September 2, 2009
Invoking the Miraculous: A Case for the Public Health Option
If JT had private insurance and not Florida Medicaid, her baby would probably be dead.
JT’s pregnancy was miraculous, considering she had conceived with only one fallopian tube and ovary and she had no prior children. Things went well until her 27th week when she developed vaginal spotting. She went to a local hospital and was discharged home with a clean bill of health although they never ordered an ultrasound.
Bleeding during pregnancy is not a normal phenomenon. When I saw JT three days later during a routine prenatal visit, I ordered an ultrasound although the bleeding had stopped. A few hours later, the radiologist emergently reported that the placenta completely covered the opening to her womb and the baby’s umbilical cord was wrapped tightly around its neck three times. JT had a complete placenta previa and someone at the local hospital had regretfully missed the diagnosis.
I discussed JT’s case with a high-risk obstetrician and we both agreed that she should be admitted to the specialty hospital if only for observation. Thankfully, JT had state-sponsored Medicaid insurance because a commercial insurer would have made us jump through hoops. They would have required pre-authorization, endless forms and an inappropriate premature discharge home where she would have subsequently returned to the hospital with a dead baby.
What was supposed to be a 24-hour admission turned into a sixty-four day hospital stay because JT bled on a weekly basis. The cord remained around the baby’s neck and the prognosis was guarded regarding successfully carrying the baby until it was full term.
At 35 weeks, JT had an amniocentesis to make certain that her baby’s lungs were mature. She was subsequently delivered by cesarean section with the umbilical cord STILL wrapped around her baby’s neck. Because of skill, compassion and medical expertise, both mother and baby are just fine.
Marie Curie once said, “Nothing in life is to be feared. It is only to be understood.”
Please do not let fear cloud your judgment. Support the public health option, America. We need these miracles to continue.