Obstetrician–Gynecologists’ Practices in Postpartum Sterilization Without a Valid Medicaid Consent Form

Obstetrician–Gynecologists’ Practices in Postpartum Sterilization Without a Valid Medicaid Consent Form
Kavita Shah Arora, Roselle Ponsaran, Laura Morello, Leila Katabi, Rosemary T. Behmer Hansen, Nikki Zite, Kari White
Obstetrics & Gynecology, 10 June 2021
Abstract
Objective
To explore the practices of obstetrician–gynecologists (ob-gyns) in the United States surrounding postpartum sterilization when the Medicaid consent form was not valid.
Methods
Using the American College of Obstetricians and Gynecologists’ online directory, we conducted a qualitative study where we recruited ob-gyns practicing in 10 geographically diverse U.S. states for a qualitative study using semi-structured interviews conducted by telephone. We analyzed interview transcripts using the constant comparative method and principles of grounded theory.
Results
Thirty ob-gyns (63% women, 77% nonsubspecialized, and 53% academic setting) were interviewed. Although most physicians stated that they did not perform sterilizations without a valid Medicaid sterilization form, others noted that they sometimes did due to a sense of ethical obligation toward their patient’s health, being in a role with more authority or seniority, interpreting the emergency justification section of the form more broadly, or backdating the form. The physicians who said that they never went ahead without a signed form tended to work at large institutions and were concerned with losing funding and engaging in potentially illegal or fraudulent behavior.
Conclusion
Physicians’ varied behaviors related to providing postpartum sterilization without a valid Medicaid consent form demonstrate that the policy is in need of revision. Unclear terminology and ramifications of the Medicaid sterilization policy need to be addressed to ensure equitable care.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s