Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Miriam Axel-Lute — Sat, 20 Dec 2008 20:54:02 GMT

Sarah: Thanks for the tip. That's worth a post of its own.

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Sarah — Sat, 20 Dec 2008 19:52:20 GMT

Only kind of related- this woman had her baby induced because she was losing health insurance. And insurance ended up denying her claim anyway.

www.nytimes.com/.../us 07uninsured.html?pagewanted=2

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Alice — Sat, 20 Dec 2008 02:13:33 GMT

Do not let this country hand your health over to non-medical personnel at an insurance company. ONLY doctors shoudl medical decisions for their patients. I dont give a rats ass what one study says. Your OB knows your risks and benefits much better than some guy in Rhode Island with an Actuary degree who is trying to make his quota.

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Miriam Axel-Lute — Fri, 19 Dec 2008 20:41:53 GMT

gpgirl: There's a study cited in the op-ed that talks about pre 39 weeks vs post 39 weeks. Sounds like Amy read other stuff too.

Jeanne: As I said above, I think it should be up to the docs to document necessity, not the insurers to judge it. And I definitely don't mean don't insure scheduled c-sections, just not unjustified pre-term one. But it is hard when you can't trust anyone to make their decisions based on best interests of kids or moms.

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

JeanneSager — Fri, 19 Dec 2008 20:29:00 GMT

I'm with the mothers who would worry about what an insurance company would deem "necessary." I wouldn't advocate for anyone to do a C unless she has to, of course, but insurance companies already have a track record of refusing to cover plenty of VERY NECESSARY health services. My friend had a horrible delivery with her first child, he was too far into the birth canal by the time they realized they should have done a C, he ended up with dislocated shoulders, she had excessive bleeding the ended up needing a D&C . . . the works. So she ended up scheduling a C for her second child. Ironically, her second child was a petite little thing, and the doctor said she probably would have delivered her fine if she'd gone vaginal . . . but they didn't know. But if an insurance company had that power, they could walk in, look at the chart, and say "hey, why did they do a C with this woman, she didn't need it..." Aach, sorry, I just hate insurance companies!

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

gpgirl — Fri, 19 Dec 2008 18:56:55 GMT

Amy, could you post the link to the info on risks of 38-week C-sections? I had only read about 34 to 36 week risks. Thanks.

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Amy Kuras — Fri, 19 Dec 2008 17:33:39 GMT

I had an emergency C-section with my daughter, ad for lots of reasns scheduled one with my son -- who was due right after my OB's 40th birthday. You can see where this is going, right? I could have scheduled it at 38 weeks or right on my due date, but the OB would be on vacation in between then. I had read, right here on SD as a matter of fact, the risks of 38-week elective C-sections so opted to wait. And I am so glad I did -- he's had a ton of colds and I am glad he had those two extra weeks of lung development. I think they generally like to do them at 39 weeks so you don't end up going into labor on your own if you want or need a c-section. I would have felt OK about 39 weeks but 38 just didn't feel right.

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Miriam Axel-Lute — Fri, 19 Dec 2008 17:20:37 GMT

Barb: Apparently docs schedule them early often for convenience, especially so they're not taken by surprise by an early labor, but also to avoid holidays, mothers' or docs' vacations, etc.

Chiken: I am not an expert, so I don't know about the stress of an "emergency" c-section, but I do know that if labor doesn't start, mom and baby miss out on the benefits of oxytocin. Still, 39 weeks is full term, so it doesn't sound like you need to worry.

gpgirl: Yes, I would be hesistant to hand the decision to insurance cos. I think it would make a difference if the insurance companies just made docs justify the timing and then took their word for it if they said it was necessary. Some would make something up, I'm sure, but at least the point would have been made that scheduling a c-section pre-term was something that needs a pressing medical reason.

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Barb — Fri, 19 Dec 2008 16:59:14 GMT

I agree, gpgirl: having insurance companies making decisions like that, as in, "No, we're not coving you," opens a whole new can of worms...

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

gpgirl — Fri, 19 Dec 2008 16:47:15 GMT

The question is - how would insurance define "unnecessary". From what I understand, as long as the doctor says it is necessary, insurance will cover it. Will insurance companies now have to define what necessary is?

I think it is important for doctors to know that late pre-term births can be dangerous, and then make the decision from there. But insurance companies taking over this decision seems like the wrong move.

Chiken, when they talk about late pre-term, they mean 34 to 36 weeks. They are comparing these births to those after 37 weeks, which are still viewed as being "term". So at 39 weeks, you are well within term. (Click on some of the links Miriam has in her post for more info.)

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Barb — Fri, 19 Dec 2008 16:42:22 GMT

This is confusing information--you never say why a DOCTOR would agree to a pre-term c-section. The fact that it's dangerous to the baby to be pre-term seems like something doctors already know, so why would they schedule pre-term c-sections unless it was medically necessary? Has anybody had this experience? If so, why did you want to have the baby early?

In my own personal experience of two c-sections, the doctors "allowed" me to go late because I desperately wanted a vaginal delivery, but, alas, it wasn't meant to be for me. But I was at 41 weeks with my first-born (she came out at 11 pounds! they knew she was big, which is why they didn't want to induce me), and 42 weeks with my second-born (he was smaller, at 9 pounds, but they wouldn't induce since I'd had a previous c-section). I'm just curious to hear about other women's experiences...

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Chiken — Fri, 19 Dec 2008 16:23:58 GMT

I am currently scheduled for a c-section at 39 weeks because my baby is in the breech position. My doctor suggested that we do it then because there is some evidence that c-sections before labor starts are less stressful on the baby than so-called emergency c-sections. This new information is making me somewhat nervous....although she won't be significantly pre-term.

re: Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Evvie — Fri, 19 Dec 2008 16:09:21 GMT

I agree..... i mean, God forbid they pay for a doula!