As a mom, issues surrounding childbirth tend to resonate with me, and I’ve written several articles about the subject.  So it was with great interest that I read Kathy Petersen’s article about how c-sections increase risks for future pregnancies.  Kathy’s article highlights the importance of truly informed consent, and points out the ways that women are swayed (manipulated?) towards opting for repeat c-sections in the name of safety, without being truly informed about the risks on both sides of the issue.

A friend of mine who lives in a smallish Colorado town had a c-section with her first baby after 45 hours of labor.  She wanted to try for a VBAC with baby number two, but was told that she would have to go to Denver a month before her due date and stay near one of the big metro hospitals until she gave birth.  Between her job and taking care of her toddler, that wasn’t a particularly viable option, and so she had a repeat c-section.  In fact, several of my friends had c-sections with their first babies, and all have gone on to have repeat c-sections.  They were all warned ominously that they could suffer uterine rupture if they opted for a VBAC, but none of them mentioned anything about the issues that Kathy raised in her article.

United HealthOne has changed the way they underwrite applicants in Colorado who have had a c-section.  They now charge an additional 30% on top of the standard premiums in these cases.  All health insurance carriers in Colorado cover “complications of pregnancy”, but most of them do not consider c-sections to be complications.  United does consider c-sections to be complications, but only if they are emergency c-sections (ie, not scheduled).  Since most OBs schedule repeat c-sections, it’s rare that a woman would end up with an unplanned, emergency repeat c-section.  So I was a bit perplexed by the new underwriting actions.  But after reading Kathy’s article and learning about the problems that can occur in a subsequent pregnancy following a c-section, it makes more sense.

I found Kathy’s article in the Cavalcade of Risk, hosted last week at Healthcare Manumission.