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.