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Low Birthweight and Maternity Care for All


 The decline in infant mortality in 1983-84 was less than the average decline the US has been experiencing since the mid-1960s, suggesting that infant mortality may be reaching a plateau. Moreover, indicators of timely provision of prenatal care decreased in 1983-84. 3 observations have been made regarding these new trends:) 1) the fact that infant mortality has been declining, albeit at a slower rate, despite relative stagnation in the rate of low birth weight infants, suggests that hospital-based intensive care is succeeding in preserving low birth weight babies; 2) the plateau in infant mortality may reflect the fact that the ability of neonatal intensive care to salvage low birth weight infants may be nearing its limit; and 3) Reagan's attack on social programs may be creating access problems that have a negative impact on infant mortality. Many feel that further reductions in neonatal mortality will be achieved only by reducing low birth weight, which accounts for 2/3 of infant mortality. Activities with potential for reducing low birth weight include: 1) risk identification, general health education, and family planning; 2) increased accessibility of early and regular prenatal care; 3) expansion of the content of prenatal care; 4) an extensive public information campaign; and 5) a multifaceted program of research on low birth weight. The Council on Maternal and Child Health of the national Association for Public Health Policy has proposed a universal maternity care program for the US aimed at assuring comprehensive prenatal and delivery care to all women and expanding the content of prenatal care to include nutrition, health education, and support services. Inadequacies in coverage for women with and without private insurance will be addressed by requiring insurrers to fully cover maternity care and offer coverage for the indigent. Such a program of universal maternity care would be a step toward a national health program.
