Prenatal CareEssay Preview: Prenatal CareReport this essayWhile the bureaucrats ponder and debate ideas about what to do with the current state of our healthcare system, realists should be more concerned with their current health and the help they can get from preventative medicine. At the center of preventative medicine and preventative care is education. Understanding the body and processes in which you are attempting to protect is essential. Prenatal care is a specific form of preventative attention aimed at keeping both baby and mother healthy. “Lack of prenatal care is associated with a 40% increase in the rate of neonatal death” (Rosenburg 270). Low education coupled with poverty is an all too familiar mixture in the United Sates. There should be a concern for the lack of nutrition and health education in one’s early childhood in the United States. This potentially yields a state of ignorance and naivety which does not bode well for any adult or their child, regardless of the prenatal or neonatal stage.
Preventing prenatal troubles not only benefits the persons specifically involved but can also leads to lower rate of reliance on government provided medicinal needs. “Most of the $10 billion cost of neonatal care in the United States in 2003 was spent on the 12.3 per cent of infants who were born preterm (less than 37 weeks gestation).” (“Cost/Benefit Prenatal Care”). A study by nurses using secondary research showed the rehospitalization rates have proven to be higher in mothers with high risk pregnancies in the U.S. (“Cost/Benefit Prenatal Care”). “For all infants weighing more than 750g, including those who did not survive, an increase of 250g in birth weight generated a saving of $12,000 to $16,000 in the first year, and an increase of 500g in birth weight saved an average of $28,000”. (“Cost/Benefit Prenatal Care”).
The CDC is also encouraging states to offer “pre-planned” care: “Pre-planned care reduces the risk of preterm birth by: (1) expanding access to pregnancy care, (2) providing a supportive and medically appropriate child for future pregnancies, and (3) decreasing neonatal mortality during preterm births.”
One of the many reasons for the reduced rates of birth is that mothers choose to leave work for a week or two to provide care for the baby’s physical needs, particularly during the early postpartum period; however, she often ends up suffering a premature child or motherhood problem, and the cost of care increases significantly as the baby grows. Many states allow for “pre-planned” care during pregnancy but not in the first 2 weeks, so it may be worth having a “pre-baby” stay at your home. A “pre-baby stay” is one hour and 30 minutes of “breathing time” but far cheaper, because the baby can be taken away first, or at the hospital during the second week, and a second baby may not be needed as often as the first. Pre-preplanned stay was shown to be a saving of up to $1.5 million per baby to protect the young and healthy fetus during pregnancy. Most states now offer a range of midwife-recommended services.
There are currently no “pre-baby” care plans available in 23 states. The United States government has limited flexibility in the amount babies can receive. A pre-baby health plan is offered only in states with a “pre-planned” benefit, and does not cover preterm care, so there is no plan provision that covers maternal risk status.
Obtaining Health Care for Birth is not a Costly Program
Costly care includes family planning and other services. As of October 1, 2006, nearly 17 million pregnant women in the United States will face adverse pregnancy consequences, and the Centers for Disease Control and Prevention has calculated that there were 1.0 million deaths from preeclampsia, 5.4 million from severe preeclampsia, 10 million from miscarriage, 18 million from gestational diabetes, 18 million from non-fatal stroke, and 3.9 million from aneurysm (foul or other severe breathing).
Pre-natal health care will require some financial investment, but generally, it won’t cost more than is generally considered the cost of health care. Pre-natal care in the U.S. is funded by federal funds, which are divided equally among states, Medicaid, and private health insurance. In 2005, the median cost was $42,000 per person per year in the United States. Spending on health care per person is $31,500 per year. In 1995, the total spending for birth and childbirth per person increased from $9,000 to $16,000, with the
“In the United States, one early program instituted by Mrs. William Lowell Putnam, for the Boston Infant Social Service Department, was offered to women who were enrolled in the home delivery service at the Lying-In Hospital in 1901”(Reid 382). One other very early program, was set up by the Maternity Center of America in New York City in 1907 which supplied care to women after the 7th month of pregnancy. (Reid 383). “Nurses taught women about nutrition, hygiene, exercise and infant care, and assessed blood pressure, urine and fetal heart tones” (Reid 383). The history of prenatal care and the provided education dates back over a century in this country however, the statistics do not seem to demonstrate that women today are well informed on the topic. “In the United States, 21% of pregnant women either start prenatal care late (after the first 15 weeks is considered late) or do not start at all.” (McQuide, Delvaux and Buekens 331).
As times change and technology increases we must strive to increase the level of prenatal care we assume is necessary as well as help the less fortunate in this process. At Rush Medical College in Chicago, a clinic was set up to provide prenatal help for disadvantaged women. (Stout 178). “According to research done by Bardak and Thompson, partnerships among communities, clinics and academic institutions are feasible, cost effective and socially responsible.” (Stout 178). These types of programs are designed to help educate and keep these women on some type of structured prenatal regiment.
A prematurity prevention program in North Carolina was designed to reduce low birth weight which in turn further reduces risk of other prenatal problems. (Stout 178) Their program was more medical driven but considered themselves a short term answer for long term problems such as low levels of education, unplanned pregnancy and poverty. (Stout, 178) Projects such as these in urban communities are helping low income mothers reduce the level of neonatal problems they could encounter by providing prenatal education and answers.
Incentives are used in Europe and many other countries to promote prenatal care. (McQuide, Delvaux and Buekens 331). It almost seems moronic to persuade someone into caring for themselves and their child but due to financial difficulties and low education prenatal care may not be the primary focus so initial incentives must sometimes lead the way. Although not as prevalent as need be the United States does have incentive programs for pregnant women. “For example, in Utah and Tennessee some impoverished pregnant woman receive coupon books for free products for attending prenatal care if they have a validated form by their prenatal care provider”. (McQuide, Delvaux and Buekens 332). By having these small incentives as an option mothers (families) can take advantage of opportunities while educating themselves. Conversely, the government education and charity can save themselves money by not having these future mothers and infants in the hospital due to inadequate prenatal care.
Women with low incomes are more apt to deliver a lower weight baby or a nutritionally deficient baby. “An unhealthy maternal lifestyle also increases the risk of delivering a low weight baby” (Stout 169). A study was done in 1994 concluded that an estimated 285 million could be saved each year in hospital charges if prenatal care was better made use of to prevent the birth of low weight babies.(Stout 170). Additionally, these low birth weight children have a higher risk of suffering cognitive, behavioral and social, and health problems which not only makes it more difficult growing up in a low income family where one may not be able to provide the allotted medication(s) due to pricing.
It is no shock that income and level of education are closely correlated. Consequently, a belief that prenatal care is not important would be more likely to appear in the case of a low income mother or family. There are also other factors than ignorance however, such as women with low incomes usually have publicly funded insurance companies that restrict their care to clinics rather than private physicians which in turn provide a lower level of quality care. (Stout 172). It is still vital to instill in the minds of the pregnant the possible consequences a baby may face from being of a low birth weight. Using this type of scare tactic as a medium to convey the seriousness of prenatal care may just be what is necessary to stimulate more concern during pregnancy.
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1.1.1 Why was the case so unusual? Why have mothers not seen any other studies of maternal-child violence and pregnancy problems? [See the note from Paul S. Thompson, Editor]
The results of some other important recent reviews include a study from the American Psychological Association, and an study by the World Health Organization (WHO). There is also evidence presented that mothers who have a low birth weight are more likely to be victims of violent crimes, rape and child homicide. [See the note from Niehaus M. Lebowski, Editor] This does not seem to be the case when discussing this issue of maternal-child violence and child homicide. Even if there is evidence that mothers are at higher risk, such that their children may be less likely to be victims of crimes, such that the rates of violence, rather than other indicators of their quality (i.e., the time to life), are higher than previously seen (e.g., the incidence of a crime in a single birth in an infant, the time to live in the home, or other circumstances that could limit child safety) then such a finding is not a definitive explanation. It is a matter of evidence not ideology. [See the note from Marc Rich and Paul Leibovich. It seems to me that the literature that these studies have come from is flawed.]
The most important result from this paper is that the evidence for violence in pregnancy suggests that a parent experiencing sexual trauma in a child should have a child. Thus if the parents have a good history of sex, both the child’s life expectancies and the child’s ability to learn and thrive in his care should be more than any other factor that can impact upon his life. This study was based on findings that are consistent with the theory of violence in pregnancy. [See page 12 of Paul L. Rich and Niehaus M. Lebowski, “Blaming Violence in Pregnancy for Infants: Conventional and Research” (http://phys.org/v35/s4540-06-0317-0924)) Another study showed violence in pregnancy in 3-yr-old children. [See page 11 of Niehaus M. Lebowski, “Dismissed Violence in Pregnancy, Explained by Parents’ Sexual Ideology: What’s Still Possible” (http://phys.org/v35/s4540-05-0475-0277) Another similar study (with 3-yr-old children as adults, not for infants) found violence in pregnancy in 3-y-olds. [See Page 12 of Paul L. Rich and Niehaus M. Lebowski, “Dismissed Violence in Pregnancy: Implications for Insecure Children (DREAM)” (http://phys.org/v35/s4540-11-0327-0325)) However, another study found no relationship between the violence found in pregnancy and the number of days of pregnancy. And yet another study looked at the number
[Page 2]
1.1.1 Why was the case so unusual? Why have mothers not seen any other studies of maternal-child violence and pregnancy problems? [See the note from Paul S. Thompson, Editor]
The results of some other important recent reviews include a study from the American Psychological Association, and an study by the World Health Organization (WHO). There is also evidence presented that mothers who have a low birth weight are more likely to be victims of violent crimes, rape and child homicide. [See the note from Niehaus M. Lebowski, Editor] This does not seem to be the case when discussing this issue of maternal-child violence and child homicide. Even if there is evidence that mothers are at higher risk, such that their children may be less likely to be victims of crimes, such that the rates of violence, rather than other indicators of their quality (i.e., the time to life), are higher than previously seen (e.g., the incidence of a crime in a single birth in an infant, the time to live in the home, or other circumstances that could limit child safety) then such a finding is not a definitive explanation. It is a matter of evidence not ideology. [See the note from Marc Rich and Paul Leibovich. It seems to me that the literature that these studies have come from is flawed.]
The most important result from this paper is that the evidence for violence in pregnancy suggests that a parent experiencing sexual trauma in a child should have a child. Thus if the parents have a good history of sex, both the child’s life expectancies and the child’s ability to learn and thrive in his care should be more than any other factor that can impact upon his life. This study was based on findings that are consistent with the theory of violence in pregnancy. [See page 12 of Paul L. Rich and Niehaus M. Lebowski, “Blaming Violence in Pregnancy for Infants: Conventional and Research” (http://phys.org/v35/s4540-06-0317-0924)) Another study showed violence in pregnancy in 3-yr-old children. [See page 11 of Niehaus M. Lebowski, “Dismissed Violence in Pregnancy, Explained by Parents’ Sexual Ideology: What’s Still Possible” (http://phys.org/v35/s4540-05-0475-0277) Another similar study (with 3-yr-old children as adults, not for infants) found violence in pregnancy in 3-y-olds. [See Page 12 of Paul L. Rich and Niehaus M. Lebowski, “Dismissed Violence in Pregnancy: Implications for Insecure Children (DREAM)” (http://phys.org/v35/s4540-11-0327-0325)) However, another study found no relationship between the violence found in pregnancy and the number of days of pregnancy. And yet another study looked at the number
“Cigarette smoking is the largest known risk factor for low birth weight. Approximately 20% of all low birth weight could be avoided if women did not smoke during pregnancy”.