This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Jennifer S. Haas, MD, MSPH; I. Steven Udvarhelyi, MD, MS; Arnold M. Epstein, MD, MA
Harvard Medical School Boston, Mass

JAMA. 1993;270(20):2435.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—We agree with Dr Waszak that cesarean sections are frequently performed for fetal indications. Although our article reports on the effect of coverage for uninsured pregnant women on maternal health status and the use of cesarean section, we had previously reported that expanded health coverage was not associated with improved rates of low birth weight or prematurity.¹

We recognize that our data do not permit us to examine the appropriateness of the observed increase in cesarean sections. Nevertheless, our article adds to a growing body of literature that suggests that insurance status may be a determinant of cesarean section use independent of clinical circumstance.^2-4 Further study will be needed to examine prospectively the appropriateness of cesarean section use.

Prior studies on the impact of expanded health coverage for low-income pregnant woman have focused solely on infant health outcomes. Our study was intended to be an initial . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?