The Kaiser Family Foundation and Health Management Associates conducted
a survey of states (40 states and DC) about the status of Medicaid benefit
policies for perinatal and family planning services across United States 43.
Key findings of the report were that all states that took part in the survey
cover prenatal vitamins and ultrasounds for pregnant women however, some states
impose quantity limits or require a prescription for vitamins 43.
Other finding was that nearly all responding states (38/41) cover amniocentesis
and chorionic villus sampling tests but only few (33/41) cover genetic
counseling; all states provide substance or alcohol abuse treatment services to
pregnant or postpartum women 43. Three-fourth of the states cover
prenatal home visits 43. The affordable care Act also requires new
private plans to cover prenatal visits and many preventive services routinely
provided in prenatal care such as vaccinations, screening for gestational
diabetes, sexually transmitted diseases; screening and counseling for tobacco
and alcohol use and interpersonal and domestic violence, without cost sharing 3.
The Healthy People 2020 initiative has set a goal of increasing the
proportion 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 to
increase the proportion of pregnant women who receive early and adequate
prenatal care from 70.5% in 2007 to 77.6% in 2020 with a target of 10%
improvement 44. Ohio mothers have consistently surpassed this
target between the year 2000 and 2009, with at least 79 percent starting
prenatal acre in the first trimester each year 13.
Prenatal care is one of the most frequently used preventive care
services in United States. Prenatal care has played and can continue to play an
important role in improving maternal and infant health outcomes 35.
Women have identified multiple barriers to obtaining early and adequate
prenatal care which show remarkable similarity across geographic, racial and
socioeconomic groups 12. Clinic staff and providers should develop
a connection with each woman by providing care that meets her physical,
cultural and personal needs 32. Careful study of multiple health
service models and incorporation of effective interventions can assist in
improving maternal and infant outcomes on a local, national and international
level 32. Substance use in pregnancy remains a significant public
health problem, type and degree of the drug used, as well as the point of
exposure, all influence the effects of drug use in pregnancy, these factors
should be taken in to account when developing interventions for prenatal
substance use treatments 26. Regardless of the outcome of the
debates over the future of Medicaid or the Affordable Care Act, millions of
low-income pregnant women that are served by Medicaid will continue to need to
have access to coverage that includes the broad range of pregnancy-related
services that help assure positive maternal
and infant outcomes 43.