As if the Nadya Suleman “Octo-Mom” story couldn’t get any more convoluted or weird, the LA Times is now reporting that her fertility doctor, Dr. Michael Kamrava, has another patient expecting multiples. The Times reports that a 49-year old uninsured woman is pregnant with quadruplets and is on bed rest. She was recently transferred to County-USC from another hospital because she lacked insurance. The 49-year old woman is denying that Dr. Kamrava is her fertility doctor; however, the Times is citing several sources speaking on the condition of anonymity. The uninsured mom-to-be is currently on bed rest and will remain on bed rest for 2 to 3 more months until the babies are born. This new twist in the Nadya Suleman saga proves that this story will be grabbing headlines for months to come.
The LA Times article puts forth that that the 49-year old woman was implanted with 7 embryos, of which four survived. This woman’s pregnancy risk is further increased due to her age. For those keeping score, Nadya Suleman has stated in interviews that Dr. Kamrava implanted her with 6 embryos, which resulted in the octuplets due to two of the embryos splitting into twins.
Should medical insurance be factored into a doctor’s IVF decisions?
As a twin, and considering my family history of twins, I was the first to ask the sonographer for each of my pregnancies to let me know if they saw more than one baby in my uterus. Thankfully (thus far) I’ve dodged the generations old twin bullet in my family. However, should there have been more than one baby in there, we would have needed to make some serious financial decisions because of our health insurance. At the time my daughter was born, we carried a high co-insurance type of insurance. Her birth, start to finish, cost us well in excess of $3,000 out of pocket. It could easily have been twice that, given my family’s history for twins.
With insurance coverage being scaled back and employees being asked more and more to shoulder the burden of the cost for care, I do think that one’s health insurance coverage should be factored into IVF decisions. Granted, Dr. Kamrava does seem to be placing more than the norm in his patients’ wombs, but for the most part, twins are pushing it for the maximum that a woman can safely carry without significant health risk to mother and babies. Higher order births such as triplets and quads or even octuplets virtually guarantee a premature birth that will cost a considerable sum of money. Should taxpayers be forced to bear the brunt of irresponsible doctors who implant more than 2 embryos per IVF cycle? Should taxpayers be forced to pay for the care of women without health insurance or adequate health insurance who choose to pursue IVF to achieve pregnancy?
Doctors should discuss health risks and make sure their patients have adequate insurance or funds to cover the costs of birth
Doctors should factor a patient’s insurance coverage (or lack thereof) into these decisions. Along with discussing the risks associated with IVF, doctors should also be making sure that the babies will not become a burden that taxpayers will have to bear by frankly discussing the likelihood of prematurity and the cost of care. Granted, embryos can split (as they did in Nadya Suleman’s case) but placing a large number of embryos in a woman’s womb just courts disaster. Multiple moms can rack up a large amount of medical bills starting with months in the hospital for bed rest, to the massive amount of doctors and nurses needed to manage the birth, to the after care – almost assuredly NICU care – for the children. A doctor would factor in your general health and reproductive needs when making a decision of how many embryos to implant in an IVF attempt. The doctor should also factor in a patient’s ability to pay for the staggering cost of care should they wish to place large numbers of embryos in a patient’s womb. Aside from having to afford the children once they are born, some consideration should be given to whether or not a patient can even afford the medical costs associated with a higher birth order pregnancy. The AP reported earlier this week that the average cost of a premature baby’s hospital stay was over $164,000 (2006 figures). Californians are quickly doing the math and estimating just how much Nadya Suleman’s bid for “just one more girl” is going to cost their already financially strapped state.
As a Catholic, I would never advocate selective reduction, a/k/a abortion. What’s done is done in these two cases. However, I would advocate that these women should never have been implanted with more embryos than they could afford given their circumstances. Asking the taxpayers of California to foot the costs of these births is egregious and Californians have every right to be angry.