SC, top insurer halt coverage for early elective births

Published: November 20, 2012 

— Many South Carolina mothers looking for convenience by delivering babies in the weeks before they reach full-term will not have insurance for the procedure soon.

The state’s Medicaid program and BlueCross BlueShield of South Carolina, the state’s largest insurer, announced Monday they will no longer provide coverage for women wanting to deliver babies early for non-medical reasons starting Jan. 1. The state and BlueCross account for about 85 percent of the births in the state.

South Carolina appears to be among the first in the nation halting coverage for what’s known as early-elective deliveries, which take place before the 39th week of pregnancy that’s considered full term and can pose greater health risks to babies, health experts said.

Nearly 20 percent of all births between 37 and 39 weeks in South Carolina were elective last year -- higher than the national average of 14 percent, according to a survey by The Leapfrog Group, a Washington-based patient safety organization.

“It’s not healthy, it’s not right, we’re not going to do it,” Gov. Nikki Haley said.

Women will ask to deliver babies a week or two early they have relatives from other states nearby or husbands in the military heading overseas, experts said. Some mothers want the early deliveries because they live in rural areas far from the hospital. Other times, doctors have requested early deliveries to fit their schedules.

But about 10 percent of babies born electively before the 39th week will need to go to intensive care, said Dr. Amy Picklesimer, an obstetrician from Greenville who has worked on a state program aimed at curbing premature births. Babies born before full-term face potential problems from underdeveloped brains, hearts and lungs, she said.

And it’s more costly. A typical intensive-care stay costs $22,000 versus $1,200 for a normal delivery, Picklesimer said.

The push to reduce early-elective births has grown in recent years. Federal health started an awareness campaign this spring.

South Carolina officials have worked with medical and hospital groups since last year to lower the number early-elective births.

The number has dropped to 1,000 a year from about 2,000 a year, said Tony Keck, director of state Department of Health and Human Services.

South Carolina officials said they have the backing of hospitals and doctors to ban early-elective deliveries along with insurers, which are looking to reduce costs and health risks.

“It is well-established medical practice that when possible, babies do best with at least 39 weeks gestation,” BlueCross said in a statement. “We believe we have an important role to play in this effort and are pleased to be part of a statewide initiative that is dedicated to ensuring children get the healthiest possible start in life.”

South Carolina also continues to wrestle with premature births overall.

The state received a D grade from the March of Dimes last week for having 14.1 percent of babies born before the 37th week last year. The national average was 11.7 percent.

South Carolina aims to reduce its 9,000 annual premature births by eight percent by 2014 with continuing health and anti-smoking education programs, Keck said. That would mean 700 more babies born full term.

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