After giving birth to her first child, Clancy Smith was left in chronic pain.
The Sydney mum experienced a common post-partum side effect – her stomach muscles separated. Only in Clancy’s case, the muscles didn’t rejoin.
Clancy told Mamamia that after her second child, the separation had become so bad she could fit four fingers between her lower abs.
“The first one did most of the damage and the second one just helped it along,” she said. “It was pretty intense. I had a hernia coming through because there was such a gap.”
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The result of the 35-year-old’s condition, medically known as diastasis recti, was that she suffered “excruciating” chronic back pain, as well as problems with incontinence.
“I had a lot of lower back pain, because there was no support. You use your core for everything and I had absolutely no support.”
“It really messes with you physically and emotionally.”
Clancy, who described herself as a “very active” person, said she tried “everything” to regain the proper use of her ab muscles and ease her back pain.
“I tried Pilates, normal gym work, any other classes. I was strong everywhere else, but still had that lower back pain and that weak core. No matter what I did, nothing strengthened it.”
“I knew myself that something had to be done, I couldn’t function. It was just becoming too much.”
So Clancy turned to her doctor, who advised she undergo an abdominoplasty – aka a tummy tuck – to essentially sew the muscles back together.
In 2015, when her son Hudson was three, she underwent the procedure. She said the difference was “remarkable”.
“It was really noticeable. It probably took me six months to get full function in my abs again, but since then I’ve had no issues. I haven’t had the back pain since.”
“It’s amazing how much a difference the core makes.”
For Clancy and her family, the out-of-pocket was about $10,000, with Medicare covering the remainder. Clancy said it was a significant amount to pay, but something she saw as an investment in her health and quality of life.
However, she was disappointed to learn the already expensive procedure that helped her so much was now out of reach for most women.
Tummy tucks are no longer covered by Medicare
In 2016, the Department of Health removed post-pregnancy abdominoplasty from the Medicare schedule after concluding the procedure had no benefit beyond “cosmetic” purposes. Now, any woman seeking a tummy tuck, whether it’s to change the shape of their stomach – or in Clancy’s case, to treat chronic pain – faces paying up to $20,000 for the procedure.
A spokesperson for the Department of Health told Mamamia the group responsible for making the call on what is covered by Medicare and what isn’t, is the Medical Services Advisory Committee.
“On the evidence before it, the committee found that the benefits of abdominoplasty following pregnancy were largely cosmetic as diastasis recti had no significant health consequences,” they said.
Clancy’s experience suggests completely the opposite. She said her situation – including not being able to carry her baby for longer than 20 minutes – left her feeling miserable, agitated and depressed.
A recent Australian study backs up Clancy’s experience and has prompted renewed calls for abdominoplasty to be put back on the Medicare schedule.
The study, published in US journal, Plastic And Reconstructive Surgery, looked at 214 women before and after undergoing an abdominoplasty. It showed rates of incontinence and back pain dropped significantly within the group six months after the procedure.
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The results have prompted the Australian Society of Plastic Surgeons to call for the MSAC to review its decision to keep postpartum tummy tucks from being tax-payer funded.
“The Australian Society of Plastic Surgeons hopes this new evidence will persuade the Government to review its decision removing the Medicare item number for this operation for postpartum women, a decision which has made the procedure unaffordable for a large number of women living with chronic pain and incontinence,” ASPS president Professor Mark Ashton said.
“Women should not be unfairly penalised for giving birth.
“There are many operations performed for relief of chronic pain and instability incurred by sports injuries that are reimbursed by Medicare. Abdominoplasty should be considered in a similar light in that it is a procedure that fixes an instability and addresses pain and function issues.”
The Department of Health spokesperson said the Federal Government encouraged the ASPS or any other medical body to request MSAC to reconsider its recommendation.
Meanwhile, the Australian Medical Association supported any changes to Medicare only as long as they were based on evidence.
“We’ve really got to make sure we get the most out of each dollar and we’ve really got to prioritise clinical care outcomes rather than anything else. And that’s what Medicare is there for,” AMA vice president Dr Tony Bartone told Mamamia.
As far as Clancy is concerned, the evidence that abdominoplasty is more than just a “cosmetic” procedure is in the way she can now run around with her children pain-free.
“The cosmetic I can live with, that’s a fact of life. For me, that’s baby scars and I’m proud of the scars and I’m happy to have them. That just shows how strong my body is. But to not be able to have the use of my stomach muscles. That’s not okay. That needed to be fixed,” she said.
“It’s tough enough as a new mother, without this on top of it. We need all the help we can get.”
Do you think tummy tucks should be covered by Medicare? Tell us in the comments below.