Does a caesarean = no insurance?

I'm currently pregnant with my second child. My first child was a C-section after complications arose during labor. My first is now nine years old, so I obviously waited quite a longtime to have another child!

I'm now 10 weeks away from giving birth to my second child. My doctor didn't seem fond of a VBAC although it sounded like she would've supported me if I really fought for it. However, she did scare me into asking for a repeat C-section.

I am fortunate to be covered by employer's insurance, and I will end up paying between 10 and 40 percent of all of my hospital bills (depending on what is "in network" and what is "out of network"). My motivation to returning to an office environment after being on a flex schedule for years? Insurance.

Until doctors and insurance companies are as supportive of VBACs as their policy would make you think, it ought to be illegal to deny a woman coverage purely for c-section reasons. After all, a c-section saved my baby's life the first time around.

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I had a scheduled C-section for medical reasons two years ago. We are going to try to conceive #2 soon, and I've already asked my OB/GYN about VBAC -- he doesn't do them.
I'm glad you posted this article, I hadn't even thought about the insurance ramifications. I guess I need to check my insurance company's policies!

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I had two c-sections, in 1989 and 1993, and two VBACs, in 1995 and 1998. When I had my first they told me all of my future deliveries would be by c-section but by the time I was pregnant with my third times had changed. I was required, by my insurance, to attempt a VBAC or to have a true emergency delivery or they would not pay for a c-section. With my fourth I had a different insurance and still had the same requirments.

During the 90's the insurance companies also limited hospital stays to 24 hours for a vaginal birth and 72 hours for c-section. Eventually some states stepped in and mandated minimum hospital stays that were more reasonable. Insurance companies are always trying to find ways to limit what they have to pay and they really don't care about the people they are supposedly serving. In this case, they have run up against the AMA and new VBAC guidelines so they are taking a different approach and just refusing to insure.

I'm glad that I had the VBACs and am a little surprised that so many OBs have no-VBAC policies now but I don't think insurance companies should ever have the power to influence patient care like they did back then.

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Interesting photo choice.

My SIL has had 2 VBAC's with no problem. She wants to have a large family, which is why she chose the VBAC.

It's just wrong that C-section would be a pre-existing condition.

It would be nice if doctor's would stop doing so many unnecessary C-sections. I have many friends who had C-sections because "they weren't progressing" I was afraid of this happening to me, so I didn't go to the hospital until after 22 hours of labor. My OB told me I could wait until I couldn't speak during contractions and they were 4 minutes apart. I was still in labor another 9 hours, and they gave me pitocin without even asking. They want to hurry. That's why this has happened with the insurance companies. Long labor should not equal C-section.

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I had two c-sections, both of them medically necessary. I'm one of the lucky women for whom vaginal birth must be impossible--my first was 36 weeks, 6.5 pounds, and after 2 hours of pushing, her head could not descend past my cervix (well, the crown did, and she had a lovely conehead for a couple of days). She was posterior, which didn't help matters, and came out with a large abrasion on the back of her head from my pelvic bones. Baby #2 was full-term, weighed 7lbs 12oz at birth (so, not small, but not a 10-pounder either). After over 24 hours of laboring (drug free, walking, on a ball, and every other VBAC-friendly position/trick I had read up on), his head had not descended even to my cervix. I was at 4cm and had been for like 8 hours, and still laboring hard. This was after 1.5 weeks of onagain/offagain labor that kept dialating my cervix a tad but not descending the baby's head....he was otherwise perfectly positioned (no posterior presentation this time). My pelvis is not built to allow a baby's head through. Without c-sections, I would have been one of those "died in childbirth" notes on a family tree somewhere.

And for this, I would be denied medical coverage? Hey, I guess I'd be a lot cheaper to insure once I'm dead!

Lucky me that I'm 1) done having children, as far as I know and 2) covered and covered well by my employer, a huge multi-national corporation with the buying power to provide good insurance to its employees.

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Well what will the insurance companies come up with next? Soon they will make the common cold a pre-existing condition.

I am not enlightened enough to desire the holistic, at home type of birth. That means, I want the men in white coats to put me to sleep and wake me up when the baby is here. OK, I exaggerate, but I mean that I am all for anything that increases my odds of a safe delivery. Since I know nothing about medicine, I take my doctor's word for it. I had 2 via C-section. He would have done the VBAC if I wanted it, but seemed glad that I chose the C-section, since supposedly there was less risk.

So I would think that VBACs are becoming more common, but who knows. I don't know what the odds are for uterine rupture, but those two words alone were enough for me to order up a C-section.

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While this isn't an issue for me because I live in Canada and our medical system automatically covers all birth situations, I had understood that one of the reasons that U.S. docs often don't do VBACs is that their insurance discourages it by charging very high premiums (one of the most common reasons OBs get sued is for not doing a c-section earlier than they did in cases where the baby sustained harm from prolonged birth).

So, if I understand correctly, the insurance companies charge women more if they pose a high risk for a c-section, and they charge doctors more if they are supportive of VBACs. Hm. Seems like a pretty sweet deal for the insurance companies since they get more money in premiums either way.

Personally, I had an emergency c-section the first time and my OB told me that she'd support me if I wanted to try for a VBAC... but she also rather neutrally gave me my odds for success based on my situation and numbers and they weren't particularly encouraging. Planned c-section for me tomorrow morning. (Hence the distracting of self by commenting on blogs right now.)

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Actually V-BACs have a much lower risk than each subsequent c-section. For a VBAC the risk is anywhere from .05%-.3% and for each subsequest cesarean are already beyond that number and get higher for each one. The risks for the cesareans are asphyxiation, infection, sterility, embolism, embolism rupture and most of these end in death. Most maternal deaths are caused from an aftereffect of cesarean even if they are not marked as such on the death certificate. This is because once you leave a hospital with your baby and you have to return if you were to die from one of these cesarean complications they would not connect it to that birth even though there would have been no other causes. They just mark the reason for death, but not what caused it. I recommend the book PUSHED! for any and every woman. The author does not pick a side, but was very thorough about her sources and what these doctors and hospitals say is sometimes horrifying. I believe if a woman needs a c-section she should have one, no worrying about insurance. I've had 1 child in a hospital, on their sped up schedule and it was horrible. My second was at a birth center, if I would have gone to the hospital I would have had an unnecessary section because I am a slow laborer. I may be biased, but my fear of cut-happy drs will forever keep me away from giving birth in another hospital for the rest of my life.

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It's unbelievable that a woman wouldn't be covered for a c-section!
My first was a c-section because my body just would not dilate past 5cm more than 14 hours after my water had broken -- if I had known then what I know now, I might have tried to labor a bit longer.
I attempted a vbac with my second, but after going into labor I again stalled at 5 cm for many, many hours. I even gave in and tried the epidural at the docs recommendation because he said it might get me going. Nope. Daughter was born healthy via c-section.
I wanted to try a vbac, but I imagine there are plenty of women out there who really don't want to do so. They are scared by doctors or books and afraid that a vbac is putting their baby at risk. It's a shame, but I think they should have the right to make that choice and insurance shouldn't be part of the equation.

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This sounds just wonderful....not!

I had my first child c/s due to breeche position. Then my second as a repeat due to concerns of rupture.

I already have Mitral Valve Prolapse (which is mild) but due to the fact that I take a prescription medication for this, I have already run into insurance companies denying me. Wonder what will happen in the future if I need new health insurance when you factor in this.

Thanks for the info!

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I think it's fair ONLY for those women who have elective c-sections (which is becomming quite popular now). They should have to pay more for forcing their insurance companies to pay for this. However, those with no choice because of a problem with the pregnancy/delivery or those who have no choice because of a previous c-section should not have to pay more.

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That is very unfair.
I had to have a C with DD10 because she wouldn't stop rolling back onto her back, and the cord got caught under her chin when I tried to push. I was able to go VBAC with DD8 by the hair of my chinny chin chin, with the help of forceps and an episiotomy that went from stem to stern.
If a woman elects to have a C, that is one thing, but to penalize her for having a medically necessary C is not acceptable.

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Doctors who don't "do" VBAC's are not the kind of Dr. I would want to go to. Point being if you want a VBAC (which is quite low risk) you have the right to demand it, or find a new care provider if your's tells you No. It's your body, your baby, your birth.

Oh and I was denied health insurance in January from a company (and was actually interviewed for the NYT's article though I wasn't quoted) I was told that if either my husband or myself agreed to be sterilized the company would cover us....Yeah...sterilized.

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I agree with B....Dr's who wont do a VBAC isn't a Dr I would want to see.

My first was born via c/s at a civilian hospital. I then had 2 VBAC's. My husband is in the military and military hospitals/Dr's are very pro VBAC b/c they don't have to worry like civilian Dr's about being sued or getting in trouble. It was the best experience and I encourage women to try for VBAC's but if they cant or dont want to then they should NOT be denied insurance. Its just wrong.

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Insurance companies are nothing but a bunch of greedy profit *hores.

This keeps up with their behavior, I see Universal Health Care in the near future.

That's what happens when corporations are STRICTLY a for-profit-only business....our health (or lack thereof) is their PROFIT.

Enough said.

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Good Grief! They have been pushing VBAC's for 20 years, at a VERY successful rate I might add, in Birmingham, AL. I know because I worked Labor and Delivery while in nursing school 20 yrs ago. This is soooo not new.

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I had an emergency c-section in 2005 when my daughter's heartrate dropped durring labor. Shortly after that my husband changed jobs and we were required to get our own insurance. They put a rider on the insurance that they would not cover a c-section for five years. I switched doctors when I got pregnant with my son in 2007 because the dr. I used for my daughter didn't do VBACs. I used the only dr. in our area to offer them so my insurance would cover it. Well, at 20 weeks they found a mass on my ovary that they thought was cancer. I was transfered to a specialist that recommended a c-section so they could take the mass out. They were also afraid it would rupture durring labor and could kill my baby and me. He contacted my insurance company himself and got them to agree to cover it as the condition was life threatening and would probably cost them more money in the long run if I had to deliver and then have surgery to remove the mass. Sounds great huh? Well, the biopsy came back benign and now they are not going to pay for any of it. Absolutely Outrageous! Whoever heard of an insurace company punishing you for not having cancer!

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I'm really surprised at how many women have stated that their doctors scare them into having another c-section or wont even attempt VBAC delivery! My first was an unplanned c-section after I wouldn't dialate past 8 cm and my daughter's neck was "crooked" and they were afraid to have me push her out. With my second, my doctors actually encouraged VBAC and I even attended VBAC classes. I was able to deliver my second daughter without incident vaginally. The exact same situation with my sister- unplanned C first, vaginal delivery second.

I can understand if there is an extreme emergency or if there is a medical reason why a woman shouldn't try to deliver vaginally (maybe size or shape of hip bones, or if she is at an extreme risk of uterine rupture), but I have seen, more than once, first hand at how VBAC works-

Insurance carriers should allow for multiple C-sections if it's deemed necessary for those reasons, or if out of the blue, during an attempted VBAC, there is a problem and they have to get the baby out quickly. But I think the overall idea that "once a secion... always a section" is outdated and if a doctor insists on not allowing VBAC's, you might want to question as to why.

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My wife had 2 c-sections and then I got fixed. Insurance companies have to do something to make health insurance affordable, and this sounds like a reasonable limitation.

What I find irritating me is that people believe they should be able to get whatever health insurance they want no matter what their decisions in life are. Such thinking is what drives the cost of health insurance up for everyone.

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