The Affordable Care Act
On June 10, 2010, the Health Resources and Services Administration (HRSA), in collaboration with the Administration for Children and Families (ACF) announced that some $90 million dollars has been allocated for The Affordable Care Act (ACA) for funding of the Maternal, Infant, and Early Childhood Home Visiting Programs.
I was thrilled that “the powers that be” are recognizing that if effort and energy (as well as funds) are expended for prevention to provide care and support to high risk pregnant women and subsequently to families that have infants and children with special needs, then millions of dollars and many maternal, infant and children’s lives can be saved.
Evidence-based research reveals that women who are at risk for preterm labor and families with children with special needs that receive home visits fare better. Maternal and infant morbidity and mortality go down. Other countries have known this and have successful, effective home care programs that have existed for years. Let’s hope that this study will finally bring the United States in line with other countries
High risk pregnancy affects a wide variety of women-regardless of race, socioeconomic status or age. While it is common knowledge that women who don’t receive good prenatal care are at increased risk for pregnancy complications, young women, older women, African American women and women who have utilized assisted reproductive technologies in order to become pregnant are also at increased risk for pregnancy complications, going into preterm labor and delivering premature infants who in turn often have behavioral and developmental problems. Evidence-based research has proven that early intervention, such as home visits and supportive services, improves outcomes. So if pregnant women prescribed bed rest receive home visits and their needs are identified and met, then perhaps we can reduce maternal and infant rates in this country-rates that are higher than in many industrialized and “developing” nations.
African American Women have the highest perinatal mortality rate of all American women, regardless of age, socioeconomic status or prenatal care. According to the California Maternity Quality Care Collaborative, in California alone,
“In 2004, there were 13.6 maternal deaths per 100,000 live births, above the national rate of 13.1 and well above the Healthy People 2010 target of 4.3 maternal deaths per 100,000 live births. Pregnancy-related deaths among African-American women in California were 3 times higher than rates for Whites or Hispanics (37.6 deaths per 100,000 live births for African-Americans versus 12.0 and 11.9 for Whites and Hispanics, respectively). In addition, when researchers examined mortality rates in African American women due to the five major complications of pregnancy, they learned that these complications did not occur at higher rates in this population but African American women were 2-3 times more likely to die from the complications than were White women in the US. (Tucker, AJPH, 2007)”
This home visitation program under ACA can provide invaluable services to high risk pregnant African American women, but it may also provide insight into why African American women have such high morbidity and mortality and ways to lower these rates.
The Affordable Care Act is a good thing. It has the potential to lower maternal, infant and child morbidity and mortality in the United States. It has the potential to provide insight into why some women are at increased risk for complications and why others are not. It has the potential to completely change the way high risk pregnant women are managed. If this 5 year program definitively proves that home visits by skilled medical professionals reduces pregnancy complications and lowers maternal and infant mortality, surely home visits will be made available to all high risk American women and new standards of care will be established.
Currently, the funds can only be accessed by federal, state and local agencies, so we here at Mamas on Bedrest & Beyond are busily working to strengthen collaborations and alliances so that we may be able to qualify for these grant and in turn, be able to serve more women. Initial inquiries have been made and we will keep you, our mamas on bed rest, informed.
What do you think of the Affordable Care Act (ACA)? Please add your comments below and share this post with other women who may be affected or assisted by this program.
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As many of you know I have been traveling around the country with my kids visiting family and friends for the past several weeks. Early on I wrote a blog describing how many new mamas were working diligently to regain their pre-pregnancy physiques in a park in East Tennessee. These mamas were walking and while I wholeheartedly support their efforts, observing them prompted me to write Walking Gets Mama into Shape After Bedrest giving 4 tips on how to start a walking program after being a mama on bed rest.
I’ve thought about those mamas and the many others I’ve seen along my journey. The gentle strolls around the park are a good start, but if they want to enhance their effort, they should incorporate these 5 tips into their walking programs.
- Increase the duration of the workouts. Many new mamas, especially mamas who had been on bed rest prior to delivery, start out only able to walk for just a few minutes. But as you get stronger, try to exercise for longer durations. Walking for 30-45 minutes daily at a moderate pace will increase cardiovascular health, increase leg muscle tone and will aid in weight loss when combined with a reduced calorie diet.
- Increase the intensity of the workouts. Now that you are stronger, press yourself a bit. Walk faster and see if you can cover the same distance in a shorter amount of time. Vary your route. If you typically walk in a flat park, try to find a route that has a few small hills. Increasing the intensity of your workouts will increase your cardiovascular health, improve your muscle tone and will increase your energy expenditure . This is important if your goal is to lose weight. To lose weight you must burn/expend more calories than your take in. So walking more intensely will burn more calories than strolling.Walking a more strenuous course will increase muscle tone in your legs. The more muscle you have, thttp://www.mamasonbedrest.com/wp-admin/post.php?action=edit&post=1418he more calories you burn. Combined with a reduced calorie diet, you will be more likely to lose your pregnancy weight faster and keep it off.
- Practice contracting and holding in your abdominal muscles while you walk. One of the most common complaints of post partum women is the “poochie belly”. The abdominal muscles are so stretched from pregnancy that they must be rehabilitated not only to regain the flat pre-pregnancy belly but also to improve posture and to increase core muscle strength. While walking, draw your abdominal muscles in, pulling your navel to your spine. DO NOT HOLD YOUR BREATH!! Hold for 1-2 seconds and release. Repeat several times during your walk. Gradually increase the amount of time you are able to hold your abs in while you walk. With practice, you will be able to hold you abs in for an entire walk.
- Do Kegel Exercises while you walk. Kegels are also important exercises to help strengthen the core as well as the pelvic floor muscles. Several repetitions should be performed several times a day in order to strengthen the pelvic floor, strengthen the core, reduce incontinence and reduce the incidence of organ prolapse. Our blog post Kegels: Essential Exercises for Mamas on Bed Rest gives a full explanation of the benefits of Kegels as well as how to do them.
- Get Support. Numerous studies have shown that exercise and weight loss efforts are enhanced when people, especially women, have a partner. When I was walking in the park and watching the mamas walk, I was really pleased to see a dad walking alongside a new mama. While working out with a significant other can have its challenges, it can also draw a couple closer, an added benefit for new parents who may be feeling stressed.
What are your tips for working out post partum? Please share with our community by posting in the comments section below.
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Want a full body workout you can do while on bed rest? Order Bedrest Fitness today! Bedrest Fitness is a set of modified prenatal exercises a woman on bed rest can do while on bed rest. Order now and get free shipping, a $6 savings!
On July 12, 2010 I had the opportunity to meet with a congressional assistant to Senator Babara Mikulski, D-MD on behalf of all mamas on bedrest and all high risk pregnant women.
If you are an advocate of women’s health issues and don’t know “Senator Barb” you need to. Senator Mikulski is a senior member of the Health, Education, Labor and Pensions Committee (HELP), which oversees issues such as education, labor, health care for seniors, long-term care, women’s health, social, nutritional, information and referral services for seniors, individuals with disabilities, and Social Security. Senator Mikulski is also a senior member of the Senate Appropriations Committee and a member of the Senate Select Committee on Intelligence. I requested to meet with Senator Mikulski or one of her representatives to ask that she start the legislative process to amend the Family Medical Leave Act so that family leave (and hence maternity leave) will be extended to 3-6 months and for that leave to be paid. Additionally we asked Senator Mikulski to use her influence to increase research into the causes and treatments for high risk pregnancy. Joanie Reisfeld, executive director of Better Bedrest, Inc., accompanied me to the meeting and together we presented a compelling case for why these topics should be considered.
I learned a lot from this experience, mainly that we have a long road ahead of us if we are to obtain legislation that will make paid maternity leave law.
We met with a congressional assistant, a young single woman who seemed to me not at all in the mindset to discuss childbearing-let alone high risk pregnancy and medical leave for such. Her job is to listen to people who come before her, gather any information that they present and then to compile and summarize the information in a memo to the Senator.
I was initially disheartened. It sounded like our requests would land in a pile of summaries in some remote corner of the Senator’s office. All the preparation and data collection seemed to be for nothing. Before giving up all hope, I asked the assistant, “What does the Senator need to advance her women’s health initiatives, how could we perhaps fold these requests into these initiatives and how can we help?”
In that moment, the tenor of the conversation changed. We had been focused on presenting an enormous amount of information (a complete binder full of statistics and testimonials) in a short amount of time (30 minutes). But as all the marketers that I respect and follow say, you have to approach your prospective customers with “What’s in it for them”. By simply shifting our approach from “We would like the Senator to consider and act on our requests” to “What is the Senator currently working on and how can we help integrate our requests into those initiatives and help her move them forward?” We go more specific information from the assistant and, now, a direct point of contact in Senator Mikulski’s office.
It takes about 2 weeks for requests to be processed; i.e. for the congressional assistants to compile the information they receive, summarize it and get it to the next in the chain of command.
We can follow up on the status of our request and our meeting by corresponding directly with this assistant.
The best way to correspond with her is via e-mail.
She can and will find out which specific initiatives Senator Mikulski is working on and will share that information with us so that we can see if we can tailor our requests to better coincide with what is already in motion.
I will be the point of contact on this end so that she can contact me directly if she needs more information.
So the first step has been taken. I am sure that it is one of many thousands that will be necessary in order for Family Medical Leave (FMLA) to be extented and to be paid time off.
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