Insurers Denying Coverage to Women Who’ve Had C-sections

If you have read my blog for a while, you know that I write frequently about c-sections.  It is my opinion that Cesarean sections are over performed in this country.  Previous posts I have written, discuss many of the complications that can arise from c-sections.  Despite the many risks and complications associated with c-sections, the c-section rate continues to rise.  Last year in the US, it was 31.1 percent of births.  That is a little more than one in three births.

The New York Times had an article on Sunday reporting that many insurance companies will no longer accept mothers who have had a previous c-section.  The thinking behind this is, once a woman has had one c-section chances are, she will have another one.  Because VBAC’s (vaginal birth after cesarean) are banned and prohibited in so many hospitals, the only choice basically left for women birthing another baby after a c-section, is another c-section.  Because so many c-sections are not medically necessary, the insurance companies don’t want to pay for them. 

Insurance companies are rejecting these mothers coverage, and some insurers even consider having a c-section, a pre-existing condition.  What makes this even scarier, is once someone has been denied coverage and rejected by one insurance company, they have to disclose that to subsequent insurance companies they apply to.  Once an insurance company sees the mother has been rejected, a red flag goes up, and makes it even harder to get coverage.  If they do get coverage their premiums are extremely pricey and expensive.  In Colorado it was estimated some premiums would be 140% more than standard rates. 

The article quoted Pamela Udy, from the nonprofit group, International Caesarean Awareness Network, (ICAN) whose mission is to prevent unnecessary Cesareans.  “Obstetricians are rendering large numbers of women uninsurable by overusing this surgery.”

There are a few “exceptions” some of the insurance companies are making, where they will cover a woman who has had a previous c-section, such as:  

  • If the woman has been sterilized after the cesarean section
  • If the woman is over the age of 40 AND at least two years had past since the c-section
  • If after five years, there has not been a complicated pregnancy AND another c-section

These hardly seem like fair options.  You can only get coverage after a c-section if you have been sterilized? 

This is definitely a fall out from c-sections being performed unnecessarily.  The article mentions that women are caught in the middle of this mess between insurance companies and doctors. Pamela Udy says,  “Women are caught in the middle of a dysfunctional system. Doctors are telling them they need surgery, even when they don’t, and insurance companies, who are tired of paying the bill for so many frivolous surgeries, are punishing women for the poor medical care of doctors.”

This situation should be alarming for every woman in their child bearing years.  Even if you have no intention what-so-ever of having a c-section, in the rare case that you did need a medically necessary one, you can be denied insurance coverage now, because the procedure has been over performed.

Doctors and hospitals must start allowing VBAC’s, and return to delivering breech babies, in order to lower the ever rising c-section rate.  If nothing else, c-sections should be reserved for true emergency situations.  Something has to change- now more than ever, our very health depends on it.