Home Care

How the “Affordable Care Act” Could Benefit All Mamas on Bedrest

July 28th, 2010

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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