An article from The American Prospect from a few days ago addressed the inequities in continuous health care coverage for women. Since women have fewer opportunities for employer-provided health insurance, straight women often depend on their partner’s health insurance to cover them. This makes women much more vulnerable to losing their health insurance due to relationship or family issues that disrupt the relationship that provides them coverage. Dana Goldstein makes the case in this article that “[women who experienced health disruptions] had a greater probability of experiencing a change in usual clinic/provider (71 percent), delaying filling or taking fewer medications than prescribed because of the cost (75 percent), going to the emergency room (52 percent), and had lower average mental health scores than women who did not experience an insurance disruption.”
This highlights the importance of providing women with health insurance that they choose, on their terms, and controlled by them. Women need self-determinations in all areas of life, and health insurance is an important piece of the puzzle.
An interesting article from Feministing about midwives and health reform. Check it out!
A study in the Journal of Women’s Health found that women with depression or depression symptoms are much more likely to give birth preterm. This trend is much more pronounced in communities of color, with the risk for black women twice that of white women. You can read the abstract here, and the summary article from the National Partnership for Women and Families here. This is evidence that health disparities are alive and well in our health care system and is one of the reasons we need to continue to fight for the rights of women of color and other marginalized groups.
Raising Women’s Voices wants to give a shout-out to Tina Reynolds from Women on the Rise Telling HerStory (WORTH), an advocacy and consulting group of formerly and currently incarcerated women working toward mutual support, leadership development, fighting public stigma about women in prison, and working to change public policy. Tina and WORTH have been instrumental in getting S.1290-A/A.3373-A through both houses of the state legislature. This bill forbids the use of restraints on incarcerated women during labor and post-delivery recovery and restricts the use of restraints during transport to and from the hospital. This violation of international human rights standards doesn’t have a place in the great state of New York.
Tina spoke at our Raising Women’s Voices Speak-out in April, bringing stories of incarcerated women and the challenges they face in getting fair, comprehensive health care. You can make a difference by signing on to the letter being sent to Governor Paterson urging him to sign the bill into law, or writing your own letter to send to the state house. Please contact email@example.com to sign on. You can also fax to 212-473-2807 or mail a letter to: Women in Prison Project/Correctional Association of New York, 2090 Adam Clayton Powell Blvd. Suite 200, New York, New York 10027. It’s easy and great – please make your voice heard!
Funding for primary reproductive and sexual health care in the United States and around the world has not been as robust as those participating in the first international conference on population development 15 years ago. Women continue to die of pregnancy-related infections, complications, and other issues related to the lack of services available. The United Nations Human Rights council adopted a resolution that classifies maternal death and sickness as human rights violations. This resolution will hopefully guide nations and international organizations to pressure governments to provide more comprehensive education and services. Specifically, it has been stated that “the work of the Human Rights Committee, just as an example, is clear: Where women are forced to risk their lives and health because safe abortion services are not available, governments are in violation of their international treaty obligations”. This is a very exciting development and something to be celebrated. Read the whole article about this UN resolution at RH Reality Check.
This column about maternal and infant health outlines the various studies that have happened recently that dissect the decline in hospital-based obstetric care available to rural American populations. The total number of hospitals has declined since the 1980s, and a number of factors have caused decreases in doctors and institutions offering obstetric care. Difficulties in the staffing of health care professionals, rising malpractice insurance premiums, and disparities in payments due to a high proportion of rural communities being on Medicaid are all reasons hospitals cut down on obstetric care. Read the full article here.
HR2358 has been introduced into the House, according to a call for action from Our Bodies, Our Blog. This bill would amend title XIX of the Social Security Act to require federal funding for freestanding birth centers through Medicaid.
While not the most exciting part of getting pregnant and having a baby, welcoming another member into any family is a major financial undertaking. But even before expecting mothers and families start paying for food, clothes, childcare, and schooling, bringing a new baby into the world can place a huge financial burden on families in the first moments and days of their babies’ lives.
Anna Wilde Mathews had a piece in the Wall Street Journal on May 7 about the hospital bills for the uncomplicated traditional delivery of her baby son last December. As someone who is fortunate enough to have good health insurance, she did not have to pay much of the $36,625 bill that was sent to her home for three days of care, which charged her and her son separately. Mathews stresses how important it is for expecting mothers, and patients in general, to have an idea in advance of how much they are going to owe for a hospital visit. But in order to be informed “consumers” of health care, information needs to be made more accessible to patients. In the weeks leading up to and following her son’s birth, Mathews had a difficult time getting her hands on specific, understandable information about the services she was charged for and the ultimate price she would have to cover out-of-pocket after her insurance company negotiated costs with the hospital.
In a call to her insurance company prior to her due date, Mathews asked how much the bill would be, assuming an uncomplicated delivery. She never received a direct answer, and searching through the company’s website only got her an average expected cost for Los Angeles-area hospitals — no information was available for the specific hospital she had in mind. When she did eventually receive five separate bills for her and her son’s stays in the hospital, the charges for each indivdual component of care seemed to her “stunningly high,” but she had little way of knowing whether such pricetags were generally accepted as appropriate for these services, or if something was wrong.
Furthermore, while Mathews’ plan places a $2,000 cap on her annual out-of-pocket charges on in-network care, she was unaware that when her son was born, he, too, came with a $2,000 cap, doubling the maximum amount she could be charged out-of-pocket for their care.
To decipher other items, I decided to check out consumer services that advise people about medical bills… Although my bills were hard to decipher, I couldn’t point to any mistakes in them, so I paid up. The experience left me befuddled, though. To be smart medical consumers, we need to be able to easily learn and compare prices for medical services. And we should have a way to effectively check our bills.
Mathews says that hospitals and insurers are aware of these problems in transparency and some are trying to work together to keep patients more informed. Some hospitals have experts on-call 24 hours a day to answer patients’ questions about projected costs; others have websites capable of generating estimated out-of-pocket costs for a particular patient. Her insurance company and the hospital where she delivered her son later informed Mathews that she could have called the hospital for an advanced estimate of out-of-pocket costs (although she was never informed of this option) and that they were working to add hospital-specific cost information to the insurer’s website.
A spokesperson for the insurance company later told Mathews they “view [it] as an error” that their customer-service representative failed to tell Mathews about her baby’s deductible in advance.
The Coalition for Improving Maternity Services (CIMS) has released thousands of feedback postings on obstetricians, midwives, hospitals, birth centers, and home birth services. The program is “dedicated to improving maternity care for all women. We will do this by 1) creating a higher level of transparency in maternity care so that women will be better able to make informed decisions about where and with whom to birth and 2) providing practitioners and hospitals with information that will aid in evaluating and improving quality of care.”
The Birth Survey allows individuals to share their own experiences and birth stories, connect with other mothers, hospitals, doctors and midwives in their area, and learn more about the intervention rates of hospitals.
The program’s objectives include:
- Annually obtain maternity care intervention rates on an institutional level for all fifty states.
- Collect feedback about women’s birth experiences using an online, ongoing survey, The Birth Survey.
- Present official hospital intervention rates, results of The Birth Survey, and information about the MFCI in an on-line format.
- Increase public awareness of differences among maternity care providers and facilities and increase recognition of the MFCI as the gold standard for maternity care.
“A woman who looks at a list of names from her insurance company is often choosing a provider on nothing but blind luck. Where and with whom to give birth are important health care decisions. Research shows that both provider and location have a significant impact on birth outcomes. CIMS wants expectant parents to ask questions of their providers and facilities, and have access to more information about their local options”, said Elan McAllister, founder of Choices in Childbirth in New York City and co-chair of the The Birth Survey committee.
To volunteer or get more information about the New York City Pilot please e-mail firstname.lastname@example.org.
From Our Bodies Our Blog:
A statistical brief from The Healthcare Cost and Utilization Project entitled Hospitalizations Related to Childbirth, 2006 finds that there has been a 40% increase in repeat cesarean sections, up from 64.7% in 1997 to 90.3% in 2006.
Other findings conclude that uninsured women have the lowest c-section rates, that delivery via c-section rose from 21% in 1997 to 31.6% in 2006, and that c-sections were “overall, the most commonly performed operating room procedures in U.S. hospitals” in 2006.
C-sections tend to be costlier than vaginal deliveries. Without complications, C-sections run on average $4,500 to vaginal delivery’s $2,600. With complications, those numbers increase to $6,100 and $3,500 respectively.
Another question to ask is how much insurance covers each type of delivery.
In light of the shocking increases in both c-section deliveries as well as repeat cesareans, Obstetrician/gynecologist Lauren Plante has written an article in the International Journal of Feminist Approaches to Bioethics. She argues that c-sections present women with a pain-free, risk-free method of childbirth that takes away their autonomy and removes them from what their bodies are capable of doing. And that the ‘autonomy’ women have in childbirth options is really only supported when it gives more power to the doctor (such as choosing c-section over home-birth).
For the Our Bodies Our Blog synopsis, click here.
For the full article click here.