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Will Obama's Plan Stop Unnecessary C-Sections?

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I'm not trying to be mom-centric (well, maybe I am), but I'm wondering if all the hoopla about healthcare reform will change the way we give birth.

woman in operating room

Kate Tuttle: Last week, big health news came when Congress finally passed the Obama administration's healthcare reform bill, signaling the end of a yearlong debate over what role the government, insurance companies and individuals should play in securing healthcare. It's a story everybody has a stake in.

In the same week, a new study reported that nearly one out of every three babies born in the United States in 2007 arrived via C-section. The number of Cesarean births -- now hovering around 32 percent -- has risen precipitously in the past decade (it was just over 20 percent 10 years earlier), and it's a stark reminder of how things have changed since the 1960s, when only 5 percent of babies were born surgically. While many C-sections are medically necessary and some of their rise in number can be tied to medical reasons (an increase in the number of multiple births, for instance), the real explanation comes not from the operating room but from the boardroom.

Increasingly, hospitals and health insurance companies, eager to protect profits and prevent lawsuits, are mandating repeat C-sections for every woman who's ever had one -- even though, in many cases, vaginal birth after Cesarean (VBAC) is safer for mother and child.

So what does this have to do with Obama's healthcare bill, and what does the future hold for women hoping to give birth vaginally? Will the new law allow women and their doctors to challenge insurance regulations and bring down the number of unnecessary Cesareans, as a recent National Institutes of Health panel recommended? Nobody's willing to say yet whether they're expecting to see C-section rates go down under the new law, but most analysts seem to think that the more women who have access to prenatal care (and the more women in the risk pool overall), the more the numbers will go down. And no longer will women who have had a previous C-section be denied any health insurance coverage at all -- which happened frequently in the private insurance market.




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