Elective inductions and insurance

iVillage Member
Registered: 07-27-2007
Elective inductions and insurance
15
Mon, 12-14-2009 - 11:41am

Does health insurance provide coverage/payment for elective induction of labor? In looking at my own insurance information, I'm not seeing that it does, but then I wonder how so many elective inductions are being allowed to occur. Are doctors billing the insurance companies for the inductions using false claims about medical conditions? I think this must be the case sometimes; I've known women who have "officially" been induced for some relatively minor conditions, like mild PIH and/or GD, "pain" (including leg, back and pelvic discomfort), etc. How about women who are induced early so that Dad can be home on military or work leave? Or women who want to give birth at a specific time so that Grandma can stay with the older kids? The list of reasons to be induced can go on and on, of course, but I'm really wondering how they manage to have the inductions paid for.

Elective inductions are almost the norm these days. Having been the CL of a pregnancy board for over a year, I saw a multitude of women come through that community and many of them were induced. If I had to take a guess as to how many of those inductions were basically unnecessary, I would say the number was at least 50%. Having been induced twice myself, for serious medically-necessary reasons, I would never suggest to another woman that she be induced unless she truly needed to be. I don't remember anyone ever saying that they had to pay out of pocket for their inductions, in spite of the fact that so many seemed totally unnecessary, so I do wonder if reasons were being invented. Some of those women were induced as early as 36-37 weeks for no real reason, other than that they were feeling "done". I think that's very scary and sad, and I don't approve at all, but obviously that's JMNSHO, as the mom of two 37-weekers, born via difficult induction processes.

Would you have an elective induction if you knew the insurance company wasn't going to provide coverage for your L&D, hospital stay, or baby's care? Would you still take the risks of early induction (provided you had learned them and cared about them) if there wasn't going to be any financial provision made for your family? I would not. But then I wouldn't be induced at all if I didn't HAVE TO be in the first place.

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iVillage Member
Registered: 08-22-2008
Mon, 12-14-2009 - 5:55pm

Reasons can be created to substantiate any medical procedure, kwim?

iVillage Member
Registered: 05-02-2006
Tue, 12-15-2009 - 12:09pm

That's an interesting question.

2010 Siggy
iVillage Member
Registered: 03-24-2008
Tue, 12-15-2009 - 12:44pm

I think elliminating ellective inductions should be a priority of the medical establishment, they create a need for more c-section, are associated with prematurity and ashma, and create a higher number of babies with RDS.


I think the insurance compaines should be all over the stopping of ellective inductions due to the previously mentioned costly outcomes.


Perhaps this could be accomplished by

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iVillage Member
Registered: 06-26-2009
Fri, 12-18-2009 - 7:52pm

Like you, I'd be reluctant to induce at all unless necessary. We were looking at the very real possibility with my firstborn because of his size relative to my size but I went into labor the day we had an appointment to discuss it. He was born a week overdue, just over 9 pounds and more than a third my height.


I sympathize with feeling "done" several weeks early but do not think it is responsible for doctors to birth babies early based on that or on people's vacation plans, etc.

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iVillage Member
Registered: 02-06-2009
Tue, 12-22-2009 - 5:13pm

< But then I wouldn't be induced at all if I didn't HAVE TO be in the first place.>

This right here.

I really find it hard to believe that women who go for elective inductions actually know what they're letting themselves in for.

iVillage Member
Registered: 09-22-2004
Wed, 12-23-2009 - 3:46pm

>>Perhaps this could be accomplished by insurance companies refusing to pay for inductions unless the woman is past 42 weeks or three doctors state that an induction is a medical neccesity.<<

This will definitely help the insurance companies, as there will far less people to insure with the increase in the mortality rate this will cause. 3 doctors? Okay with my insurance that would take 2 weeks for the referral, so if there was something suspect, I would have to wait an additional 2 weeks to see another doctor or a specialist. I am sorry but I trust the opinion of my OB, that is why I selected him. What would be the benefit of 2 other dr's seeing me, who have not been with me my entire pregnancy? If my dr says I need to be induced then I need to be induced. I trust him, that is why I chose him as my dr.

Kerri

iVillage Member
Registered: 09-22-2004
Wed, 12-23-2009 - 3:57pm

Okay I forgot the 42 week thing. What I understood is that there would be no induction before 42 weeks? (unless three drs agreed).

The risk of stillbirth increases. The risk of surgical birth increases, including the use of forceps and the vacuum. The risk of placental deterioration.

I am good with induction at 40 weeks.

Just my thoughts,

Kerri

iVillage Member
Registered: 07-27-2007
Thu, 12-24-2009 - 6:22pm

<<>>

You would feel this way, no matter what? Even if you were being induced for a condition that could reasonably be managed with bedrest or other lifestyle changes (i.e., diet), such as PIH or GD?

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iVillage Member
Registered: 09-22-2004
Mon, 12-28-2009 - 10:14am

>>You would feel this way, no matter what? Even if you were being induced for a condition that could reasonably be managed with bedrest or other lifestyle changes (i.e., diet), such as PIH or GD?<<

See that is why I chose a doctor that I am comfortable with and we had a very good dialogue during my pregnancy. So yes, I would trust my doctor if he said that I should be induced. He is all about natural intervention free birth. I had to read a ton of literature on epidurals because I told him that I wanted one. My daughter was in distress during birth due to her cord which was wrapped twice around her neck and 1/2 around her waist. Her heart rate would drop with every contraction, but would come back after each one. Instead of jumping in to a c-section he sat with us and monitored her heart to make sure it wasn't causing too much stress on her. I ended up with a vaginal delivery because he was very patient and willing to take his time with us (on a Saturday).

My previous experience (my first daughter) was with an intervention heavy idiot. I ended up firing him in the delivery room and using a staff doctor. I am really good at advocating for myself.

Kerri

Avatar for bmcm1
iVillage Member
Registered: 03-25-2003
Wed, 01-06-2010 - 9:20pm

Where I work, the induction rates sent out to us monthly vary from 20-30 percent. There is no differentiation for elective or medically necessary. This also does not include augmentation of labor. Strictly induction. I have not heard anyone say that their insurance won't cover elective induction or mention that it was a concern at all. I imagine that most do though. Although, our billing sheets (what we fill out and send to our billing guy) don't ask for a reason, or if it is elective or not. There is a box for "induction" and that is it. So, I am not so sure the insurance companies care?

To answer the questions....
Would you have an elective induction if you knew the insurance company wasn't going to provide coverage for your L&D, hospital stay, or baby's care?

I would avoid elective induction regardless of if the insurance would cover it.

Would you still take the risks of early induction (provided you had learned them and cared about them) if there wasn't going to be any financial provision made for your family? I would not. But then I wouldn't be induced at all if I didn't HAVE TO be in the first place.

I would not have an early elective induction period. It is one thing to have a medical concern for mom or baby and the risks outweigh the benefits and another to add those risks with no real medical benefit.

"Some of those women were induced as early as 36-37 weeks for no real reason"

I can count on one hand the times I have seen this over the last several years. In my area, it isn't common. Although, the thing that gets me is the "post date" inductions that are 40 weeks and 1 day. Always makes me roll my eyes.

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