Ontario not delisting C-sections, health minister says

While there won't be a delisting of all caesarian section childbirths, the government may delist those deemed medically unnecessary. Paul Bliss reports.

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Ontario Health Minister Deb Matthews speaks in Toronto on Thursday, Jan. 26, 2012.

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ctvtoronto.ca

Date: Thursday Jan. 26, 2012 6:33 PM ET

One day after floating the idea of putting limits on the number of planned caesarean sections, Ontario Health Minister Deb Matthews said the province will not be delisting the procedure from OHIP.

"We are not delisting C-section procedures. Evidence will guide our decision making process," she told reporters Thursday morning.

On Wednesday, Matthews cited "pretty interesting research" that suggested some urban centres in Ontario perform more caesarean sections than others.

Matthews, who is in charge of Ontario's most expensive ministry during a time when the government is looking to find savings, said there must be evidence that medical procedures and tests improve health outcomes.

A spokesperson for Matthews clarified later Wednesday that OHIP would continue to cover any C-sections deemed necessary by a medical professional.

According to a 2011 Institute for Clinical Evaluative Sciences study, 28 per cent of babies delivered in Ontario hospitals are by caesarean section.

That number jumps to 84 per cent for mothers who had a previous caesarean section, according to the study which was funded by an agency of the Ministry of Health and Long-Term Care.

Ontario is looking to trim a $16-billion deficit and the government is reviewing all health services.

"We need to really be rigorous in our determination to fund services that have an evidence-basis and not fund those that don't," Matthews said Wednesday.

Health programs make up 44 per cent of Ontario's spending.

Comments are now closed for this story

AM
said

There needs to be a complete review as to what is 'deemed medically necessary'. Many c-sections are performed for nor other reason than the mothers don't want a natural delivery. It's the whole "too posh to push" phenomenon.
Even having had a previous c-section should not automatically allow a mother to have another. Each pregnancy and delivery is different and unless there is a risk to mother or baby, there should be no option.

MikeW
said

This goverenment is an absolute mess. Who would believe a word that comes out of their mouths. Where was all this talk of cutbacks and slaying the defecit/debt before the election. Oh ya that would have cost them votes or more worrisome is they have no clue as to what the debt/defecit is. The Libs are very fortunate that Hudak is as inept as they are by offering no alternative

Ottawa Jack
said

A decision based solely on political & not medical reasoning.
Welcome to the Ontario Liberals of Dalton McGuinty

Wendy Willer
said

It would seem to me that if a woman has had one C-section and her doctors say she must have another one for her 2nd or 3rd child Government and OHIP should have no say on this woman,s health or the health of her unborn child.

Edie
said

Maybe they should look at eliminating some of the 54% of the budget that is salaries to the
government it's self. Then there would be enough for health care

B.J.
said

The Ontario Goevrnment is going to slowly chip away at health care because they can. They have no desire to think outside the box. If they suggest something and change their mind then it will return under another cover. They are the most incompetent government, irresponsible where money is concerned, how they were re-elected is beyond me. Our health care system is going to become more like the USA because of the Liberals. They have had 8 years and we are worse off than before. There is always something being delisted.

Paul
said

The costs of *not* having a c-section when medically necessary based on a quota being exhausted would be ridiculous, socially and financially.

Sara
said

Does Deb Mathews have a medical degree, if then she is not qualified to determine when a C- section is deemed or not. Her governmnet has already made a mess of the health care system so stop meddling in stuff your are not qualified on.

Kelly
said

This 'too posh to push' thing phenomenon is always being headlined in the media but this is not Hollywood and most women can't demand a C-section because they don't want to push. Most women have to get them for health reasons.

Lynne
said

Instead of cutting services, why don't you spend some time on streamling the systems out there ie: is it necessary to have medical costs go thru WSIB. Look at the adminstration costs, high salaries, paperwork. Is it necessary that we have private insurance cover dental and drugs, when that should not be covered for all. All of this creates higher tax dollars for all of us. Cutting services is only going to make it worse for the already poor.

Do not get injured or sick in Ontario
said

Do not get injured in Ontario, Damage your knee have the operation but the physiotherapy is not covered I know so many people who have lost productive jobs because physio was not covered in Ontario. Does it not make sense to keep our population healthy so that they can be productive. Or do governments think that people should just endure the pain be unable to work and then end up on social assistance. as for private insurance the majority of people can not afford it.

C.T.
said

People should not be charged for elective c-sections. we are not talking about face lifts or tummy tucks, we are talking about the safe delivery of a human being. Many people who plan for delivery end up as a c-section and people should not be charged for believing that it would be the easiest way to give birth...the OB/GYN still has the say over when and how they are done, you can't plan them like a spa day!

Jodie's
said

@ 'AM' ... Oh, don't be so judgmental. Posh versus push is Not common. And saying that having a previous c-section should not automatically allow you to have another...who are you to say this? While the risk of uterine rupture is a little less than 1%, it is still a very real risk with possibly catastrophic results. So it's okay that say, 1 in 120 women have their uterus rupture from a previous scar? I don't and didn't like those odds and that should always be a choice.

Mike
said

If I were an O.B. I would want all births by C section. Michelle born at 11, Timmy born at 12 lunch 12:30 Johnny at 1:30 Paycheque at 5:00 The more I could schedule the more $$$$ I could make. Set up the baby production line because nature takes to long. Hmmmm I wonder what the Association of Ontario Midwives or the Ontario Duola Association would think of my comments

Just Saying - Ottawa
said

What about the re-instating of funding that George Smitherman (while Health Minister) brought back for sex changes. Money is spent by this Government like water down the drain and at the same time cut funding at a young age for Autism..certainly does not make any sense and possibly needed hysterectomies and who knows what else..oops forgot the $5 million of Ontario taxpayers dollars going to a museum in Winnipeg for a Human Rights..sending $50,000 over 10 years to another Province..this Government has already made us a "have not Province" doubt there is much left they can do but bankrupt this once beautiful place to live.

Check it Out - Ottawa
said

Perhaps with the Health Care System they should do away with the "red and white" cards asap - there are apparently more then there are Ontario people...simply does not make any sense.

Theressa
said

Really disappointed in the news anchor coverage of this today and the 'random' phone call responses that were aired on TV--of course all believe that having planned c-sections are not a good idea, and receiving empathetic nods from the news hosts. give me a break!

still need more cost-cutting in ontario? uhh, what about no eye exams anymore, no hearing exams, no physiotherapy coverage, virtually no home care, scant health resources in the community...and the list goes on.

i'm a nurse and am disgusted with the lack of care and follow up antenatal care available for mom/baby in birthing departments...1 day stays in hospital! there was a study that came out of Scar. general hosp years ago showing that cost-cutting in maternity areas has shown serious negative impact on mother and developing child. and that wont cost the hc system more in the long term??

women are having children older, that is a fact. i personally believe that if a woman is over the age of 30, the discussion about having a c vs. vag birth needs to happen, because there are more inherent risks due to mother's age. and those risks continue to increase with age.

i have a better idea...scrap the regional "LHIN programs" (they have absolutely no function anyway except to cut hc spending), e-health ontario, mandatory outsourcing of hospital computerization documentation contracts to 3rd party companies--all of which are robbing ontario tax payers BILLIONS of health care dollars annually...

trust me, there would be more than enough money left for eye & ear exams and home care again, and yes...for c-sections so that all women could retain the choice to deliver their children safely which will of course help to reduce costs, by delivering healthy well babies at birth and as they develop.

Anne
said

We should all be a little nervous about this report. C-sections that are medically required of course should be covered. Those due to convenience of doctor or mother should not. It was a mistake to delist eyecare, a know a lot of people who are unable to get much needed new prescriptions because they cannot afford the cost of the appointment, so make do with the glasses they already had. So if eyesight is not deemed to be important enough to cover, we should be quaking in our shoes over what they are going to chop next.

rollinghereyes
said

There are risks to the mother to deliver her second or third child etc. naturally if she had a c-section for the previous child/children. These risks may not be as big in some woman as they are in others but there is always going to be the chance of the uterus rupturing at the site of incision from the strain of contractions.

Everyone's perspective of what's medically necessary is different, and telling a woman how to have her child is crossing the line.

Leslie
said

Please remember that the provincial government has recieved less funds from the federal government, which is the conservative government. It just so happens that its the liberals who have to deal with those budget cuts. Any medically NECESSARY procedure will maintain coverage under OHIP, I think the jist of their idea is to remove non-medically necessary coverage, such as c-sections with no medical basis. It's like circumcision, they don't cover that anymore because its not medically necessary to the health or livelyhood of a human being. At any point if a cesarian section becomes medically necessary, it would be covered, they certainly aren't going to jeoprodize the lives of mothers and babies to save a few bucks.

Liz
said

Ridiculous!!!
After the e-health & ORNGE debacles who is this minister to declare what is medically necessary??

omega
said

28% of births are by section?! I highly doubt every single one of those were medically necessary. More likely fear mongering by doctors. Many will not do a normal delivery for breech or twins any more. Most reccommend epidurals, known to hinder normal labor. They section when labor goes a little long. If you take the medical mind out of childbirth, then most of those sections would not be needed.

MikeW
said

@Leslie- who are you kidding, have you been hiding under a rock. It was the Fed Libs who cut transfer payments to slay the defecit on the backs of education and health care. The Cons have not decreased spending in either of these areas and in fact they have been increasing. Keep drink the Lib Koolaid. LOL

IN AWE
said

Another lead trial balloon by the Liberal government and their so called Catholic premier who happily funds abortions and sex re-assignment surgeries, but "tests out" the market to curve C-Sections. Shameful.

reidjr
said

Leslie
I know for some its fun and easy just to blame the feds and maybe to a degree they should get some blame but the liberals should get most of it.Look at the amount of scandals under the liberals watch look at the massive amount of waste a perfect exzample is $1billion plus on green energy i could go on and on and on the liberals while maybe you can't blame it all on them hold a ton of blame.

Lesley
said

Around 1980 there was a big outcry that doctors were doing too many C-sections as it took shorter time then natural birth so they could deliver more babies this way. There were signs posted all over North York at the time by people against this. I myself had an emergency C section and because of the cut I had to have my second child the same way.

My personal opinion is that if it is to safe either the baby or mother's life it should be covered my our medical.

I

Mark
said

Ever more cowardice from McGuinty. Instead of dealing with the fundamental problems with our healthcare system which is the diminishing funding formula, and over-taxed population and over 50% of the provincial budge on salaries, benefits and the like-this government floats trial balloons like C-section de-listing.

The arrogance of this government becomes ever more pervasive and obvious every day.

Paul Kitchener
said

I hope the Conservatives and NDP are planning a "Non-Confidence" vote as early as possible in this term. The only way to stop this LIEberal government, of spend till we drop, is to "DEFEAT through NON-CONFIDENCE. Ontario is a have not broken provice ~ SO ~ Give us another election ~ NOW !!!

Paul
said

They should delist abortion. In the majority of cases it is not medically necessary, very expensive and it is very detrimental to the health of the baby being aborted.

Tim
said

The Minister of health needs to get a psychiatric exam, she is off her rocker. All the liberals do is find ways to cut services so they can save money which they so blatantly spend on other things. They have had so much experience at wasting they cant stop. There is always a huge mess somewhere that surfaces because of poor fiscal management with the liberals that they cant stop. Another 4 years of this. !!

Mark
said

Universal health care is in a third world horrendous state. My wife recently had her ACL ligament in her knee snap. She is in tremendous pain and cannot bear any weight or move her leg. The Dr. at Emerg prescribed Tylenol 3, a brace and crutches and only ordered an MRI after I insisted, which he said would take three months. He gave her a referral to a physio clinic. First off that injury cannot be rehabbed and they are not doctors so they cannot speed up MRI'S as he alluded they could. She should have been admitted, seen an orthopedic surgeon had an MRI and then surgery say over 5-10 days
max. This whole mismanged process could take 6-9 months to fix. Meanwhile she is in serious pain cannot work walk etc. The system is barbaric and many of the nurses and doctors could care less, as I saw first hand. Same goes for the government. How dare they even consider delisting c-sections for women and their babies. Want to start to fix it, start by chopping highly bloated inefficient government by 50%, then highly overpaid Hospital CEO's and senior management. That would save 10's of Billions that could be directed to front line health care, proper diagnostic equipment with fast access to MRI scans and expedited surgery times, reduced wait time for specialists etc. Universal health care as it presently exists kills people with brutal waiting times and or leaves people seriously disabled and helpless.

pat
said

While there risks involved in major surgery, there are very real risks involved in attempting a vaginal delivery after a Caesarean (VBAC). Every woman considering a VBAC is made aware of these risks when given a choice between another section and a VBAC. It is not an easy choice to make. My first child was a footling breech delivered by a planned c-section. My second was also a c-section. When my 3rd child was due, my OB offered to let me try a vaginal delivery. I weighed the risks to me and my baby and opted for another c-section. After the delivery in recovery, my Doctor told me it was a very good thing I had not opted for labour. The site of my previous incision on the uterus was paper thin and could have ruptured. I sensed she was slightly shaken. Footling breech babies are rare. I was lucky to have had the planned caesarean. Ruptured uterus are rare in VBAC. I was luckly to have made the right decision. I hate to think that money may have influenced my decision.

I foresee mothers opting to go for another section and partners refusing to pay. And what about a mother who can't afford to choose to have another c-section and suffers a ruptured uterus in labour. The government better be prepared for the inevitable lawsuits.

If there are Doctors offering unnecessary planned deliveries to first time mothers, they should be investigated. Leave the decision of VBAC to women and their doctors. Money should not have to be part of that decision.