FIPO condemns Bupa over its caesarean policy

A day after my blog post about Bupa's decision to only pay for cesareans in private hospitals if the mother's life is at risk (not the baby's), the Federation of Independent Practitioner Organisations (FIPO) strongly condemned Bupa’s policy changes in this press release: "In a letter sent to obstetricians and hospitals Bupa has advised that it will no longer pay for caesarean sections unless “there is a risk to maternal life”. This contradicts the NICE guidelines, which clearly state that emergency Caesareans should be carried out not only if the life of the mother, but also if the life of the baby is in danger, or

if there is maternal or foetal compromise which is not immediately life threatening. Bupa will no longer cover cases where the life of a baby is in danger.

As Geoffrey Glazer, chairman of FIPO says: “Bupa’s position is perplexing and worrying for pregnant women, given the latest NICE clinical guidelines on Caesarean sections. Unless Bupa knows something that NICE doesn’t, it is flying in the face of nationally accepted practice.”
FIPO is aware of a mother who was pregnant with twins, one lying in the breach position and one lying in the transverse position. There was danger to both babies and the mother was suffering from severe fluid retention. Yet, even in this case, Bupa refused cover for an emergency Caesarean because they did not consider the situation to be life-threatening to the mother.

In a statement on the controversy published recently in the Sunday Times [April 29, Bupa denies mothers caesareans unless life is at risk, Sarah-Kate Templeton], a Bupa spokeswoman said: “I can confirm that we will only cover a Caesarean section if the mother’s health or life is at risk. We have recently clarified our position as we saw a dramatic increase in the number of caesarean sections carried out by obstetricians that did not meet clinical guidelines.”

Geoffrey Glazer takes issue with this. He says: “This statement from Bupa contradicts its own guidelines, as in the letter sent to obstetricians and hospitals it said ‘in future benefit will only be payable for Caesarean section when there is a risk to maternal life’.

“Bupa should not only make it clear exactly what its policy is, but also exactly what clinical guidelines it is referring to. We believe this is to the detriment of Bupa patients and is clearly a worry for women and their partners who may suddenly find themselves in a crisis in labour and no cover for an emergency Caesarean section.”