08161nam 2200625Ia 450 991081222140332120200520144314.01-280-21467-897866102146790-309-54289-80-585-14286-6(CKB)111004366657440(OCoLC)427404665(CaPaEBR)ebrary10062789(SSID)ssj0000226472(PQKBManifestationID)11188085(PQKBTitleCode)TC0000226472(PQKBWorkID)10257910(PQKB)11632512(MiAaPQ)EBC3376934(Au-PeEL)EBL3376934(CaPaEBR)ebr10062789(OCoLC)923267121(EXLCZ)9911100436665744019881212d1988 uy 0engurcn|||||||||txtrdacontentcrdamediacrrdacarrierPrenatal 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 Medicine1st ed.Washington, D.C. National Academy Press19881 online resource (264 pages)Bibliographic Level Mode of Issuance: Monograph0-309-03892-8 Includes bibliographies and index.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 FOCUS -- 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 -- Age -- Education -- Birth Order -- Marital Status -- Income -- RELATIONSHIPS AMONG DEMOGRAPHIC RISK FACTORS -- GEOGRAPHIC POCKETS OF NEED -- TRENDS IN THE USE OF PRENATAL CARE -- SUMMARY -- REFERENCES AND NOTES -- 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 -- SUMMARY -- REFERENCES AND NOTES -- 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 -- MULTIVARIATE ANALYSIS -- SUMMARY -- 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 -- SUMMARY -- REFERENCES AND NOTES -- 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 -- FINANCIAL BARRIERS -- INADEQUATE SYSTEM CAPACITY -- 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 -- SUMMARY -- REFERENCES AND NOTES -- 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 -- REFERENCES AND NOTES -- 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 -- REFERENCES -- 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 -- REFERENCES AND NOTES -- Index.Prenatal careWomen's health servicesPrenatal care.Women's health services.362.1/982Brown Sarah S1671269Institute of Medicine (U.S.).Committee to Study Outreach for Prenatal Care.MiAaPQMiAaPQMiAaPQBOOK9910812221403321Prenatal care4050193UNINA