The Kaiser Family Foundation and Health Management Associates conducteda survey of states (40 states and DC) about the status of Medicaid benefitpolicies for perinatal and family planning services across United States 43.Key findings of the report were that all states that took part in the surveycover prenatal vitamins and ultrasounds for pregnant women however, some statesimpose quantity limits or require a prescription for vitamins 43.Other finding was that nearly all responding states (38/41) cover amniocentesisand chorionic villus sampling tests but only few (33/41) cover geneticcounseling; all states provide substance or alcohol abuse treatment services topregnant or postpartum women 43.

Three-fourth of the states coverprenatal home visits 43. The affordable care Act also requires newprivate plans to cover prenatal visits and many preventive services routinelyprovided in prenatal care such as vaccinations, screening for gestationaldiabetes, sexually transmitted diseases; screening and counseling for tobaccoand alcohol use and interpersonal and domestic violence, without cost sharing 3.                          The Healthy People 2020 initiative has set a goal of increasing theproportion of pregnant women who receive care in the first trimester from 70.8%in 2007 to 77.9% in 2020 with a target of 10% improvement, as well as a goal toincrease the proportion of pregnant women who receive early and adequateprenatal care from 70.5% in 2007 to 77.6% in 2020 with a target of 10%improvement 44.

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Ohio mothers have consistently surpassed thistarget between the year 2000 and 2009, with at least 79 percent startingprenatal acre in the first trimester each year 13.Conclusion                            Prenatal care is one of the most frequently used preventive careservices in United States. Prenatal care has played and can continue to play animportant role in improving maternal and infant health outcomes 35.Women have identified multiple barriers to obtaining early and adequateprenatal care which show remarkable similarity across geographic, racial andsocioeconomic groups 12. Clinic staff and providers should developa connection with each woman by providing care that meets her physical,cultural and personal needs 32.

Careful study of multiple healthservice models and incorporation of effective interventions can assist inimproving maternal and infant outcomes on a local, national and internationallevel 32. Substance use in pregnancy remains a significant publichealth problem, type and degree of the drug used, as well as the point ofexposure, all influence the effects of drug use in pregnancy, these factorsshould be taken in to account when developing interventions for prenatalsubstance use treatments 26. Regardless of the outcome of thedebates over the future of Medicaid or the Affordable Care Act, millions oflow-income pregnant women that are served by Medicaid will continue to need tohave access to coverage that includes the broad range of pregnancy-relatedservices that help assure positive maternaland infant outcomes 43.