Prenatal care : reaching mothers, reaching infants / Sarah S. Brown, editor ; Committee to Study Outreach for Prenatal Care, Division of Health Promotion and Diseases Prevention, Institute of Medicine.

Format:

Book

Contributor:

Brown, Sarah S.

Institute of Medicine (U.S.). Committee to Study Outreach for Prenatal Care.

Language:

English

Subjects (All):

Prenatal care.

Women's health services.

Physical Description:

1 online resource (264 pages)

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1988.

Language Note:

English

Summary:

Prenatal care programs have proven effective in improving birth outcomes and preventing low birthweight. Yet over one-fourth of all pregnant women in the United States do not begin prenatal care in the first 3 months of pregnancy, and for some groups--such as black teenagers--participation in prenatal care is declining. To find out why, the authors studied 30 prenatal care programs and analyzed surveys of mothers who did not seek prenatal care. This new book reports their findings and offers specific recommendations for improving the nation's maternity system and increasing the use of prenatal care programs.

Contents:

Prenatal Care

Copyright

Acknowledgments

Contents

Summary

STUDY FOCUS

DEMOGRAPHIC RISK FACTORS

Minority Status

Age

Education

Birth order

Marital status

Income

Geographic location

BARRIERS TO THE USE OF PRENATAL CARE

Financial Barriers

Inadequate System Capacity

Organization, Practices, and Atmosphere of Prenatal Services

Cultural and Personal Barriers

BARRIERS TO CARE: WOMEN'S AND PROVIDERS' PERSPECTIVES

MULTIVARIATE ANALYSIS

IMPROVING THE USE OF PRENATAL CARE: PROGRAM EXPERIENCE

Program Implementation and Evaluation

CONCLUSIONS AND RECOMMENDATIONS

SPECIFIC RECOMMENDATIONS

Introduction

STUDY METHOD

ORGANIZATION OF THE REPORT

THE VALUE OF PRENATAL CARE: AN UNDERLYING ASSUMPTION

REFERENCES AND NOTES

Chapter 1 Who Obtains Insufficient Prenatal Care?

TERMINOLOGY AND MEASURES

CURRENT PATTERNS OF USE

Racial and Ethnic Subgroups

Birth Order

Marital Status

RELATIONSHIPS AMONG DEMOGRAPHIC RISK FACTORS

GEOGRAPHIC POCKETS OF NEED

TRENDS IN THE USE OF PRENATAL CARE

SUMMARY

Chapter 2 Barriers to the Use of Prenatal Care

FINANCIAL BARRIERS

Private Insurance

Eligibility for Coverage

Scope and Depth of Coverage

Patient Cost-Sharing

Medicaid

Uninsured Women

INADEQUATE SYSTEM CAPACITY

Services in Organized Settings

Maternity Care Providers

Malpractice

ORGANIZATION, PRACTICES, AND ATMOSPHERE OF PRENATAL SERVICES

Links Among Services

Medicaid Application Procedures

Classic Barriers to Access

CULTURAL AND PERSONAL BARRIERS

Chapter 3 Women's Perceptions of Barriers to Care

SELECTION AND SYNTHESIS OF STUDIES

Studies of Women with Insufficient Prenatal Care.

Studies of Women with No Prenatal Care

Studies of Adolescents

Limitations

PROVIDER PERSPECTIVES

REFERENCES

Chapter 4 Improving the Use of Prenatal Care: Program Experience

SELECTION AND CLASSIFICATION OF PROGRAMS

THE PROGRAMS STUDIED

Programs That Reduce Financial Barriers

Programs That Increase System Capacity

Programs That Improve Institutional Practices

Programs That Conduct Casefinding

Programs That Provide Social Support

OBSERVATIONS ON PROGRAM EFFECTIVENESS

PROGRAM DESIGN AND MANAGEMENT

COMMON DIFFICULTIES IN PROGRAM IMPLEMENTATION AND MAINTENANCE

Finding Financial and Community Support

Recruiting and Keeping Personnel

Dealing with Bureaucracies

Planning and Sustaining Programs

Other Problems

PROGRAM EVALUATION

Chapter 5 Conclusions and Recommendations

REVISING THE NATION'S MATERNITY CARE SYSTEM: A LONG-TERM GOAL

DEVELOPING A COMPREHENSIVE, MULTIFACTED PROGRAM: A SHORT-TERM GOAL

INSTITUTIONAL ORGANIZATION, PRACTICES, AND ATMOSPHERE

PUBLIC INFORMATION AND EDUCATION

THE ROLE OF OUTREACH: A GENERAL FRAMEWORK

CASEFINDING

SOCIAL SUPPORT

MANAGEMENT AND EVALUATION

RESEARCH

A NOTE TO FUNDERS

Appendix A Summaries of the 31 Programs Studied

TYPE 1: PROGRAMS TO REDUCE FINANCIAL BARRIERS

Healthy Start Program-Massachusetts

Prenatal-Postpartum Care Program-Michigan

TYPE 2: PROGRAMS TO INCREASE SYSTEM CAPACITY

Obstetrical Access Pilot Project-California

Perinatal Program-Lea County, New Mexico

Prenatal Care Assistance Program-New York State

Prevention of Low Birthweight Program-Onondaga County, New York

TYPE 3: PROGRAMS TO IMPROVE INSTITUTIONAL PRACTICES.

Maternity and Infant Care Projects-Ohio and North Carolina

Improved Pregnancy Outcome Project-Two Counties in North Carolina

Improved Child Health Project-Two Areas of Mississippi

Child Survival Project, Columbia-Presbyterian Medical Center-New York City

Development of a Perinatal System in Shelby County, Tennessee

TYPE 4: PROGRAMS THAT CONDUCT CASEFINDING

Central Harlem Outreach Program-New York City

Community Health Advocacy Program-New York City

The Better Babies Project-Washington, D.C.

The Maternity and Infant Outreach Project-Hartford, Connecticut

Pregnancy Healthline-New York City

The 961-BABY Telephone Information and Referral Service-Detroit, Michigan

Concern for Health Options: Information, Care and Education (CHOICE)-Philadelphia, Pennsylvania

The Free Pregnancy Testing and Prenatal Care Advocate Program-Tulsa, Oklahoma

The Special Supplemental Food Program for Women, Infants, and Children (WIC)-Six Studies

Baby Showers-Seven Counties in Michigan

TYPE 5: PROGRAMS THAT PROVIDE SOCIAL SUPPORT

Resource Mothers-Three Counties in South Carolina

Comprehensive Service Programs for Pregnant Adolescents-A Summary of Six Programs

Improving Institutional Arrangements

Casefinding

Social Support

Evaluation

The Prenatal and Infancy Home Visiting Program-Elmira, New York

The Grannies Program-Bibb County, Georgia

Appendix B Prenatal Care Outreach: An International Perspective

STUDY COUNTRIES

ADEQUACY OF DATA

CHARACTERISTICS OF STUDY COUNTRIES

Demographics

Teenage Childbearing

Household Income

National Finances

Health Care Financing and Delivery

MATERNITY-RELATED SERVICES

Public Clinics

Number of Prenatal Visits

Home Visiting

Incentives to Participate in Prenatal Care

Home Deliveries

Hospital Deliveries.

Continuity of Care

MATERNITY-RELATED BENEFITS

CONCLUSIONS

Appendix C The Medical Malpractice Crisis and Poor Women

CAUSES OF THE INCREASE IN MALPRACTICE INSURANCE COSTS

Medical Advances and the Demise of the Locality Rule

Large Awards

Substandard Physicians

Contingency Fees

Insurance Companies

Underfinancing of Maternity Care

RESPONSE BY PROVIDERS OF OBSTETRICAL CARE

Cessation of Obstetrical Practice

Impact on Providers of Maternity Care to the Poor

Rejection of High-Risk Women

Rejection of Underfinanced Women

STATE RESPONSES

CONCLUSION AND RECOMMENDATIONS

Index.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographies and index.

ISBN:

9786610214679

9781280214677

1280214678

9780309542890

0309542898

9780585142869

0585142866

OCLC:

427404665