Among the world’s most developed countries, the United States has one of the highest rates of infant mortality, primarily due to the poorer health of babies born to women in lower socioeconomic groups.
While early and regular prenatal care is vital for identifying and managing risks during pregnancy, other conditions such as maternal chronic disease and substance abuse that can create a high-risk pregnancy often begin years before conception.
In a new review, researchers found that the Medicaid expansions for low-income parents that took place in 34 states between 1996 and 2011 resulted in a 7.9 percent decrease in the number of mothers who didn’t have insurance during pregnancy and a 2.3 percent decrease in the number of uninsured women who already had a child and became pregnant again.
The expansions also led to 0.4 percent more pregnant mothers beginning prenatal care earlier in their pregnancies. In addition, pregnant mothers with lower levels of education were 1.7 percent more likely to receive adequate prenatal care as a result of the expansions.
For the study, Dr. Laura Wherry, an assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA), looked at data from the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment and Monitoring surveys taken between 1997 and 2012.
Wherry analyzed the changes in the percentage of mothers who were eligible for state Medicaid programs. She also estimated changes in the number of insured mothers both before and during pregnancy, assessed whether pregnancies were unwanted or mistimed, and analyzed any changes in prenatal care use for pregnant mothers associated with Medicaid expansion.
Her findings, published in the journal Health Services Research, suggest that expanded Medicaid coverage for low-income parents can lead to improvements in health insurance coverage and expanded use of prenatal care, all of which may have important consequences for their children’s health.
For example, when women have health insurance coverage prior to pregnancy, it allows doctors and other health care providers an opportunity to address risk factors associated with high-risk pregnancies, and to promote behaviors and activities that can lead to healthier pregnancies and babies.