c-sections. I'm anti-stupid.

Women have been made to believe they are weak and fragile when it comes to birthing. It is what a woman's body is MADE to do. The process is fussed with way too much. And I've talked about this way to long.

Texas has had tort reform and still has one of the highest c-rates in the country. In Houston, nearly half of women end up with a c-section. Women need to educate themselves and start having faith in their bodies. And doctors need to learn the skills to make difficult deliveries and stop being such complete weenies.

MaxedOutMama said...

Well, Dr. M, those stats and details are what's worrying me. I can understand docs being afraid of liability. I've got one doc in the family who has been slapped with wildly ridiculous lawsuits. He's a cardiologist. Try this one: 86 year old man comes in for check up. Doc notices some changes in heart beat. Puts him in hospital for obbo and testing (normally outpatient, but not at this guy's age and condition). In the hospital the man has a massive heart attack and dies in his bed. Grieving widow sues hospital and doc under the theory that the hospital should have saved her husband's life and that the doc should have known he was going to have that heart attack and should have been standing by his bedside, or something like that. The allegation targeted against him was basically neglect.

Coming back to babies, many types of injuries can be attributed to stressful deliveries, and the awards are very large and the juries are very sympathetic. I seem to be remembering that John Edwards made some big money off those types of cases.

I'd be totally scared to say no if a doctor told me he thought the baby might be injured.

Melissa Clouthier said...

Well, the interventions (besides elective c-sections) start the ball rolling. If a woman is educated and assertive and confident before the process, and if she's supported by a loving husband who is assertive, educated and confident, and research shows, they are supported by another woman (doula, midwife), her chances of c-section plummets.

Women fear child birth. Doctors fear lawsuits. Insurance companies fear losing money. The only thing worse than this situation is socialized medicine where no accountability would exist in the system at all.

The solution is an educated consumer. The more women know and the more good stories they hear from other women, the more likely the system will change.

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