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The VBAC Companion
The Expectant Mother's Guide to Vaginal Birth After Cesarean
By Diana Korte
A decade ago, Cesareans added $1.5 billion to the total U.S. tab for childbirth. Today's total Cesarean cost is unknown, but surely it's still more than a billion dollars. If your insurance covers all costs for your birth, then perhaps the price of childbirth, whether VBAC or repeat Cesarean, is not a pocketbook issue for you. More and more couples, however, are having to make larger co-payments for hospital charges, whether for extra days in the hospital or for medications. An epidural costs $500 to $2,500, for example, depending on the hospital and the anesthesiologist. An extra day in the hospital in 1994 averaged $931, up from $245 in 1980. And at least some insurance plans, especially HMOs, encourage VBACs to the point that all Cesareans have to be prepared by the insurance company. If the Cesarean is not approved, the doctor does not get reimbursed for the cost difference between a vaginal and Cesarean birth.
- Approximately how many VBACs have you attended?
- Of those patients in your practice who wanted VBACs, how many were successful?
- What do you think my chances are of VBAC success, given my childbirth history?
- What is your Cesarean rate?
- How do you usually manage a postdate pregnancy or a suspected CPD?
- What's a reasonable length of time for a VBAC labor if I'm healthy and my baby appears to be healthy?
- What percentage of your patients do you deliver yourself?
- How many people can I have with me during the labor and birth?
- What is your usual recommendation for IVs, Pitocin, prostaglandin gel, epidurals, confinement to bed, EFM (and so on)?
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