Prenatal Care

While 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”).
“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.
“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”. (Stout 171) This seems to be a case of pure lack of concern but in some instances it could be possible that non-educated young mothers may not fully understand the hazard smoking presents to their unborn child. There are a few general things most doctors or prenatal care provider will stress in their education to their patients. Proper intake of folic acid, regular physical activity, specific immunizations and overall healthy lifestyle are essential for the mothers and baby’s sake. (“Preconception Care”). A mother supporting her child should be just as concerned with taking in the premiums as they are avoiding the hazards. Pregnant women who gain less than 22lbs are more susceptible to having a low weight baby and an estimated 15%-33% fit into this category (Stout 171). Studies have shown the additional weight however, can sometimes lead to insecurities in women concerning their bodies. In a study done in the United Kingdom for example, up to 80% of pregnant women may have attempted to limit their caloric in take. (Derbyshire 43). However, given the choice between proper weight gain and inadequate nutrition for a newborn child should not be a difficult one provided they are equipped with this information. Pregnant women who received information on vitamins, weight gain, and things to avoid showed a significant difference in number of low weight births.(Stout 172). Prenatal care habits may have a strong effect on a baby’s health that is considered to be of a low gestational age. “The gestational age is defined as the period of time between conception and birth during which the fetus grows and develops inside the mother 's womb.” (“Medical Encyclopedia). In a study involving observation of multiple statistical variables, infants born 24-35 weeks gestation to mothers without prenatal care were 20% more likely to have their child die with in the first month than a mother/child who took part in proper prenatal care. (Rosenburg 270). When improving medical care in general it is fundamental that education in that area must be improved as well. Prenatal care is a necessary step and the lack of it is an obvious dilemma. Preventing future medical problems is a plus for both citizen and country and both financially and psychologically. Access to the same level of prenatal care, medications or facilities for everyone is not yet a plausible feat in the United States, but education in this area can help close the gap significantly.

Works Cited
"Cost and Benefit Analysis of Improved Prenatal Care." 19 (2005): 18. Academic Search Premier. EBSCO. Cook Library, Towson. 13 Mar. 2008.
Derbyshire, Emma. "Low Maternal Weight: Effects on Maternal and Infant Health During Pregnancy." Nursing Standard 22 (2007): 43-46. Academic Search Premier. EBSCO. Cook Library, Towson. 11 Mar. 2008. Keyword: Prenatal Care.
McQuide, Pamela A., Thérèse Delvaux, and Pierre Buekens. "Prenatal Care Incentives in Europe." Journal of Public Health Policy 19 (1998): 331-339. JSTOR. Cook Library, Towson. 13 Mar. 2008. Keyword: Prenatal care.
"Medical Encyclopedia." MedlinePlus. 20 Feb. 08. U.S. National Library of Medicine. 21 Mar. 2008 <http://www.nlm.nih.gov/medlineplus/ency/article/002367.htm>.
"Preconception Care." 25 May 2007. National Institute of Child Health and Human Developtment. 22 Mar. 2008 <http://www.nichd.nih.gov/health/topics/preconception_care.cfm>.
Reid, Jacquelyn. "Centering Pregnancy: a Model for Group Prenatal Care." Nursing for Women\_Health 11 (2007): 382-388. Health Source: Nursing/Academic Edition. EBSCO. Cook Library, Towson. 7 Mar. 2008.
Rosenburg, J. "Neonatal Death Risk: Effect of Prenatal Care is Most Evident After Term Birth." Perspectives on Sexual and Reproductive Health 34 (2002): 270. JSTOR. Cook Library, Towson. 11 Mar. 2008. Keyword: Prenatal.
Stout, Anne E. "Prenatal Care for Low-Income Women and the Health Belief Model: a New Beginning." Journal of Community Health Nursing 14 (1997): 169-180. JSTOR. Cook Library, Towson. 14 Mar. 2008. Keyword: Prenatal.
Prenatal Care in the United States
Mike Rothery
March 25, 2008

Cited: "Cost and Benefit Analysis of Improved Prenatal Care." 19 (2005): 18. Academic Search Premier. EBSCO. Cook Library, Towson. 13 Mar. 2008. Derbyshire, Emma McQuide, Pamela A., Thérèse Delvaux, and Pierre Buekens. "Prenatal Care Incentives in Europe." Journal of Public Health Policy 19 (1998): 331-339. JSTOR. Cook Library, Towson. 13 Mar. 2008. Keyword: Prenatal care. "Medical Encyclopedia." MedlinePlus "Preconception Care." 25 May 2007. National Institute of Child Health and Human Developtment. 22 Mar. 2008 <http://www.nichd.nih.gov/health/topics/preconception_care.cfm>. Reid, Jacquelyn Rosenburg, J. "Neonatal Death Risk: Effect of Prenatal Care is Most Evident After Term Birth." Perspectives on Sexual and Reproductive Health 34 (2002): 270. JSTOR. Cook Library, Towson. 11 Mar. 2008. Keyword: Prenatal. Stout, Anne E March 25, 2008