Medical Schemes Don’t Want to Pay for C-Sections Any More

An official of the Council for Medical Schemes (CMS) has reported that medical schemes are unhappy with the number of C-section claims by South African women.

Dr Anton de Villiers, head of research and monitoring at the CMS, says a massive 71% of all births in private hospitals are by Caesarean section. He called this “unacceptable”.

World Health Organisation (WHO) guidelines say 10 – 15% of births should be by C-section.

Dr de Villiers told the parliamentary committee for health that when the Prescribed Minimum Benefits (PMBs) for medical schemes were reviewed again, childbirth methods should be discussed.

C-section Rates in South AfricaDr Heinrich Volmink, DA MP, who is a member of the parliamentary committee, said 71% was a worrying figure. He noted that even in the public sector 23% of births were by C-section and even this was very high.

“The 71% rate in the private sector is unconscionable,” said Dr Volmink. “Is convenience for the obstetrician the more important factor here? Or are they afraid of legal action so they take the “safer” route? But what about the risks for the mother and child from surgery and anaesthetics?”

Volmink asks why the CMS doesn’t make it more difficult for gynaecologists to select C-sections. “71% is unacceptable. There is a considerable cost difference between a natural birth and a C-section.

Volmink called for the CMS to review the PMBs.