restricted access The Medicaid Prejudice
In lieu of an abstract, here is a brief excerpt of the content:

The Medicaid Prejudice

This story should start with my pregnancy. I became pregnant while in graduate school. At the time, I had group health coverage through the university. Unfortunately, the pregnancy combined with a need to work at multiple temporary jobs and restaurant jobs to support the family bills necessitated that I drop out of the graduate program and apply for Medicaid health insurance and food stamps through the Federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). My doctor agreed to keep me as a patient only because I was on group coverage when he first started treating me for the pregnancy, but made it clear he was not a Medicaid provider and was not happy about having to accept the Medicaid contractual payment rate.

On December 2, 2001, I went into labor with my daughter. I had the initial excitement of any mother going into labor with her first child: I timed the contractions, I made phone calls, and I made sure that the bag for the hospital was ready. I had read What to Expect When You are Expecting and paid attention to everything the doctors told me. When contractions got to about five minutes apart, my friends and then–husband drove me to the hospital. Labor stopped. After many laps around the hospital hallways, I was sent home and asked to follow up with my OB/GYN. Another doctor in his practice told me that I was dilated about 3 cm and scheduled to induce if I did not deliver by December 7, 2001.

On December 6, 2001, I woke up in full–blown labor shortly after 5:00 a.m. I could not even get a word out! We rushed to the hospital and the staff started working immediately to contact my doctor. He could not be found. Labor was progressing quickly, but my water still had not broken. In an attempt to slow the labor, I was given an epidural. I had hoped to avoid an epidural and proceed with natural childbirth, but in light of the situation, I had to consent. I was told only my doctor could break my water. My blood pressure went through the roof as labor progressed, so I was put on an IV to reduce it. Finally, at just over 9 cm dilation, my doctor came into the room and broke my water. My daughter was born less than 10 minutes later, at 2:57 p.m. I required a third–degree episiotomy from the sudden delivery. My daughter did not cry when she was born, so they jerked her away in a panic. Between the blood pressure medication and the epidural, they were afraid that there was something wrong. However, she screamed the second they jerked her away.

By the morning of December 8, the hospital wanted to release me but I still had not had a BM. The contractual rate paid through Medicaid is extremely low, so the hospital had every incentive to discharge me as soon as possible. Legally, they had to be able to notate I had a BM in order to do that. The hospital, once again, could not reach my doctor to see if they could administer a stool softener. In the absence of the approval, I was given a Fleet’s kit (enema) without a softener. It caused a minor explosion which, unknown to me at the time, ripped and infected the stitches from the episiotomy. I was released.

Within 24 hours, I was running a 101 fever. My mother took my daughter and me to the OBGYN’s office and I saw another doctor in his practice. That doctor examined the stitches and had me admitted to the nearest hospital immediately. I [End Page 188] was placed on a triple antibiotic drip and told it was OK to continue breastfeeding. I was told that these antibiotics were intended for new mothers and would not harm my newborn. I was on the triple antibiotic drip for 10 days and breastfed my daughter the entire time. After 10 days on the antibiotics, another surgery had to be done wherein the stitches were removed, all of the infected tissue...


pdf