Posts Tagged - ‘cesarean section’

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Family Health Insurance Steers Pregnant Women Towards C-Sections

Friday, February 5th, 2010

(Image: Andrea Fregnani under CC 2.0)

It was recently found that almost one-third of the pregnant women in the United States give birth by Cesarean section, a far higher rate than other developed nations. While C-sections are often necessary, they are nevertheless surgical procedures that can harm both mother and child. Many doctors believe that they be performed in only 10% of pregnancies at most.

A common misconception is that American women choose to have C-sections–sometimes even scheduling them–but that is actually relatively rare. Another explanation for the high Cesarean section rate in the U.S. may be our health insurance system. Unlike many other countries, family health insurance reimburses physicians and hospitals with a flat fee for the birth, regardless of how it is performed. Some doctors may unconsciously steer their patients towards a C-section, since medical insurance doesn’t offer an incentive for them to perform longer vaginal labor instead. To the contrary: some medical insurance companies actually have higher reimbursement rates for C-sections!

Meanwhile, most hospitals can charge far more for a Cesarean section birth, which gives them more opportunity to pad their maternity care profit margins. In addition, doctors may also be performing C-sections in order to lessen the risk of a medical malpractice claim being filed against them; physicians tend to be sued for failing to take action more often than taking the wrong action. Breech babies (which are in the wrong position for vaginal birth) can sometimes be turned around through changes in positioning and waiting, but time pressures and legal concerns reduce the likelihood that an obstetrician would take that risk. All of those factors combine, and the cost is passed onto the new mother through her family health insurance premiums.

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