As my daughter turns 4, I’m thankful for health care

Cross-posted on BlogHer. If you haven’t been to BlogHer in the last couple of days, I hope you’ll stop by and check out the new look. 🙂

In less than a week, my firstborn child, my baby girl Ava will turn 4. While this isn’t often considered a major milestone, it is still very dear to my heart, being her mother and all. It got me thinking about how good we have it here in North America. I feel fortunate to live in a country where we have access to things such as clean water, nutritious food and medical care. Elsewhere in the world, however, in places like Darfur, Nepal and Afghanistan, where those basic essentials are lacking, a child living to see his or her fourth birthday truly is a major milestone.

Even if our health care system in the United States is not ideal, at least we have access to medical assistance when we need it. When Ava was 13 months old she came down with a nasty case of croup. “Croup is a viral infection that affects mostly younger children (under 5-6). It causes swelling in the child’s vocal cords, which is what causes the barky cough. The vocal cords are already the narrowest part of the air passages, and any swelling from infection may narrow the airway enough to obstruct breathing.”

We kept a close eye/ear on her breathing and did the recommended trips to the steamy bathroom, then out into the night air to help open her airways, but her condition continued to get worse. By 2:30 a.m., as I lay with her on my chest on the couch in our living room her breathing became very labored. Her sternum started to cave in as she inhaled, and that combined with the stridor (whooping sound) were enough for me to tell my husband Jody that we needed to get her to the Emergency Room NOW.

072905-1-s.jpgI feel so fortunate that the nearest hospital is less than three minutes from our house because by the time we pulled into the ER parking lot, the skin around Ava’s little mouth was turning blue. Jody dropped me off at the door and, with my little girl in my arms, I ran in. A nurse immediately heard Ava’s labored breathing and we were seen right away.

Ava ended up needing to be admitted to the pediatric unit for two nights. By the time we went home, our little girl was doing much, much better.

Ava and daddy in the hospital 7/29/05It’s easy for me to take the medical care Ava received for granted. After all, I’ve never been in a situation where we’ve been without it. But if I stop to think about what would’ve happened if we hadn’t had access to a hospital right then when we needed it most, it’s enough to bring me to tears. It’s a very frightening thought to imagine living without access to medical care for my children and I’m thankful that it’s not something I’ll (hopefully) never have to worry about.

Candace of Mamanista! and Mama Saga has blogged in the past about her daughter Baby Diva who was born with tetralogy of fallot, a congenital heart defect.

Heart defects are among the most common birth defects–approximately 40,000 babies (1-2%) in the United States are born each year with a heart defect–and they are the leading cause of defect-related infant death. And yet, there is comparatively little funding going into researching the causes of these defects and treatment options.

Without surgery, depending on the exact pathology, tetralogy of fallot has a mortality of 30% of patients by age 2 years to 50% by age 6 years, 80% by age 10 years, and 95% by age 20…and those statistics are for the more straightforward cases.

However, just one surgery with a very high success rate (95% success in the absence of complicating factors) and Baby Diva now has a good chance to live a normal life.

My fellow BlogHers Act CE Her Bad Mother recently blogged about having to take her newborn baby back to the hospital for tests.

When they tell you that you need to bring your baby to the hospital for tests, that they need to check his spine, that he has some markers for spinal problems, for serious things but maybe nothing but still maybe serious, that it might not be anything but maybe it’s something so it must be checked, it must, your heart constricts and you hold your breath.

Jenny at Crash Test Mommy wrote about the time her daughter Emma was diagnosed with pneumonia and x-rays revealed that part of her right lung had collapsed.

WOW. The doctor and I agreed that it was amazing, seeing as how Emma wasn’t acting *that* sick and didn’t look *that* sick. And WOW. Just WOW.

So now, a week’s worth of Augmentin and back-pounding later, Emma’s doing well and still coughing up lungcrap.

Astacia AKA Mamikaze at Life on the Run writes about her 3 1/2 year old daughter “Bear” who has cerebral palsy.

Even when she’s sick, she is in a good mood. She knows what she wants out of life. I suspect she wants to rule the world. Go for it, I say. It may have taken her 3 years to learn how to walk, but she is no slouch.

A year ago, Anna of Hank & Willie reflected on the birth of her son Henry at 36 weeks and his battle with respiratory distress syndrome. She also has blogged about trying to raise money for the March of Dimes March for Babies.

We remain forever grateful for the excellent care, lifesaving procedures and sophisticated equipment that were available to Henry when he was born prematurely nearly two years ago.

I think it’s safe to say that like Anna, all of these mothers are thankful for the medical care their children have received and/or are continuing to receive. All of our children are alive and we are very fortunate.

At the time of this writing, the BlogHer Global Giving projects have received $6,140 in donations. In honor of Ava’s fourth birthday and in hopes of helping another child across the globe reach her fourth birthday, I am going to make a donation to one of the projects. It is my hope that other mothers will consider following suit on their children’s next birthday. We have a lot to be thankful for. Why not share the love and help out another mother and child?

Nature’s Avenger organic weed killer (review & giveaway)

UPDATE: This giveaway has concluded and is closed to new entries. 

Every spring I have the best of intentions of keeping my yard and patio well-weeded. And every spring I do my best to keep up with the little suckers, but because I can’t make weeding my full-time job (after all I do have two kiddos to watch after and a little thing called a blog to tend to), the weeds eventually declare victory and I hang my head in defeat.

This spring, however, I decided to get a headstart and try my hand at creating a natural weed killer. With two little kids and two dogs, I don’t do petro chemicals in my yard, so making something as non-toxic as possible was a requirement. I played mad scientist and concocted a mixture of vinegar, hot water and dish soap, sprayed it on the little buggers and waited. While it worked to some degree (they shriveled a bit), it was not the miracle herbicide I was hoping for.

spraypic.jpgThankfully, right about that time, I was contacted to review an organic weed killer called Nature’s Avenger. I was more than happy to give it a try. Nature’s Avenger is made with natural citrus oil which gives it a very pleasant scent, is EPA-certified, safe around children and pets, and, I’m pleased to report, it gets the job done! I tried it on a few rogue weeds in my yard and it killed them and quickly too (within a couple hours). While I wouldn’t use it all of the time (it’s still fun to get my hands dirty now and then), it is nice to have an organic weed-killing alternative for those occasions I don’t have hours to spend weeding the yard.

Find a store near you that sells Nature’s Avenger or you can buy it online.

If you’d like to try to win a bottle of Nature’s Avenger, just leave a comment here AND link to this post on your blog. If you don’t have a blog, that’s OK. You can still enter to win. The deadline to enter is Friday, June 27. The winner will be chosen using and notified via email the following day. Please make sure you include a valid email address.

If you are looking for another eco-friendly giveaway, head over to A Mama’s Blog for a Let’s Go Green giveaway.

Getting your feet wet (BSM)

Even though I captured this with my P&S, I had a feeling it just might become my Best Shot Monday choice. The photo was taken a week ago last weekend as Jody and the kids waded into the freezing cold (at least, in my opinion) water of the Boulder Creek. The kids didn’t mind the water temp one bit and Jody endured it, ‘cuz that’s what daddies do. These are the types of moments that I never want to forget.

Ava, Julian and Jody getting their feet wet in the creek - 6/7/08

See more Best Shot Monday posts over at Mother May I?.

Dad’s day

I apologize for being a craptastic blogger the past week/weekend. Jody was out working in CA all week and my mom got in from MI for a 12-day stay on Thursday. So between solo parenting and trying to get the house in decent shape, plus then spending time with my mom the past few days and Jody when he returned, I’ve been an absentee blogger (though you can always find me micro-blogging on Twitter – hint, hint).

While Jody was gone this week I received a good reminder of why I love him. He’s an awesome dad and his involvement both in the kids’ lives and around the house helps me be a better mother. And he lets the kids play things like this, without batting an eye:

I was so happy to have him return home safely late Friday night. 🙂

For the past three years, I’ve made a Father’s Day photo collage for Jody. (Take a look at last year’s and the previous two years.) This year it has yet to happen as I haven’t had the opportunity to take the Ava and Julian’s pictures, but I still plan to do it. Really, I do. 🙂 Jody appreciates the tradition I’ve started and hopes that I will carry it on for years to come. (And I hope I can carry it on for years to come too!)

We’re not doing anything elaborate this Father’s Day. Jody talked about going for a drive up to Rocky Mountain National Park to enjoy nature, but instead we are opting for something with a lesser carbon footprint and going to the pool at the rec center, where Ava can show off her new skills acquired at swimming lessons (she just passed from a “Turtle” to an “Alligator”) and we can just spend time together playing in the water.

Happy Father’s Day to all of the dads out there. 🙂

Related Father’s Day posts:
Fathers and AP (Attachment Parenting)
Reflections on Father’s Day

Little things

It’s my first year growing a garden on my own. You can call me a dork, but it’s the little things that excite me. 🙂

Little things like…
Green beans sprouting:
Bean plant sprouting 6/11/08
Zucchini sprouting:
Zucchini sprouting 6/11/08
And the first red tomato of the season:
First red tomato of the season 6/11/08

I just created a new category “gardening” as I suspect I’ll have more to say on this topic in the future. I’m enjoying the experience so far. 🙂

Everyone’s eager to meet baby, but are elective inductions safe?

ivbag.jpgElective inductions are on the rise in the United States, and while this means many excited mothers get to meet their babies sooner than if they waited for labor to begin spontaneously, it also means they are much more likely to meet their babies as a result of a cesarean section, which of course comes with it’s own set of risks to both mother and child.

According to a study linked on Birthfriend’s Place to Ponder:

In 2004, the National Vital Statistics Report showed the total induction rate (in the United States) to be 21.2%. Of that number, 25% were reported to have no apparent medical indication and were done for the convenience of either the patient or the physician (Martin et al., 2006). This rate represents a 9.5% increase since 1990. An even higher induction rate of 41% was found by the Listening to Mothers II survey (Declercq, Sakala, Corry, Applebaum, & Risher, 2006).

The desire to bring about the onset of labor is nothing new. Throughout history, women have tried to induce labor naturally through “home remedies” such as nipple stimulation, Castor oil, herbal remedies, sexual intercourse and more. As I neared the 41 weeks marker with my son, even I tried to naturally jump start labor by way of acupuncture to increase my chances of having a home birth. I went into labor that night. Had I reached 42 weeks, my likelihood of being legally allowed to have a home birth would have decreased.

The way I see it though is the difference between using natural means of inducing labor and medical means is the end result. With either one labor will begin only if the woman’s body (cervix) is ready. However, with the natural methods, if labor doesn’t begin, the end result is the woman is still pregnant and has to wait until her body is ready. With the medical/pharmaceutical means of induction, if labor doesn’t begin or progress according to the care provider’s timetable, the end result will most often be a c-section.

It is important to note that a woman should consult with her care provider before trying any induction method, even natural ones.

If you are leaning towards a medical elective induction, in addition to discussing your options and risk factors with your care provider, it is also important to do your own research and be an informed customer so you can make the choice that’s best for the health of both you and your baby.

Although the American College of Obstetrics and Gynecologists recommends against elective inductions citing “Induction of labor is indicated when the benefits to either the mother or fetus outweigh those of continuing the pregnancy” (in other words, when medically necessary), many doctors are more than happy to accommodate a mom who is tired of being pregnant. Some doctors routinely do inductions at 40 weeks, even if “it’s perfectly normal for 80 percent of healthy babies to have anywhere from a 38- to 42-week gestation” and even if a woman is not asking for it.

NedaAnn (AKA Iluvmysweetpea) who blogs at The unstable mind of an unhealthy body told me on Twitter that when she was preparing for the birth of her daughter four and a half years ago, she and the rest of the women in her childbirth class were told that at 40 weeks they would be induced. “We were told that at 40 weeks our fluid started to diminish, so it was a danger to baby. That’s why we needed to be induced.” On top of that, she said, her doctor who practiced at Albert Lea Medical Center in Minnesota told the class they use Cytotec for inductions. Having had done her research about the safety of Cytotec, she asked him about it and was told it was “not that bad.” Her daughter Trinity came a month early, so she never had to deal with a possible induction, but NedaAnn believes, “Pregnancy used to be 42 weeks long, so why are we inducing at 40 weeks or before? I know there are legit reasons in a few cases, but overall it is a matter of convenience and I just don’t think the risks are worth the convenience. And Cytotec should be banned.”

The issue with Cytotec (misoprostol), if you are unfamiliar with this drug, is it has been FDA-approved only for treating ulcers, NOT for inducing labor. According to Marsden Wagner, MD, MS, “On the Cytotec label it is explicitly written that this drug is contraindicated for use on pregnant women.” Using Cytotec to induce labor has many “serious adverse effects … including maternal or fetal death, uterine rupture, and severe vaginal bleeding and shock.” These risks are even greater if the woman is attempting a vaginal birth after cesarean (VBAC). According to an article on iVillage, “Cytotec’s sole appeal is price. Cytotec costs pennies per induction, whereas Prepidil and Cervidil cost close to $100 per dose, and more than one dose may be needed. Cytotec also reduces the need for intravenous oxytocin (Pitocin), the hormone that stimulates contractions, another savings.”

According to an article on CNN “Five Ways to Avoid a C-section,” the number one way to avoid having a c-section to to get induced only if it’s medically necessary and points out that first-time moms have a greatly increased risk of having a c-section after an induction.

One of the biggest risks of an elective induction is that it will, the majority of the time, end up in a c-section.

“If you decide to have an induction because your obstetrician is going out of town, or because your husband is going out of town, that may seem like a bona fide reason, but you’ll pay the price with an increased rate in C-sections,” said Dr. Michael Klein, emeritus professor of family practice and pediatrics at the University of British Columbia, who’s studied C-sections.

Klein says studies of first-time moms show that 44 percent of those who are induced end up with a C-section but that only 8 percent of those who go into labor spontaneously end up with a C-section. Doctors say many times, inducing women way before the cervix is ready can lead to unproductive labor, which then necessitates a C-section.”

A labor and delivery nurse who blogs at At Your Cervix says in her post Inductions Galore, “My last few shifts at work have been a wide variety of patients. Inductions that go no where, inductions that take off super fast and precipitously deliver, pretermers, preeclamptics, c-sections. I think I’ve done it all in the last few shifts. What bugs me are the inductions. These docs really dig for reasons to induce.” And then she details the list of reasons doctors will induce. Then she also adds, “Then again, we have some docs who refuse to induce for made up reasons.”

While many women may not have heard of this, there is a tool that helps care providers assess a woman’s likelihood of having a successful induction – it’s called the Bishop or Bishop’s score. According to Revolution Health: “For the purpose of inducing labor with medicine, the Bishop score helps a health professional assess a woman’s physical readiness to progress through vaginal delivery. The Bishop score is a rating of how soft, open, and thinned the cervix is (dilation and effacement), as well as how low in the pelvis the cervix and baby are positioned.

Bishop scores range from 0 to 10. The higher the number, the more likely a vaginal delivery will be successful. ”

Want to know if you are ready for induction? You can even take an interactive quiz online that will assess the readiness of your cervix.

Jennifer Block at Pushed Birth discusses Why Not Schedule It?

What will an induction mean for you? If you induce, you’ll be admitted to the hospital and will most likely spend the next 24 hours of labor confined to bed. Because staff will need to kickstart and maintain contractions and dilation with drugs like Pitocin, Cytotec, and Cervidil, they will require IV fluids and continuous fetal monitoring. At that point you’ll very likely want an epidural, because Pitocin contractions are more painful, especially when you can’t move around. A director of OB/GYN in New York City called Pitocin without an epidural “cruel and unusual punishment.”

Jennifer adds:

If you’re considering a medically unnecessary induction, think about whom it will really benefit. While it may seem more convenient to just book it, think of the inconvenience of recovering from major surgery, or waiting for your baby to be released from a NICU — two very real possibilities. And think also about the increased risk to your pelvic parts of a pushed birth. Again, the best, healthiest option for both you and your baby is labor that your body starts on its own, progresses on its own, and concludes on its own terms.

Although there is a lot of information out there against elective inductions, there are legitimate reasons why a woman would opt for one. Christine from Watch me! No, watch me! (a mama who graduated from medical school just a month before her son was due) decided on an elective induction at 41.5 weeks. She had contracted PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy) at 38.5 weeks, which, in her own words, is “a HORRIBLY itchy rash that is covered in hard plaques. So, you’re itchy but can’t even get any temporary relief from scratching because of the hard top layer (gross, I know). Worse than that, the hard plaques themselves irritate the underlying rash. It was a nightmare. I couldn’t wear clothes and even sitting down was and excruciating mix of unbearable itchiness and pain.” By 41+ weeks, the rash had spread everywhere except her face and breasts and she was unable to sleep for more than two hours at a time.

The only thing that cures PUPPP is delivery, so at 41.5 weeks, Christine asked to be induced. After considering her condition and that she was getting weaker and weaker from lack of sleep, her doctors agreed to it. Due to her son being posterior, she was unable to progress past 6 cm, and decided along with her doctor that a c-section would be best, which Christine had a very positive experience with.

Christine notes that because of her medical background she was “a very well-informed patient.” She adds, “I knew what was going on from start to finish and this is the route I chose.”

Sheridan at Enjoy Birth Blog believes there are Five Good Reasons for an Induction, as well as Five Questionable Reasons for Induction, and Five NO Risk Alternatives to Inductions.

I’ve personally given birth to two children – one was medically induced with Pitocin due to my developing HELLP syndrome at 39 weeks and the other labor began on it’s own (well, after a round of acupuncture the night before). The difference in the two labors was very noteworthy. When I was induced with Pitocin, my contractions quickly became nearly unbearable and I felt I had no breaks in between them. They just kept hitting me over and over. With the induction I was also restricted to laboring in bed, which I feel inhibited my ability to effectively deal with the pain. Even though I had no intention of having an epidural when I went into it, I quickly changed my tune and asked for one but was denied it due to my falling platelet levels, so I had to cope with the pain in other ways. With my labor that began naturally I was able to move about freely and change positions. The pain never became unbearable. In fact, it only got really uncomfortable in the last hour or so, but was still manageable, as opposed to my medically-induced labor that was uncomfortable and borderline unbearable for hours. Both labors lasted around 12 hours, but the differences between the two were unforgettable. I’d never choose to be induced again unless (again) I had very good reason for it. I can’t imagine putting my body or my baby through that without good reason.

Additional resources:
– Mothering magazine: Let the Baby Decide: The Case against Inducing Labor
CYTOTEC petition: Cytotec (misoprostol) for Labor Induction Consumer Awareness
– From Henci Goer, author of The Thinking Woman’s Guide to a Better Birth: Elective induction of labor – “Is elective induction safe and effective?”, “Who makes a good candidate for elective induction?”, and “How can women considering elective induction minimize the risks?”
– From Descent to Truth. To Life. To Birth. To Motherhood.: Stop the Misuse of Cytotec to Induce Labor

Cross-posted on BlogHer

My backyard – where the wild things are (BSM)

Jody has been joking with me lately that I have turned into Snow White, Cinderella or some other character that all of the woodland animals love and are attracted to, as our backyard is turning into quite the animal sanctuary.

We by no means have a large yard (our whole lot is less than 1/4 of an acre), and, much to my chagrin, are surrounded by neighbors on all sides (not near a forest or field or anything), yet in the past few weeks we’ve had the following critters cohabitating in our yard:

  • 4 2 garter snakes (the first two made the unfortunate decision to venture into our redneck neighbor’s yard and soon met an untimely death)
  • 2 baby Blue Jays who were unable to fly (as well as their mother and father)
  • Several little green caterpillars
  • Bees
  • Oh, we also have another bird family living up in the eave of our house

Baby blue jay standing on my sunflower 6/5/08

Two baby Blue Jays - 6/7/08

If you follow me on Twitter, you’ve undoubtedly seen me tweeting about the baby Blue Jays in our backyard over the past week and a half or so. First there was one on the ground for about a day, then it hopped it’s way up into a tree. The next day there was another baby on the ground, but this one stayed on the ground for about four days (and caused me endless worry the whole time) before getting up into the tree itself. I’m thrilled to report that as of Saturday, they were both up in the tree (and often sitting next to each other) with their parents. Hooray!

Ava and “Poozey” the caterpillar - 6/7/08

Ava has grown very fond of the caterpillars and names each one she catches “Poozey” (from ::groan:: Dragon Tales). She carries them all over the place (yes, even in the house) and puts them into a jar in hopes that they will build a cocoon and become a butterfly. When they haven’t metamorphosized by day 2 (and are generally looking a little peaked), she lets them go, finds a new one and starts the cycle all over again.

The snakes are another treat in our backyard. Everyone gets excited when we spot one and Julian exclaims, “Snakey! Snakey!” I tried to get a shot of “snakey” the other day, but it must not have been feeling very photogenic, as it was gone by the time I returned with my camera. I am hoping the snakeys will stay in our yard (or our other kind neighbor’s yard) though so I don’t have to witness any more snake killings. One was enough. 🙁 And who kills harmless snakes for no good reason anyway? Arg.

As for the bird family living up in the eave of our house, once again this year there just doesn’t seem to be enough room there for all of the babies. Each year one or two of the tiny birds fall down onto our back patio. They are so newly hatched that they don’t have any feathers and, thus, really never had a chance at survival. This year Julian was the one to discover the fallen baby bird. He picked it up and started waving it around saying “birdy, birdy, birdy” until Jody realized what he had and shook it out of his hand. Oy.

The bees keep us on our toes. I realize they perform a valuable function and I welcome them, but I am still a bit skittish around them. I’m trying not to pass my fear onto my kids, but I also want them to be cautious around bees so they don’t get stung. The other day there was a bee buzzing around the flowers. Ava exclaimed that she didn’t like bees because they can sting, so Jody and I tried to educate her about the importance of them and mentioned that they pollinate the flowers. Julian then went walking by the flowers and, Ava, who was concerned for his safety yelled out, “Be careful Julian, or you might get pollinated!” Cue peals of laughter from Jody and me. 🙂

Yes, our backyard is full of nature, stories of both life and death, lots of learning opportunities and funny times as well. It certainly keeps things interesting around here. 🙂

I think I’m going to call the shot above of the lone baby Blue Jay perched on my sunflower plant my Best Shot for this week. Now, if you’ll excuse me, I need to step outside, sing a song and see what other woodland creatures I can summon. 😉 Feel free to head on over to Mother May I to see what everyone else has in store for their Best Shot Monday posts.

red BSM button

Quickie Shower Challenge Check-in – “How YOU doin’?”

It’s the end of week 1 of the Quickie 5-minute Shower Challenge and I want to know, in the words of Joey from Friends, “How YOU doin’?”

But before we get to that, I first have to say I’m absolutely thrilled to have had 86 people sign up (plus spouses have often been recruited as well, and even some kids, and aren’t included in that number) for the challenge so far. That’s awesome and you all rock for signing up! Thank you. 🙂 I’m still hoping to get up to least 100 sign ups, so I hope you will spread the word about your commitment to take a quickie. 🙂

This week has actually been a little out of the ordinary for me. I usually shower about 4-5 times a week for 5 minutes or less each time, but this week, because we actually had somewhere to go every morning (Ava’s swimming lessons), I found myself showering every day. So I’ve been using more water this week than usual. I suspect once swimming lessons are done (end of next week), I can go back to being a scrub again, I mean I can go back to conserving more water. 😉 I’ve been showering in 5 minutes or less (usually around 4 minutes) all week with the exception of today, when I stopped looking at the timer and actually let it run out. I think I went about 15 seconds over.

How about you? How are you doing with the challenge so far? Have you found it harder or easier than you expected? Do you have any tips to share to help others?

Two tips I’ve shared with others who have been reluctant to sign up are:

  • Turn off the water when you lather up your hair. You can stop the timer whenever the water is off. That leaves you more time to rinse your hair, which is especially helpful if your hair is longer.
  • Turn off the water when you shave your legs. Again, you can stop the timer when the water is off.

We’ll have another check-in in two weeks on June 21. Until then, enjoy your quickies and thank you for conserving water! 🙂 Oh, and if you still want to sign up, just leave me a comment and let me know you want in and I’ll add you to the list in my sidebar. 🙂

Two things I think you should know about

I have a couple of important things to quickly mention today.

It was just a couple of weeks ago that I wrote about the global food crisis where the poorest of the poor are being hit the hardest and people in Haiti are resorting to eating dirt “cookies” made from shortening, salt and dirt. I also interviewed my friend who is in the process of adopting two young children from Foyer de Sion Orphanage in Haiti.

Another friend of ours is trying to raise awareness about the food situation and do something to help out the children in the orphanage by holding a contest. It doesn’t take much to make a difference. A mere $7 donation would feed 63 children at the orphanage for two days; $100 would buy nearly 200 pounds of staple foods like rice, sugar, flour, and powdered milk. Head on over to her blog, read how you can help and also get your name entered into a drawing with a chance to win a $25 Target gift card. It’s a win-win. Hope Gives Life – Help for Haitian Children in Need

Have you ever slept next to your child? Do you currently co-sleep or bedshare with your child(ren)? Please take this short survey and help the Fennells (a family who has been involved in promoting safe co-sleeping for many years) meet their goal of getting 50,000 co-sleeping families to complete the survey before the end of the year. The Great Co-Sleeping Survey

Loss of insurance – another price to pay after a c-section?

An article in the New York Times this weekend reported that some women are being forced to pay higher health insurance premiums or are being denied insurance coverage all together if they’ve had a Caesarean section in their past. Peggy Robertson of Centennial, Colo., was turned down for individual health coverage by Golden Rule Insurance Company because she had given birth by c-section. No matter that she was in perfect health. “Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it.”

Photo courtesy grendellion
Photo courtesy grendellion

This could be a serious problem and affect countless women given the c-section rate in this country. It is believed that the current c-section rate in the United States is at a record high of more than 30% (that is nearly 1 in 3 babies is born via cesarean section) despite the World Health Organization’s recommendation that says “the best outcomes for mothers and babies appear to occur with cesarean section rates of 5% to 10%. Rates above 15% seem to do more harm than good (Althabe and Belizan 2006).”

Tina Cassidy from The Birth Book Blog believes the situation with the insurance company all comes down to money.

As always, it is money dictating the rules of health care. Of course, money (malpractice fears) is one of the reasons why the c-section rate in the US at 1 out of every 3 births. Honestly, it is surprising that it took insurance companies this long to wake up to the fact that they are paying either way — for the c-sections that don’t get done when they should, those that get done poorly (regardless of whether they were necessary) or when a woman is denied access to a vaginal birth after cesarean, which is happening more and more…

Perhaps it does all come down to money, but if that really were the case, then why wouldn’t my insurance company reimburse me a measly $2000 (relatively speaking) to cover my prenatal care, home birth, and postnatal care that I had with a midwife for my son’s birth in 2006? They refused to pay me one single penny, yet had I given birth in a hospital, they would’ve covered the entire thing (tens of thousands of dollars since I would’ve had a c-section due to my son being a surprise breech) less my one-time $10 copay. Logically, I figured that they’d rather pay for the lesser of the two, but logic apparently has no place when dealing with insurance companies. Maybe Tina is right on with her assessment. After all, why would they want to reimburse me and pay $2000 when they can get away with paying nothing at all?

Sharon Holley at The Traveling Midwife feels this is a great example for why we need national health coverage and also pondered what this could mean for the future of midwives and had other questions as well.

If insurance companies are going to start denying coverage for previous cesarean sections then what is to stop them from denying coverage for any type of previous surgery? Will this help bring midwives more respect as we have better c-section rates and still maintain excellent outcomes nationwide? Currently midwives are always battling with insurance companies to reimburse for care. Even Medicare and Medicaid does not pay 100% for services when compared to same services that are provided by physicians. Will this push women to question the need for a cesarean at the time of delivery?

Heather at A Mama’s Blog who has had both a c-section and a VBAC (vaginal birth after cesarean) and has written about in the past about her c-section experience and what a c-section is really like believes the insurance situation should be alarming for all women 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 VBACs, 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.

Louise at Colorado Health Insurance Insider writes about her experience in the insurance business and says:

I’ve written before about how caesareans should only be covered by health insurance if they are medically necessary – “elective” c-sections should always be patient-pay, regardless of what health insurance carrier the patient has. It mystifies me as to why someone would willingly choose a c-section instead of a vaginal birth, considering the increased risks, much longer recovery time, and permanent scar. But at the same time, a lot of doctors are also guilty of over-using medical intervention for convenience in obstetric care. Part of the problem is the ridiculous malpractice system we have in this country.

Louise goes on to add:

For women who are trying to secure individual health insurance policies, a prior c-section can be a headache. They should be able to find at least one company willing to offer coverage, but it may not be their first choice, and it may come with a higher price tag. Just one more reason why a c-section should be a last resort, and should never be performed without a medical reason.

Jennifer Block at Pushed Birth feels a policy like this is adding insult to injury.

The losers in all this, of course, are women and their families: going through unnecessary primary cesareans, then being discouraged or flat out denied normal, physiological birth for their next pregnancy, on top of that being denied health insurance because the repeat cesarean their providers are insisting upon would cost the insurer more money, and having babies at higher risk of being born too early, not to mention the risks of repeated major abdominal surgery for mom. And we call this maternity “care”?

Carolyn McConnell of Rock the Cradle – The Politics of Motherhood agrees and points out the results of a 2005 survey where one quarter of the women polled “reported feeling pressured by a medical professional to have a C-section.”

And then they pay for it, in a high rate of infection of the incision, extended recovery and pain in comparison to vaginal birth, risks of injury to the baby, greater difficulty initiating breastfeeding, and greater risks of breathing problems in the baby—and finally in a loss of insurance coverage.

So, what now? On one hand I think it’s good that insurance companies are finally realizing the cost they having to bear as a result of a c-section rate that is inexcusably high and perhaps this will encourage more women to become better informed about c-sections before they go to the hospital. Maybe this will also put some pressure on the OBs that are performing unnecessary c-sections. On the other hand, I don’t feel it’s fair to women to raise their premiums or deny them coverage based on something that many of them may have been pressured into in the first place. And in the case that it was a medically-necessary c-section, then what? Another thing that is disturbing to me in all of this is that many hospitals have banned VBACs, so even if a woman wants to have a vaginal birth after a c-section, her options are often very limited.

I don’t know what the answer is, but I do know something needs to change in this country and the c-section rate must be lowered. Women, and their babies, deserve better care than this.

What do you think?

Additional resources:

Cross-posted at BlogHer