Mums criticise health insurers for denying birth claims

Before she became a mother, Katrina Middler was an avid gym-goer who would happily lift weights and practise yoga at least four times a week.

But ever since the birth of her first son Leo in August 2017, even the most basic exercise can leave her in agony.

Like almost half of women who give birth, Katrina, 33, suffered a pelvic organ prolapse in labour — making lifting and running around all day after her young children almost impossible.

Despite the prevalence — and seriousness — of the condition, Katrina’s health insurer Aviva refused to cover the cost of physiotherapy. Instead, she is forced to pay out of her own pocket after NHS waiting lists proved too long for her to bear.

In recent weeks, dozens of mothers have also complained about what they see as an unfair penalty for giving birth.

One mother claims that when she challenged the policy with her insurer — also Aviva — she was told by a member of staff it was ‘her choice’ to get pregnant which is why the condition wasn’t covered.

And yet Aviva was happy to pay the fees for her husband’s physiotherapy after he suffered a football injury. 

Aviva says it was wrong of their staff member to imply the reason for birth-related exemptions was due to pregnancy being a lifestyle choice, and it has since apologised to the mother and reversed the decision to deny her cover.

The firm says insurers have never covered birth injuries such as stress incontinence and pelvic floor prolapse, which was ‘consistent with other providers across the industry’.

Provider The Exeter agrees that pregnancy and childbirth have been ‘standard exclusions on health insurance for many years’ — but says support is considered on a ‘case-by-case’ basis.

Vitality also says that private medical insurance policies ‘do not generally include cover for treatment related to maternity and childbirth’. 

But spokesmen for both Axa Health and Bupa insist they do offer cover for women suffering from birth injuries. Mothers online note they have had a positive experience with Axa in particular.

For Katrina, who signed up to the private health insurance through work, it’s frustrating that women even have to fight for support when she believes it should be standard practice. 

‘It’s absolutely ridiculous that sporting injuries are covered by insurers but injuries from childbirth are not,’ says the mother of two from Wiltshire, who works for a bank.

‘Yes, it was my choice to get pregnant but it would also be my choice if I went out on my bike and fell off it. What do they want? For women not to get pregnant?’

According to the campaigning body PelvicRoar, one in three women will experience some form of incontinence in the first three months after giving birth.

Some 45 per cent will suffer a pelvic organ prolapse which causes the muscles and the tissues supporting the pelvic organs to become weak or loose. 

The NHS website states that symptoms of a prolapse include: ‘dragging discomfort’ and problems with incontinence.

Yet many mothers suffer in silence, believing there is no support available to them. Katrina was told she could only have surgery to fix the prolapse once she had decided to stop having children.

After giving birth to her second son Walter in 2020, the pain only worsened and she attempted to seek help again. She was referred for physiotherapy on the NHS but she was put on a huge waiting list with no hope of seeing somebody in the next few months.

When she sought out physiotherapy privately for £70 a session, she describes the impact as ‘massive’.

She says: ‘I still have some problems obviously but before I started physiotherapy I felt like I was living with a disability nobody could see. Now I am able to do some specialised workouts with light weights and bands.

‘It’s sad because I just thought it was something I had to live with. I didn’t realise there were options out there for me.’

The debate echoes one that unfolded in Denmark this year. Local media outlets began reporting on how insurance providers were routinely denying coverage for physical therapy to pregnant women. 

The Danish financial watchdog ruled that the providers had discriminated against pregnant women and ordered a police probe. The mothers affected are being compensated.

In the wake of the outrage in the UK, Aviva says it is reviewing its policy on birth injuries. 

A spokesman says pregnancy and childbirth is currently an exclusion on ‘most Aviva policies’ but that some do include a ‘specific list of conditions’ relating to childbirth and pregnancy but this does not include incontinence.

As for Katrina’s case, Aviva says her insurance is funded under a private medical trust arrangement with her employer, which rules out cover for anything relating to childbirth or pregnancy. 

Vitality also says it is reviewing its cover ‘to determine how we can best support our members both during and after pregnancy’.

Pelvic physiotherapist and co-founder of PelvicRoar Elaine Miller says: ‘To cover a man’s sports injury but refuse a woman’s stress incontinence seems like discrimination on the basis of sex and maternity, both of which are protected characteristics [in discrimination law].

An analysis of NHS hospital data by the London School of Hygiene and Tropical Medicine showed a three-fold increase in the childbirth-related pelvic injuries since 2000.

Complaints about maternal units have only worsened during the pandemic, with midwives complaining there is not enough staff to operate a safe service.

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