Need postpartum abdominal repair surgery? Medicare will have you covered

For those women who suffer negative physical consequences of childbirth, there may be a light at the end of a very painful tunnel. The Medical Services Advisory Committee (MSAC) has now recommended that postpartum abdominal repair surgery should once again be covered by Medicare.

Many women suffer from post pregnancy abdominal separation or ‘diastasis recti’. This occurs in pregnant women when the two long stomach muscles separate due to the pressure of the growing baby and hormonal changes. It usually occurs in the second half of the pregnancy and is more commonly seen in women over 35, those who’ve had more than one child, or who are carrying twins, triplets or more.

For some women, the muscles can slowly come back together, but for many they do not, causing on-going problems such as back pain. For some women the only option is surgery, an expensive process called abdominoplasty surgery, where the abdominal muscles are sewn back together.

Purely cosmetic?

Up until five years ago, this process was covered by Medicare. However in 2016, it was removed from the Medicare Benefit Scheme (MBS). There were concerns that it was being used for cosmetic purposes rather than legitimate medical ones.

“Because this procedure has been commonly described as a ‘tummy tuck’ many people assume that it is always purely a cosmetic procedure and find it difficult to believe it might be for a legitimate functional reason,” says Dr Dan Kennedy, President of Australian Society of Plastic Surgeons (ASPS) in a recent press release. “However for those women who need it, this is medically-necessary reconstructive surgery that restores functionality to women, and allows them to resume normal physical activities such as picking up their children or playing sport without pain.”

According the Dr Kennedy, the ASPS estimates approximately 3500 Australian women each year suffer moderate to extreme abdominal separation and back pain. However only a quarter of those would want surgery, equating to less than $440,000 of taxpayers money per year.

A successful campaign

Last year, mother of twins, Kerrie Edwards started a petition to fight the decision, achieving 13000 signatures. It was presented to Parliament by Dr Fiona Martin, Member for Reid, who also felt strongly that things should change in order to encourage women to continue having children. “We want more Aussie babies to be born because it’s part of the economic recovery but also because we don’t have a huge population anyway so at a time like this we really need to be encouraging mums and supporting mothers,” Dr Martin reported to the Sydney Morning Herald in 2020.

After giving birth to her twin daughters, Kerrie said that she had done everything  she possibly could for her abdominal separation in terms of exercise and physiotherapy. Four years later, she was still suffering and needed surgery but was quoted the vast sum of $20,000 for the procedure.

Good news at last

The petition and the strong campaigning helped to convince to MSAC to recommend reinstating the Medicare rebate for abdominoplasty surgery. “We welcome this decision by MSAC and urge the Government to support it,” says Dr Kennedy. “Accessing this procedure will benefit those mothers who have suffered with symptoms such as chronic back pain and incontinence, resulting in a severely compromised quality of life.”

This change will not come into effect until 2022 and women will have to meet set criteria to show that the procedure is medically necessary and other non-surgical options have been tried.

However, for many women, this is still great news indeed. “I am delighted with this decision,” commented Kerrie. “This will make an enormous difference to so many women who currently cannot lift their children without pain, cannot participate in sport or exercise, or who are finding it difficult to return to the workforce.”