The VBAC and other Delivery Right Issues

Preganancy issues seem to be moving to the forefront of the medical and insurance industry these days.  A growing number of women are up in arms over discoveries that unnecessary Cessarian delivery methods have become standard practice.  Adding to the issue is the International Cesarean Awareness Network (ICAN)’s study indicting that more than 300 U.S. hospitals have banned Vaginal Birth After C-section (VBAC) — even though VBACs are safer for most women than a repeat c-section.   As example, Medical Malpractice coverage exclusions within Oklahoma have dictated that virtually all that state’s women not be allowed VBAC.  

Making matters worse, Kaiser and Aetna have stopped paying for midwife and birthing center deliveries, (even though such are exponentially less expensive than a hospital’s C-section.  This requires that women go to a hospital and endure the C-section, as VBACs are not allowed.

Women’s right to childbirth on their own terms is a moral/ethical choice.  When statistics concur that vaginal childbirth remains safer, even after C-section, it seems unlikely that insurance companies would balk at allowing a woman to choose a VBAC.  It’s equally confusing that they would not prefer to pay for a far less expensive birthing center or midwife delivery.  

Amongst other issues is that women often don’t discover that the VBAC isn’t allowed until after they’ve arrived at the hospital and are in labor.  Then, earlier in this month, came Wall Street Journal’s report of study in the New England Journal of Medicine. The study reveals that 1/3 of the C-sections are performed too early, increasing the dangers for both mother and child.

All of this combines to leave women’s rights activists (and women) feeling more and more like they have no real choice over their delivery.  Some have real concerns that this will push women to have “back-alley” deliveries, rather than endure the dangers and expenses of a hospital delivery and its mandatory C-section intervention.  

Is there another side to this story?  Are women somehow safer, despite these studies, with forced repeated C-sections?  This is obviously a patient safety issue, and whichever is truly safer, women will need to feel sure they know the truth before they can put their concerns to rest.


3 thoughts on “The VBAC and other Delivery Right Issues”

  1. I am surprised and very pleased to read this blog. I can only hope that the rest of the insurance industry — both medical malpractice and health insurance — might read, understand, and agree with you. I am an attorney who is working with midwives and consumer birth activists to bring about reform of the American maternal-child health system. I would welcome closer dialogue with you.
    Susan Jenkins
    The Big Push for Midwives
    The National Birth Law Center

  2. Consider that the average hospital delivery runs $8,000. The average Cesaerean runs $20,000. The average home birth with midwives runs $2,000.

    With 4,000,000 babies born each year that equates to $24 billion in potential savings essentially by adopting a model that is used in most of the world including the United Kingdom and which has overall better outcomes.

    The first step is for every state to repeal laws that make midwifery illegal.

  3. Elke Saunders

    It baffles the mind that insurance companies don’t do the math (and their own homework) to see that coverage for normal birthing and midwifery care would save them big money.

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