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GRIEVING PARENTS PROTEST `DRIVE-THROUGH DELIVERIES'

Michelle Bauman says her infant daughter's death shows what could be prevented by a bill requiring insurers to cover hospital stays of at least 48 hours for mothers and their newborns.

"Had she remained in the hospital an additional 24 hours, her symptoms would have surfaced, and professional trained staff would have taken the proper steps so that we could have planned a christening instead of a funeral," Bauman told lawmakers this week.The baby was born May 16 with streptococcus, a "common and treatable condition," her mother said. Mother and baby were discharged 28 hours after the birth.

"Her death certificate listed the cause of death as meningitis when it should have read `death by the system,' " Bauman said.

The Senate Labor and Human Resources Committee was considering a measure requiring minimum maternity stays sponsored by its chairwoman, Sen. Nancy Kassebaum, R-Kan., and Sen. Bill Bradley, D-N.J.

The bill would require insurers to cover at least a 48-hour stay for mothers and infants after normal births, and 96 hours after Caesarean births. The measure allows shorter hospital stays if neither the mother nor doctor objects, and follow-up home care is provided for mother and infant.

Proponents say cost pressures are forcing hospital discharges after 24 hours, before many health problems such as dehydration, infections and jaundice can be detected.

Among the groups supporting the bill are the American Medical Association, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.

"Drive-through deliveries and the policies that enforce them are more than a heartless way for insurance companies to cut costs," Bradley told the committee. "They are also a serious gamble on the health and well-being of the mother."

In addition to Bauman's description of her daughter Michelina's death after two days in her Williamstown, N.J., home, other parents tearfully and angrily recounted their own ordeals.

"For us, this is an ethical issue, not a cost issue," said Karen L. Davies, a Lawrence, Kan., woman whose daughter, Maria, survived a severe jaundice scare. "What price can we put on a newborn's health?"

Opponents countered that Congress should not follow the lead of New Jersey and Maryland, which have enacted state laws similar to the Senate bill.

They said that insurers do pay for longer stays when needed, but that lawmakers should not set one standard when no evidence exists that one measure is best for all.

"It is important to examine the science on the subject, not just anecdotes," said Dr. Sharon Levine, associate medical director of the Permanente Medical Group Inc. in Oakland, Calif. "Use of legislative mandates to establish the content of medical practice sets a worrisome precedent.

"Focusing on length of hospital stays for infants and their mothers is too narrow," Levine said. "The focus must be on assuring that mothers and children have access to appropriate care throughout the pregnancy and after delivery."