Penalizing Mothers and Babies

July 27, 1992

Not many years ago, pediatricians were up in arms when insurance companies cut hospital stays for new mothers to four days. Four days was not enough time for women to recover from childbirth and help them get a good start as a mother. Nor was the shortened stay long enough to monitor jaundice or other problems of newborns.

Now, four days in the hospital after childbirth is an unaffordable luxury. What was once considered unthinkable -- a mere 24 hours of hospitalization after childbirth -- is the maximum stay covered by many health insurance plans. In describing the new policies, reporter Patricia Meisol quoted one frustrated young mother as predicting childbirth will eventually become another outpatient procedure. That might be acceptable for uncomplicated deliveries if there were any reliable system of offering new parents visiting nurses or other support during the first days after a birth. Such arrangements are integral to other health care systems.

New families are learning the rising cost of health insurance premiums doesn't necessarily mean better care. In attempting to contain costs, health insurers are shifting the burden to families, who must take on the responsibility -- and the expense -- of making sure their newborn gets follow-up medical treatment.

It's a prime example of a health care system out of control. The policy may make sense in accounting terms -- it saves some money and is not likely to lead directly to loss of life. But long-term, the policy could add to health care costs.

One major advantage of a longer hospital stay is the greater number of mothers breast-feeding their babies. These infants are less prone to infection. Studies show that formula-fed babies are far more likely to be hospitalized in the first year of life. Also, breast-feeding measurably increases IQ levels.

Those are strong arguments, but the benefits to mothers should also interest insurers. Breast-feeding helps to suppress fertility, and thus makes it easier for a woman to space her children. Most intriguing of all, however, is the link researchers are establishing between breast-feeding and a lower risk of breast cancer. In Maryland, the state stigmatized by the nation's leading number of cancer deaths, that fact alone would be enough to dramatize the folly of any policy that discourages a practice that could protect women against a disease that already claims far too many lives.

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