Moving Towards Adequate Prenatal Care: Preventing Low Birth-weight and High Infant Mortality Rates in GR

By: Annie Hakim, Frederick Meijer Honors College, Grand Valley State University

Part two of a three-part series on prenatal care in Grand Rapids

Government and non-profits within Kent County have already made significant strides toward providing adequate prenatal care. Unfortunately statistics indicating above average instances of low birth-weight babies and infant mortality in the Grand Rapids persist. This suggests that local efforts for the promotion of appropriate pre-natal care need to be expanded. Local organizations -- both public and private -- have adequate resources to serve any and all pregnant mothers in need -- so long as mothers seek out that help for themselves. On a public level, federal funds should continue being directed to the Kent County health department, to secure the future of the Maternal Infant Health Program (MIHP), as should a portion of local tax revenue. MIHP and similar programs have been successful and resourceful [1].  Yet research has suggested that just the existence of such pre-natal care programs may not be enough. Consider an example from a different policy arena: food assistance.  One study reports that “1/3 of families eligible for food stamps experienced food insecurity in 2005”. If needy parents and families don’t even seek out food aid, how can we expect at risk mothers to insure that they receive quality pre-natal care? Generating increased awareness of the existing resources in new comprehensive ways may be the first step to addressing the acute problem of sub-par prenatal care in the Grand Rapids area.

Kids Count, a private national charitable foundation which has conducted significant research on low birth-weight babies and infant mortality, has begun to address inadequate pre-natal care among women as a far more complex problem in which several different factors play a role. When considering a new dynamic approach to promoting proper pre-natal care, the factors they identify should each be addressed. Kids Count studies suggest that pre-natal care should in fact start long before a woman gets pregnant through individual, family, and community consciousness of comprehensive health care and well-being. As Kids Count researchers point out, chronic diseases like cardiovascular disease, obesity, and type-two diabetes “affect significant percentages of women during their child bearing years. In contrast, treatable medical conditions that arise during pregnancy affect only a small portion of women”.  For this reason it is imperative that ‘at risk’ women -- especially women living under the poverty line -- register for Medicaid. Ideally, a county or citywide Medicaid enrollment drive could be very beneficial.

Considering that women in need of prenatal care may be at risk for other personal health problems -- whether chronic or related to substance abuse or poor nutrition -- it is important to make information about prenatal care available at any location they may access for help. Whether a woman seeks help to quit smoking, obtain food stamps, or address obesity, the soup kitchen, health center, clinic, hospital, cultural community center, or school counselor that she reaches out to must be aware of how to identify an at-risk mother or potential mother, and point her in the proper direction to obtain adequate comprehensive health-care and prenatal care.

Additionally, ad campaigns to promote appropriate prenatal care as well as improved comprehensive health care would definitely be a positive investment of both federal and local funds allocated to pre-natal care programs in Grand Rapids. In the event that ad campaigns were supported, it is important that their message is targeted specifically to ‘at risk’ women. This means that advertisements may need to take the form of posters at city bus stops, billboards, and pamphlets for schools and community centers in low income areas, rather than as upscale ads in newspapers, on the Internet, and on TV. It would also be beneficial to promote incentive based programs such as Women, Infants, and Children (WIC), which “provides federal grants to states for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.”³ When pregnant women visit WIC for the first time, they automatically receive supplemental food, and are guided in the appropriate direction to begin adequate prenatal care.

Aside from placing a greater emphasis on taking advantage of existing resources and advertising comprehensive health-care options for women in need, another aspect of this complex problem should be addressed. A disproportionately high number of at risk women lack a high school diploma. Research done by the Annie E. Casey Foundation points out that “women with a high school diploma are far less likely to have LBW babies." Women without high school diplomas are also more likely to live below the poverty line, which is one of the largest risk factors for women to receive inadequate prenatal care. Education reform is key to creating healthy individuals, families, and communities.

Additionally, supporting sustained research to identify risk factors of women unlikely to receive prenatal care is important. However, considering significant research has already identified risk factors, and sufficient pre-natal resources have been developed both publicly and privately, at this point generating awareness of the importance and availability of care is key. Within Grand Rapids, promoting comprehensive health-care and living healthy lifestyles, reducing the amount of substance abuse, and education reform will be the first steps to addressing the problem of inadequate prenatal care from all angles.

Part one: Prenatal Care Discrepancies within Grand Rapids
Part three: Prenatal Care Programs and Resources within Grand Rapids