Is this possible? I'm very curious.......

[DancingWind]

Hi,

I have read so many threads on mumsnet about women fighting for ELCS on the NHS. Private doctors however, seem to allow them. My question is, does anyone have any idea how things work in the USA? I assumed that since it is mostly private healthcare, you can ask for whatever you want as long as you are paying. However, I just read a post by a lady on another forum who is in Washington and 41 weeks pregnant with a 12 pound baby. She claims her doctors have refused to induce her or give her a c section. Their reasons are that this is her first baby and she "has to" have it naturally with minimal intervention. I like the fact that her doctors seem to be against intervention but isn't this a bit much? Or is this poster a troll perhaps?
What I'm trying to ask is that, does anyone have any knowledge of how much freedom women have with birth choices in america given that it is private healthcare? I'm really curious after reading the post I mentioned as I had no idea that private doctors could actually refuse such a request point blank.
I know it is silly to wonder about it but I'd genuinely like to know so if anyone has any knowledge about this, please share!
Thanks:)

I don't really know much about the American health system, but isn't there Medicaid or Medicare for the poorest, and most others covered by insurance? Some googling suggests that 80 or 90% of costs are met by the insurer and the balance by the patient.

So maybe the patient doesn't get as much choice as the insurer? And if the insurer says no inductions (maybe until 43 weeks?) or no ELCS, only emergency ones, that's how it will be.

But as I say, I really don't know, the above is guess-work.

You are actually right about the insurance bit. However, if a person was paying herself it would be different right? But in this case they still seem to be disregarding her preferences which is a shame. Assuming of course that she is telling the truth!

If she is paying and being refused her wishes then she should change consultant. There are plenty of them out there - one of them will agree.

I don't know, but I wonder if at some point it comes down to an ethical question - don't all Drs still take some form of the Hippocratic oath, which boils down to "above all, do no harm"?

I'm not sure the ability to pay should confer the ability to demand treatment. If your Dr considers it to be more likely to harm than help then it would put the Dr in a very difficult position from an ethical standpoint.

In this particular instance, however, it would seem unusual for a Dr to refuse to intervene in any way. Assuming the information that we have is correct and complete...

I'm wondering if it depends on the insurance....it will be more expensive to have a c-section than vaginal birth.

But I would like to think it would depend to the doctor...some people would want a doctor who is pro vaginal deliveries.Surely if this poster doesn't like it she can go elsewhere for her care.

TBF, I went well past my due dates both times and no-one even mentioned induction until over 42 weeks; ELCS was never even raised (and not something I'd choose anyway.) I was warned of the possibility of a difficult birth because of my shoe size.

My cousin's wife had a vaginal delivery with her first child, who was over 13lb. (She and cousin are Large People, both over 6 feet and broad-built. My sisters and I are tiny.)

My sister underwent "trial by labour" first time around, and ended up with an emergency CS, because of a narrow pelvis. Her other children were born by ELCS, no quibble.

The plural of anecdote is not data.

A combination of ethics, as per Tangle, and a (also ethical) reluctance to rack up the bill, perhaps?

Not sure that at 41 weeks I'd be inclined to be seeking out a new obstetrician.

I'd never even consider delivering a 13 pound baby vaginally. I couldn't do that to my pelvic floor.

This is all news for me because I thought that letting the pregnancy go beyond 40 weeks was bad because the baby can get too big, increasing chances of a crash c section, ventouse, forceps etc. which are quite risky. The risk of shoulder dystocia is also much higher with a baby over 9 pounds. I suppose not everyone would want to take thay risk.
In any case, coming back to the topic, I honestly thought that in USA, since you pay yourself, you can ask for anything within reason.

NatashaBee, if you had insurance other than medicare(fully private insurance) or were paying out of pocket, would the control over decisions increase? Since you are there, I suppose you'll be able to tell me based on what you've seen.There was also a post on there by a woman who wanted a c section because she just wasn't dilating, and they didn't let her have one before trying various creams and medicines etc. These posts made me wonder if american doctors are opposed to the involvement of women in the decision making process.
P.S I'm jealous. I'd love to be in your place and just be offered an ELCS. I'd jump at the chance

I'd have died delivering a child that size; would have done with DS1 if it weren't for 20thC medicine. (He was born 1987. I had ventouse and forceps.) My cousin's wife did it though, so I guess it depends on so many factors. And I am not aware of the state of her pelvic floor!

I suppose, going back to your OP, it depends on the doctor, what they're prepared to do. I mean, just because you're paying, you wouldn't expect an OB/GYN to perform an abortion if s/he were opposed to them on principle. If an OB/GYN was morally opposed to ELCS on a first birth, you couldn't change her/his mind either.

Which then leads to the question, why, if she's paying for it herself, did she choose an OB/GYN with opinions so different to her own?

Or has she changed her mind about a more "natural" birth as the pregnancy has proceeded?

Sorry, X post!

OldLadyKnowsNothing, giggle:)
I know what you mean, though.If I was paying or had fully private insurance, I'd choose a doctor who thinks like I do.

NatashaBee, I understand now.It is not as simple as I thought it would be!
25k for a CS?! OMG. You know the worst part? I'd get one anyway