The state’s system for helping the uninsured thwarts women at every turn and encourages subpar care. healthcare
, one of the most devastating complications of pregnancy. The condition can limit the flow of nutrients to the fetus and cause the placenta to tear away from the uterus, putting the baby at risk of prematurity or death. The immediate dangers to the mother include hemorrhage, seizures and postpartum stroke — and in the longer term, heart disease.
But even as chronic illnesses have become more prevalent, Texas’s staggeringly high uninsurance rate means many women aren’t getting treated, or even diagnosed, until they become pregnant. A few months of Medicaid, especially when prenatal care is delayed, often can’t counter years of neglect, said, the obstetrics and gynecology chair at UTHealth’s McGovern Medical School. He and his colleagues are often left “trying to prevent our train-wreck patients from having a train wreck,” he said.
Back when she was diagnosed with Type 2 diabetes in her late 20s, Allen was working as a teacher’s aide for special-needs kids near Houston, with decent-enough insurance to pay for her insulin and glucose test strips. But after she got married to a high school English teacher and left her job to help with a family crisis, they couldn’t afford the extra $700 a month it would have cost to cover her on his high-deductible, high-premium plan.
Finally, she and her husband went to the emergency room for advice, where a doctor told them about an option they’d never heard of: nonprescription insulin from Walmart for around $25 a vial. Allen tried it, but given her insidious combination of preexisting conditions, self-administered insulin wasn’t enough to stabilize her health. When she was finally seen by providers toward the end of her second month, Giwa recalled, “her blood sugars were terrible.
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