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DDuring their 18-week-old baby’s scan, Blanca and her husband watched anxiously as the sonographer spent 10 minutes looking for signs of life. “I could tell something was wrong,” she said, recalling that scan in late August.
“She took the ultrasound wand out of my stomach, and she said, ‘I’m sorry, but there’s no heartbeat.'” Blanca, 38, who Independent Being identified only by her first name to respect her privacy, she was heartbroken.
was already trying to recover from the loss of her baby, whom she named Jonah – the product of her last viable embryo transplant after undergoing a difficult procedure. in vitro fertilization – Two days later mother suffered a second cruel blow.
Blanca’s health insurer Aetna denies her coverage for a hospital stay so she can be induced and give birth to Jonah. The decision resulted in a delay that meant the grieving mother had to endure seven days of anguish over her dead, 4 1/2-month-old son.,
“I felt so defeated. I’d already lost my baby and now this,” Blanca said. Independent Through tears. “How much more heartache do I have to go through? Where is the humanity?”
The back-and-forth with Aetna and the bureaucratic details involved in booking Blanca into the hospital meant that Jonah was not delivered until September 5, according to Blanca, her physician, and the documents reviewed. Independent
To add to her trauma, the mother bled profusely and nearly died when her uterus ruptured and her stillborn son, Jonah, had to be delivered via emergency C-section.
“I’ve never felt that type of pain in my entire life,” the Nevada mom said. “I felt like I was going to die.”
After being told the heartbreaking news that Jonah had no heartbeat, Blanca had the option of inducing labor or undergoing a dilation and expulsion (D&E), the same procedure used for late-term abortions, in addition to waiting to give birth naturally. She wanted an induction so she could hold Jonah in her arms and say goodbye.
Her physician, Dr. Joey Adashek, a high-risk pregnancy specialist, was shocked when Aetna initially refused to cover Blanca’s stay in the hospital.
Adashek said the denial was “one of the most serious” he has seen in his more than 20-year career and also called out TikTok’s insurance company.
“So for the first time in my career, the insurance company rejected both of them,” Adashek says in the video. “Refused to start labor and refused surgery, which begs the question, how are we going to get the baby out?”
“I told my office, ‘We need to fight this,'” Adashek said. Independent. “She’s traumatized, and she has to sit there with a dead baby. This is her last chance to have a healthy baby of her own and because of the insurance company she just has to sit there and wait. Isn’t that crazy?”
Adashek’s team at Desert Perinatal Associates in Las Vegas appealed the decision and urged Aetna to reconsider, a process that can take up to 14 days.
when contacted Independent Asked for comment, an Aetna spokesperson said, “its ability to resolve coverage disputes based on the best available medical evidence.” depends on physician partners sharing critical information in a timely manner.”
“In [Blanca’s] In the case, the procedure itself was covered, but the hospital stay was not initially approved based on information provided by her physician,” the spokesperson said.
In response to Aetna, Adashek told Independent That he sticks to his version of events.
“I have seen Aetna patients for over 25 years and this is the first time they have denied authorization for this procedure,” the physician said.
Aetna finally gave the go-ahead on September 2 after AdShack conducted a peer-to-peer review, which is a standard bugbear for doctors because the “peer” on the other end of the line is often not someone in the same expert area.
The review is a discussion between a physical person and a doctor associated with the insurance company. The American Medical Association condemned the procedure as a “barrier to care”. 2021 Council on Medical Services Report.
Adashek said he was reviewed with a nurse and the phone call was brief. She claimed that the nurse informed her that induction and hospital stay had been approved, before she hung up on Adashek.
An Aetna spokesperson claimed that the peer-to-peer call “occurred at the time specified by her physician.”
“He shared new medical information that helped us quickly approve his hospital stay,” the spokesperson said.
In response to Aetna’s statement, Adashek claimed he was “not asked a single question” by the nurse during the peer-to-peer discussion.
“She never asked another question about the clinical situation and I never volunteered any information,” Adashek said. “He told me ‘it’s been approved’ and that was the extent of the conversation.”
Once final approval was given, the earliest the hospital could book in to induce Blanca was the following day, the evening of 3 September, although the labor and delivery unit was very busy.
Her treatment was pushed back one day to September 4, when she was induced, a process that could take 12 to 24 hours, sometimes longer.
Then, on September 5, just after the process had begun, things went horribly wrong.
The mother suffered uterine rupture, a rare obstetric emergency in which the wall of the uterus tears, which nearly took her life. Doctors said he lost about 2 liters of blood.
“I was bleeding,” Blanca recalled.
She was given anesthesia and doctors worked for two hours to deliver her stillborn child.
Physically exhausted and mentally exhausted, the mother was stunned when she arrived, and had to undergo more tests before she could finally hold Jonah. She was shifted to a special room where she could spend time with her child.
“Finally, I get to hold my baby,” said Blanca. “I hold my baby. I spend the whole day in that one room with my baby.”
Blanca is speaking out about her experience two months later as she is “furious” about what happened.
“A week later [the surgery] The insurance had the courage to call me and ask me if there was anything they could do to help me, said Blanca. “Oh my God, are you really going crazy?”
“Their thinking it was OK — it’s not,” said Blanca.
Due to her recent traumatic experience in the hospital and being a high-risk patient, doctors have advised Blanca that if she gets pregnant again, the birth could be dangerous. She was already a high-risk patient because as a teenager she was diagnosed with hypogonadotropic syndrome, a condition where female ovaries cannot produce sex hormones.
Now Blanca and her husband, Chris, are trying to cope with their loss and the realization that they will likely no longer be able to have biological children of their own.
Remarkably, despite everything Blanca has gone through, she said she still has hope because of her 2-year-old son, Elias.
“He’s my miracle baby and I’m ready to give him the whole world,” Blanca said. “It’s the end of raising a family with my own kids, you know, from me and my husband.”
“But,” she added, “that doesn’t mean I can’t grow a family through adoption.”