Many women choose to give birth a little early whether
through an elective C-section or induction. There are many reasons cited for
doing it and most babies end up being born healthy. Some babies, however, are
being born too early and winding up in the Neonatal Intensive Care Unit (NICU). It's these babies that Texas legislators are targeting in an effort to cut
costs as they face a budget deficit.
On the surface, the debate looks like a low-blow, but
legislators are looking into unusually high preterm birth and C-section rates
that are well-known in the United States. Some studies have found that early
birth rates are directly correlated with for-profit hospitals and the concern
that doctors are pushing more intensive medical procedures to make more money
is not new. It costs Medicaid $2,500 for a routine delivery and $45,000 for an
NICU stay. Since the decision to put some babies in the NICU can be subjective,
doctors looking to make more money can easily be biased in that direction.
Legislators estimate that they could save $36.5 million in
Medicaid over the course of two years by better managing the NICU, limiting
“convenience” C-sections and refusing to finance elective inductions before 39
weeks. State health officials say that
137 Medicaid-covered babies experienced complications in 2009 that were born
through elective inductions.
Many hospital workers don’t agree with legislators on the
cause of so many babies filling Texas NICUs. They point out figures unique to
Texas: a high birth rate, few people with health insurance, and limited
prenatal care. Plus, the rise of infertility services has increased the number
of multiple births and births to older women. Regardless of the cause of increased
preterm births, at the end of this debate, legislators could take a step that
would limit the choices of mothers on Medicaid.
What do you think of
limiting elective cesareans and inductions?
In Search of Cuts, Health Officials Question NICU Overuse [
NyTimes]