By Lemor Abrams

SACRAMENTO (CBS13) — California’s health insurance exchange is looking to curb what it says are costly and risky births in the state.

Covered California has new rules for hospitals who don’t curb Cesarean section procedure rates.

Doctors say C-sections can be life-saving for mom and baby. But insurers say the procedure can also be costly, and carries high and sometimes unnecessary risks.

Emily Moyers was at the park, happily playing with her new baby, and she can’t help but think of the ups and downs of childbirth. Six months ago, she spent the longest 48 hours of her life trying to avoid a C-section.

“They just wanted me to get out of the hospital quickly, so they didn’t really want him to come naturally. They wanted a C-section to get it done and get me out of there,” she said.

UC Davis Dr. Herman Hedriana, who serves as the director for the hospital’s maternal and fetal care division, says C-sections performed without a good medical reason can carry risks, from infection to hemorrhage, even death.

“You want to prevent very costly complications,” she said.

UC Davis Medical was recently honored for having one of the lowest C-section rates in the state.

It stands at approximately 23 percent, compared to a 70 percent C-section rate at some California hospitals.

“That’s great, that’s where we’d love to see every hospital,” said Covered California spokesman James Scullary.

And Covered California isn’t asking. The state’s health insurer is telling all California hospitals to reduce their C-section rates, or risk being excluded from the health plan.

“We want to make sure we improve health outcomes, lower costs, and provide better health care in the state,” said Scullary.

He says it’s about improving quality.

But some women request Caesareans because they’re worried their labors will go wrong. Doctors, and many moms, believe the solution is educating patients.

“I have friends who’ve had C-sections and it took forever for them to heal and they hated it,” said Moyers.

As for timing, hospitals have until next year to meet the new standards.


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