LEADER 08161nam 2200625Ia 450 001 9910812221403321 005 20200520144314.0 010 $a1-280-21467-8 010 $a9786610214679 010 $a0-309-54289-8 010 $a0-585-14286-6 035 $a(CKB)111004366657440 035 $a(OCoLC)427404665 035 $a(CaPaEBR)ebrary10062789 035 $a(SSID)ssj0000226472 035 $a(PQKBManifestationID)11188085 035 $a(PQKBTitleCode)TC0000226472 035 $a(PQKBWorkID)10257910 035 $a(PQKB)11632512 035 $a(MiAaPQ)EBC3376934 035 $a(Au-PeEL)EBL3376934 035 $a(CaPaEBR)ebr10062789 035 $a(OCoLC)923267121 035 $a(EXLCZ)99111004366657440 100 $a19881212d1988 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt$2rdacontent 182 $cc$2rdamedia 183 $acr$2rdacarrier 200 00$aPrenatal care $ereaching mothers, reaching infants /$fSarah S. Brown, editor ; Committee to Study Outreach for Prenatal Care, Division of Health Promotion and Diseases Prevention, Institute of Medicine 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1988 215 $a1 online resource (264 pages) 300 $aBibliographic Level Mode of Issuance: Monograph 311 0 $a0-309-03892-8 320 $aIncludes bibliographies and index. 327 $aPrenatal 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. 327 $aStudies 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. 327 $aMaternity 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. 327 $aContinuity 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. 606 $aPrenatal care 606 $aWomen's health services 615 0$aPrenatal care. 615 0$aWomen's health services. 676 $a362.1/982 701 $aBrown$b Sarah S$01671269 712 02$aInstitute of Medicine (U.S.).$bCommittee to Study Outreach for Prenatal Care. 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910812221403321 996 $aPrenatal care$94050193 997 $aUNINA