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Using age-related profiles helps identify risks and target interventions
Maternal, infant, and child health (MIC) encompasses health of Women of childbearing age from pre-pregnancy
through pregnancy, labor and delivery, and postpartum period
Child prior to birth through adolescence▪ Infants <1 year▪ Children 1-14 years
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2223rank.html
Families are the primary unit in which infants and children are nurtured and supported regarding healthy development
Various definitions of “family” U.S. Census Bureau definition of family▪ A group of two people or more (one of whom is the
householder) related by birth, marriage, or adoption and residing together; all such people (including related subfamily members) are considered as members of one family.
Unmarried women are more likely than married women to experience negative birth outcomes
Married women are more likely than unmarried, non-cohabitating women to initiate prenatal care early in pregnancy
Married women are less likely than unmarried, non-cohabitating women to rely on government assistance to pay for prenatal care
Teenage pregnancies more likely to result in serious health consequences for mother and baby
Teen mothers less likely to receive early prenatal care Teen mothers more likely to
Smoke during pregnancy Have preterm birth Have low-birth-weight babies Have pregnancy complications
Higher Infant mortality rate 1/3 teenage girls gets pregnant at least once before age 20
Teens who become pregnant and have a child are more likely to Drop out of school Not get married or to have a marriage end in
divorce Rely on public assistance Live in poverty
Substantial economic consequences for society
Determining the preferred number and spacing of children and choosing the appropriate means to accomplish it
Community involvement in family planning and care includes governmental and nongovernmental organizations
What is women’s Birth Right?
~½ of pregnancies in U.S. unintended▪ 43% of those end in abortion
Unintended pregnancy▪ Mistimed or unwanted
Unintended pregnancy associated with negative health behaviors:▪ Delayed prenatal care▪ Inadequate weight gain, ▪ Smoking ▪ Alcohol and other drug use
Federal program that provides funds for family planning services for low-income people Aims to reduce unintended pregnancy by providing
contraceptive and other reproductive health care services to low-income women▪ Supports 4,000+ family planning clinics in U.S.▪ Over 5 million women receive care at clinics funded by
Title X “Gag rule” – enacted in 1984, rescinded in 2009
Clinics have improved MIC health indicators▪ Have shown large reductions in unintended pregnancies,
abortions, and births▪ Each year, publicly subsidized family planning clinics
help prevent 1.9 million unplanned pregnancies that would result in:▪ 860,000 unintended births, 810,000 abortions, and 270,000
miscarriages Each public health dollar spent saves $3.74 in
Medicaid costs
Legal in early stages of pregnancy since 1973 (Roe V. Wade)
Majority of abortions Unmarried women (85%) Women aged 20-29 (57.1%) Rates highest among Non-Hispanic black women
Pro-life vs. pro-choice
Effect of pregnancy and childbirth on women important indicator of health
Pregnancy and delivery can lead to serious health problems
Maternal death Maternal mortality and morbidity rates
Causes include poverty and limited education
Medical care from time of conception until birth process
Early and continuous prenatal care leads to better pregnancy outcomes Less likely to give birth to a low birth
weight infant
Depends on many factors Mother’s health and her health behavior prior to
and during pregnancy Mother’s level of prenatal care Quality of delivery Infant’s environment after birth (home and family,
medical services) Nutrition Immunizations
Measure of a nation’s health Decline in infant mortality due to:
▪ Improved disease surveillance▪ Advanced clinical care▪ Improved access to health care▪ Better nutrition▪ Increased education
Leading causes of infant death: congenital abnormalities, preterm/low birth weight, SIDS
Premature births Low birth weight Cigarette smoking Alcohol and other drugs Breastfeeding SIDS
Most severe measure of health in children Rates have generally declined in past few
decades Unintentional injuries leading cause of death
in children▪ Specifically, motor vehicle deaths, especially those not
wearing seat belts/restraints
Unintentional injuries Significant economic, emotional, and disabling
impact Child maltreatment
Strong community response needed Infectious diseases
Importance of immunization schedule
Federal government has over 35 programs in 16 different agencies to serve needs of nation’s children
Many are categorical programs▪ Only available to people who fit into a specific group▪ Many fall through the cracks
Title V Only federal legislation dedicated to promoting and
improving health of mothers and children Maternal and Child Health Bureau (MCHB)
Established in 1990 to administer Title V funding Accomplishes goals through 4 core public health
services▪ Infrastructure building, population-based, enabling, and
direct health care services
Clinic-based program designed to provide nutritional and health-related goods and services to pregnant, postpartum, and breastfeeding women, infants up to 1 year of age, and children under age 5
Sponsored by the USDA; established in 1974 Eligibility requirements
Residency in application state, income requirements, at “nutritional risk”
2008: 9.5 million participants; nearly half of all infants born in U.S., ¼ of children ages 1-5
Children without insurance more likely to have necessary care delayed or receive no care
Medicaid – low-income individuals and families Children are slightly more than half of all
beneficiaries CHIP – targets uninsured children whose
families don’t qualify for Medicaid
FMLA – Family and Medical Leave Act Grants 12 weeks unpaid job protected leave to men
or women after birth of child, adoption, or illness in immediate family▪ Only affects businesses with 50+ employees
Cost of childcare Child Care and Development Block Grant
Numerous groups advocate for children’s health and welfare Children’s Defense Fund (CDF) United Nations Children’s Fund (UNICEF) American Academy of Pediatrics (AAP)
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