Las Vegas obstetricians

May 8, 2002 5:18 PM

Las Vegas obstetricians are turning away newly pregnant women, including existing patients who become pregnant, because they say they cannot afford to deliver more babies ... If newly pregnant women cannot find care in Las Vegas, their choices include moving elsewhere, traveling out of state for care or going without prenatal care and delivering in area emergency rooms or a casino?
posted by lola (11 comments total)

or perhaps a midwife?
posted by hob at 5:38 PM on May 8, 2002

It seems like it's becoming a problem here in the US and world-wide. This article indicates that part of the problem is a result of the insurance losses and increased risks resulting from the 9/11 attack.
posted by obedo at 5:59 PM on May 8, 2002

Interesting that I just read an article in the NYTimes about women delivering babies at home, w/o benefit of midwife or any other medical help. Perhaps this new trend will become regular in Las Vegas due to necessity... I mean, the emergency room is always a possibility, but it doesn't sound attractive to me.
posted by meep at 6:07 PM on May 8, 2002

So, in a system where the principals are a doctor and a patient, lawyers and insurance companies are sucking off a huge percentage of money in order to transfer much less than 50% of said money to a small percentage of patients in a few cases of an unlikely event, and in so doing, are causing doctors to have to refuse patients. What are the risks of being a victim of malpractice? Now what are the risks of delivering with no medical professionals present? I don't know the exact answers to those two questions, but if the latter outweighs the former, than abandoning mandatory malpractice insurance entirely would be better for the public than too-expensive insurance.
posted by Nothing at 6:11 PM on May 8, 2002

Women were never designed to force kids out flat on their backs. There are few doctors who let women use a natural birthing position, and IMO, all women are better off with a good midwife than a doctor.
posted by five fresh fish at 7:31 PM on May 8, 2002

Here in New England, and when I travel to New Jersey, it's very common to see billboards and other advertisements intended to convince you to deliver your baby at XYZ hospital. States have different restrictions on what insurers can do, and I infer from the fact that they are advertising that OB is a profitable enterprise for them. Both of the hospitals I investigated in Boston to have my baby last year were building new, expanded obstetrical wings.
posted by lisatmh at 7:52 PM on May 8, 2002

Sounds like a case of poor city planning. The casino/hospitality/tourism industry explodes, luring hundreds of thousands of workers through the nineties. An unnatural balance of working-class vs professionals occurs. The casinos, I think, bear the burden of making sure the populous (their employees) have access to fair and equally accessible healthcare(as with any big city in the country with more natural economies), by subsidizing extra hospitals and incentives to lure doctors to the Las Vegas metro area. They benefit by having a good sized pool of a workforce. And the workforce benefits by not getting caught with their pants down, as it were, when they find themselves pregnant.

As a side: Anyone have any figures as to the public school situation in Las Vegas?
posted by crasspastor at 8:17 PM on May 8, 2002

Five Fresh Fish, I'm glad that you have solved the nagging teleological mystery of what position women were designed to be in to have children. And for a healthy woman, with a more or less healthy pregnancy a midwife is a fine option. But I think you are incorrect when you say that "few doctors LET (emphasis mine)" women use a "natural" birthing position. A woman can have her baby on the sidewalk or in a barn if she wants to. If you ask for the doctor's advice, and he tells you he thinks you ought to lie down flat you are in no way required to do so, so the doctor isn't "letting" you do anything. Basically, you ask for his opinion, he gives it, and it is generally followed, because chances are the doctor probably knows better than your average guy on the street.

And this is a tired, tired argument, but when your wife (or you if you are a woman) needs serious help when your baby decides to strangle himself with the umbilical cord or something, you'll dial 1-800-ADOC-TOR.
posted by dr_emory at 8:34 PM on May 8, 2002

crasspastor: as it happens, the same paper has a series on the problems of explosive growth. It's five years old, but probably remains relevant. And yesterday the other paper covered the schools issue. Growth rates lead to a projected 2 million people in the valley by 2005, "the equivalent of building a city the size of Reno in ten years". A major concern of the mayor has been building a functional downtown and addressing the imbalance of growth among the casinos and decay in the rest of the city; last year the city condemned a vast rail yard and began building a "real downtown" focused on serving the needs of residents rather than tourists.
posted by dhartung at 11:08 PM on May 8, 2002

The last article that dhartung linked to only hints at the picture here. The City of Las Vegas proper is only a small part of the metropolitan area, much of it including the Strip is simply county land instead of part of any incorporated city. The county government controls much of what happens here while Mr. Goodman tries to revitalize downtown.

Schools are a problem, attracting good teachers is a big part of that. I don't know too much of what has happened but I know that the school district is coming under fire for its hiring practices and methods used to recruit teachers from other cities. I know a teacher that moved here several years ago and was quite fed up with the entire system, she moved back to Reno within several years.

The malpractice insurance situation is getting quite a bit of attention in the news. Some emergency rooms are threatening to shut down as well, overwhelming the others that have coped with the insurance situation so far. There is talk of a legislative solution, apparantly California has successfully coped with something similar through regulation but that will take time, the doctors are turning people away now. I'd hunt up some references but I need sleep bad...

And for the same reason I won't go into traffic, polution and other topics...
posted by mutagen at 11:55 PM on May 8, 2002

dr_emory, you're right that no doctor can force a woman into a birthing position. but unfortunately, most women don't research natural birth, and when they go into labor they do whatever their doctor tells them, unthinkingly. i know scores of women who, under the duress of their first labor, agreed to procedures or conditions they later regretted.

we are trained to put all our faith in doctors and the medical establishment, and just as often as not they let us down, despite what may be the best of intentions. babies strangle themselves with their umbilical cords in hospitals too, ya know.

does anybody have statistics on the adequate ratio of obstetricians to a population with the mean age of Las Vegas? it doesn't sound like the OB/GYN's are overworked, but that the insurance companies are forcing them to scale back. with one insurance company controlling so much of the market, it feels like there must be an antitrust violation somewhere.
posted by junkbox at 6:24 AM on May 9, 2002