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Or as my son’s Mother’s Day card to me last year said: Happy Squeezed out of your Vagina Day”

My son in ‘my tummy’ 30 years ago

I laughed out loud when he gave me this card last May and it joined my collection of funny Pelvic Health cards on the wall in my treatment room at work. But laughing out loud isn’t always your reaction when you first countenance the sometimes profound changes that childbirth does to your nether regions.

The ‘squeezed’ bit is definitely the operative word. Sometimes that squeeze bit can end badly for the woman – with her life changed forever. The cost of rehabilitating your bladder, your bowel, your pelvic floor muscles, your abdominal muscles, your nerves that feed to this area, your mental health, your self esteem, your sex life and therefore your relationship post-partum can be profound. The cost is measured in dollars (sometimes thousands over a woman’s lifetime), but also in their very sense of who they are, their sense of self. Women who have had a traumatic birth experience speak at times about their previous life pre-children, like they are a completely different woman to who they are now.

As you know in my last blog, I wrote about this pelvic floor dysfunction (crisis) as an open letter to BUPA (a private health fund) to try and advocate for women getting a refund of any sorts for the purchase of a pessary. Remember the pessary costs $60 to $95. A repair operation for prolapse costs in the order of $5000 plus. You would think that the Maths would be a no-brainer. But no, apparently not.

I finally got a reply to my email to BUPA (with the last blog embedded within it) and unfortunately there wasn’t a lot of understanding about the severity of the plight of women with prolapse from the representative tasked with the job of assessing whether a pessary could be added to the list of health aids for BUPA to rebate on.

I have copied the email in part as I was recently asked not to mention any names in my blog. I have used initials and taken phone contact details as I was asked by BUPA to do so. 

THe BUPA reply email follows (I have bolded some relevant sections): 

Dear Sue,

Thank you for contacting us in relation to your recent experiences which are indeed regrettable and we offer our sincere apologies for any upset and distress caused. We are very aware that specialists (her word) such as yourself offer complex and specialised treatment, including where the patient has been referred for treatment. These services are extremely important and valued by our customers and therefore by us.

Bupa’s Members First Network is an offering Bupa has in place for services provided by a physiotherapist and relates to providing our customers with certainty around gap payments for these services. Additional information regarding Members First can be found at https://www.bupa.com.au/health-insurance/members-first. Please note, we have information for our Frontline people readily available to this effect, which in addition includes instruction not to discuss treatment and benefits paid under Bupa’s Members First Network where treatment is provided by a physiotherapist specialist, and it is disturbing and frustrating for us where this is not heeded. We would welcome the opportunity to be able to follow up with our people and customers involved to correct any misinformation or misunderstanding and help to ensure that this does not reoccur. To allow us to do this, we would need details of the patient/customer involved so we can trace their contact points within Bupa.

As a Private Health Insurer in Australia, Bupa continues to provide benefits for services as defined under the Private Health Insurance Act. We know that our customer’s needs are broad. Bupa offers a range of healthcare products costed in accordance with the features and returns offered on each product. A number of Health Aids and Appliances services are included within some of these Products. We currently do not pay a benefit for Pessary devices as they do not currently fall within Bupa’s list of approved Health Aids and Appliances.

The decision to include new services and devices amongst those that Bupa funds, is based on a number of factors. Apart from customer interest, these factors include clinical appropriateness, financial appropriateness including utilisation and funding costs and the current benefits and services that are already available to our members. In all cases, the introduction of a particular device or service needs to be supported by clinical documented evidence of its effectiveness and appropriateness.  

 As you can no doubt imagine, Bupa receives requests for consideration of funding of new services and devices on a daily basis and a process exists to address this.  

If you would like the funding of pessaries to considered further by Bupa, please address the attached submission criteria and return to us.  It will then be considered by a review panel from across a number of areas of the business at the next meeting, which may be some months away. It is through letters such as yours, in addition to customer surveys, that we are made aware of our customers’ interest in various services.

We therefore appreciate the time you have taken to provide us with this feedback which is valuable to us.

Kind Regards,

MP, Information Officer Provider Management, HealthCare Management
Bupa, 33 Exhibition Street Melbourne VIC 3000
 E provopsancillary@bupa.com.au W bupa.com.au

As you can see MP has originally asked for patient’s experiences and I had asked you for help in supplying information. But I have since been contacted by BUPA and asked to say they no longer need any stories and they will continue to look at this situation but it will take quite a while.

Now getting a refund of $60-$90 or part there of is not going to get you a trip to Italy (if we were actually allowed to go there). It won’t even buy you much of a dinner out, but I find it a sexist and discriminatory decision on the part of any Health Fund who doesn’t refund a woman for a pessary (which is merely a fancy word for a device which behaves like a splint for your vagina) and therefore I would like us all to put aside some time to write to Melanie about this issue.

“To allow us to do this, we would need details of the patient/customer involved so we can trace their contact points within Bupa.”

Further to the work MP originally wanted me to do was to try and find the patients who told my secretaries the stories about BUPA’s employees defaming me and my practice and give her their names so she can track down the call centre or shop employees and tell them the correct words to use about physiotherapists (or dentists or podiatrists) who won’t join BUPA’s Members First ‘scheme’.

This is a difficult task for me as my secretaries at the time were too shocked by the patients’ words to respond by writing down their name and contact details in a book to pass onto MP – but we have a book now and any future patients will be recorded in there- with their permission of course. So if you are reading this blog and you are one of those patients and you would like to help me (and MP) then please email me and let me know. 

Finally, to all women who read my blog – I wish you a special reflective day where women are honoured generally. While Mother’s Day is a special day, especially because women sacrifice so much of themselves to be a mother. Sadly there are also many women who have had pregnancies and babies and lost those babies for different reasons – and for them Mother’s Day can be absolutely torturous, due to those painful memories. And there are also those who have tried many times to fall pregnant and were not able to do so. For all women, I send you love, compassion and knowledge that the world is so much better for the women in it.

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