Health Care for Women in the USA - Term Paper Example

Health Care for Women in the USA Introduction ‘Prenatal care’, which is also identified as ‘antepartum care’, can be recognised as the health related services obtained by the pregnant women prior to the birth of her child. Prenatal care has been considered as one of the most significant factors of health care system since past few years. The method of parental care was actually based upon the detection as well as treatment related to ‘preeclampsia’ and latter to ‘preterm birth’. However, recent trends depict that the focus upon the deliverance of prenatal care services has been altering. It has been focusing more upon the condition of the fetus instead of merely paying attention towards the condition of the mother. It is often argued that there also exists a close association between the use of the prenatal care services as well as birth outcomes. Studies in this regard depicted that if the individual makes proper use of the prenatal care, it shall lead to the enhancement of birth rates; while on the other hand, improper use of the prenatal care has been generally linked with the low weight births, premature births along with infant and maternal mortality (Lu, Bragonier, Silver & Bemis-Heys, 2001). Based on these arguments, the study will aim at determining the impacts of prenatal care on pregnancy outcomes for women. It will also intend to establish the role of the prenatal care to pregnant women as well as the baby. The study will further also endeavour to comprehend the role of medical practitioners in delivering prenatal care. Hence, it is expected that this study will be effective at determining whether the prenatal care can be effective enough at identifying the outcome of pregnancy or not. The paper will also aim at offering a summary at the end in order to gain better insights into the topic. Role of prenatal care Prenatal care has long been recognised as one of the most virtuous methods to determine mothers at risk of delivering an immature baby and thus offering the pregnant mothers with adequate medical, nutritional as well as educational facilities with the motive to minimise the factors as well as incidences of low birth weights. Although the perception related to the fact that prenatal care is of great significance to both mother and her child became accepted in the current century, the empirical evidences demonstrating the link between the prenatal care as well as minimised rates of low birth weights materialised slowly. Most of the controversies related to the efficiency of prenatal care in deterring low birth weight arises from the complexities in describing what leads to prenatal care and adequate prenatal care use (Alexander & Korenbrot, 1995). Illustratively, one of the majorly utilised preventive health care services has been prenatal care in the United States. It has been noted that majority of live births are delivered to women each year in the United States where a continuously increased number of women have been receiving prenatal care. Prenatal care is most likely to minimise the risks associated with fatal growth constraints during pregnancy and immediately after the birth of the child for a few weeks. It is to be mentioned that the advantages along with the impact of prenatal care may not be similar across socioeconomic, cultural and demographic groups, as the characteristics such as pre-existing health status, poverty level, age, education as well as environmental conditions are most likely to alter the impacts of prenatal care. It is worth stating that the prenatal care experience tends to have a favourable impact upon the postnatal health status of the mother as well as the child (Alexander & Korenbrot, 1995). Babies born to teenage mother tends to possess greater risks of mortality during infancy in comparison to the cases of mothers who are more than 20 years old. It is in this context that teenage mothers are often found to give birth to children at a premature stage suffering from low weight. The most common complications witnessed in the case of premature babies are identified due to underdeveloped and weak organs causing breathing problems, intestinal problems, loss of vision, and bleeding brains. Even in the case of mothers aged above 20 years, babies are often observed to suffer from various complications mostly due to genetic orders, but also due to inadequate medical guidance and insufficient care during the pregnancy and in the infancy of the baby. Hence, under such circumstances, prenatal care has emerged as quite crucial in offering the pregnant mother with greater care and support so that fatal complications can be minimised from both the mother and the child (Alexander & Kotelchuck, 2001). Prenatal care is commenced with a pregnant women’s first visit to obtain antenatal care and continues till the baby is born. In Western Europe, North America as well as many other countries the pregnant women is required to visit the health care service for obtaining prenatal care at least 12-16 times during their pregnancy to minimise any complexities. Therefore, based on the pros and cons of prenatal care, most of the medical practitioners suggest the pregnant women to have frequent prenatal care visits. As per the guidelines offered by American Medical Association, the women with a low-risk pregnancy are supposed to have 14 prenatal care visits within the duration of 40 weeks pregnancy. During the first meet, the healthcare practitioners focus on gathering a detailed note related to the patients’ social, family, medical as well as obstetric history, undertaking multiple physical assessments of the pregnant mother and identification of the risks that needs a broad range of laboratory tests. It is to be noted in this regard that during the process of succeeding visits might comprise of simple assessments, although some of the assessments tend to be conducted at each visit or at a greater frequency than other tests such as ultrasonography. It is through this test that during the period of pregnancy, the healthcare practitioners tend to focus upon the status of the developing fetus along with the preparation for safe delivery. One of the chief roles of the prenatal care has been to closely monitor the changes in the health of the expectant women, support preventive health and hence recognise the risk factors associated with the health of the mother as well as the fetus. Furthermore, during every prenatal visit the health care practitioners tend to check the weight and the blood pressure of the mother so as to monitor the weight gain of the child corresponding to the mother’s physical health and overall development of the fetus. Gradually, in the subsequent visits, the fetal heart rate is also determined. Ultrasound examination is also performed and other tests conducted during the sixteenth week of pregnancy in order to determine the genetic abnormalities (Alexander & Kotelchuck, 2001). As suggested by the National Institutes of Health, it can be observed that prenatal programs may not be capable of minimising the low birth weights, but it is most likely to enhance the positive outcomes if the care offered is capable of identifying a treatable solution (Evans & Lien, 2004). Socio-economic aspects have also been observed to impose a significant impact on the accessibility of prenatal care by the women. For instance, it has often been observed that low-income as well as non-white women in United States have to witness major risks for poor birth outcomes obtaining poorest prenatal care in the community. The women with inadequate care tend to pose greater number of barriers such as psychological, structural as well as socio-demographic factors. In such circumstances, the mother’s belief as well as endorsement obtained from others act as a motivating factor for the pregnant women. Hence, in order to minimise the effects of such barriers there is need of comprehensive, coordinated as well as multidisciplinary outreach of prenatal care that adequately addresses psychological as well as structural needs to pregnant women. This in turn can improve the prenatal care deliverance within a particular community minimising the negative effects of cultural, socio-economic and other divergences (Lia-Hoaqberg, Rode, Skovholt, Oberq, Berg, Mullet & Choi, 1990). Role of Medical Practitioner in Delivering Prenatal Care The disparities in the prenatal practitioners is not only in the way in which they treat the patient but also in the kind of delivery preferred by the expectant women and their families along with the knowledge base possessed by them concerning the criticality of pregnancy. There are numerous healthcare providers offering care to the women during pregnancy. Obstetricians / gynaecologists can be regarded as one of such medical practitioners. These doctors are entitled to undergo four years of training where they learn regarding the minute details of pregnancy, child care and mother care. Most of the pregnant women prefer gynaecologists because of the skills possessed by these healthcare practitioners concerning women’s reproductive system. On the other hand, nurse-midwives are the ones who obtain training in gynaecology at training centres and are practitioners responsible for delivering special attention to the mothers in a hospital or at birth clinics. It has often been observed that most of the midwives tend to work in collaboration with the gynaecologists to offer personalised attention to the pregnant women. Midwives therefore need to possess skills in terms of adequate medical knowledge, friendliness, superior communication attributes and proper understanding of the probable complexities might be faced by the patients. More technical methods are utilised by the midwives in comparison to the gynaecologists, even though these midwives may consult one gynaecologist for special treatments. Mothers can obtain practical knowledge regarding how effective care can be offered to the child avoiding various risks associated with insufficient knowledge which may also lead to miscarriage. It is the chief role of midwives to stimulate parents as well as the other members of the family to act proactively in supporting the pregnant woman (Epigee, 2012). Family physicians, as the name suggests, are the doctors who do not concentrate in any kind of pregnancy cases but are general practitioners offering medical attention to the entire family. Most of the parents prefer to take the feedback from their family physician instead of solely relying upon an obstetrician or midwife based on their reliability and confidence that the family physicians can offer adequate professional information and can also offer intense care to the child and mother after birth understanding the influencing factors closely and more intensely. However, upon the requirement of specialised prenatal care, family physicians may refer the patient to an obstetrician. In most instances, it has been found that the family doctors generally prefer natural births avoiding riskier methods of surgery. Nevertheless, is felt necessary to undergo a surgery owing to the complexities of natural birth, the expectant woman might be referred to other specialised doctors. Family doctors also opt for a friendly method and hence support the spouse to understand the significance of prenatal care and further participate in the pregnancy and delivery program of their partner (Epigee, 2012). A doula is considered to be a professional individual who is not responsible to look after the child’s birth but act as a support for the mother. Doulas are often found to prevail in two forms, i.e. a group entitled for taking care of the prenatal health of the mother and the other offering postnatal support. Some of the doulas are found offering both of the services as well (Epigee, 2012). Furthermore, a Certified Professional Midwife is an autonomous and specialized midwifery practitioner meeting the standards that has been set by the North American Registry of Midwives. They are further qualified to offer the mothers with Midwives Model of Care. Most of the Certified Professional Midwives tend to offer their assistance in private home or birth centre based practices all over the United States, Mexico as well as Canada (North American Registry of Midwives, 2012). It is worth mentioning in this context that the skilled attendants such as midwives, doctors as well as nurses who have attained training to supervise pregnancies, child birth programs and to identify or refer to the complications among the women and their infants are of greater assistance to ensure the survival as well as safety of pregnant women along with their babies. Irrespective of their professional title, healthcare practitioners rendering their services as skilled attendants, need to be capable of demonstrating early signs of complications and hence offer the patients with quality care whenever required (Barros, Tavares & Rodrigues, 2010) It has been noted that in the rural United States which generally accounts to nearly 23 percent of the country’s population, around two-third of the obstetrical providers tend to be family practitioners or general practitioners. However, the recent trends depict that there has been major decline in the number of family physicians offering obstetrical care in the country (Nesbitt, Connell, Hart & Rosenblatt, 2012). It has been proposed that in order to be effective it is quite significant for the skilled attendants to work in close association with obstetric team, healthcare providers as well as lay caregivers such as traditional healers as well as family members. These lay caregivers have a significant social as well as cultural role and are required to function as a team in order to ensure that both the mother as well as the child receives the best possible care. Inadequate care might lead to greater chances of iatrogenic incidents, i.e. the complexities arising due to the ill-effects of a medical treatment causing chronic illnesses to be suffered by the mother and the child both. Although there is need of greater investment to strengthen the referral services within the healthcare services, it is also the duty of the healthcare providers to become more accountable in delivering quality care to the pregnant women (Bernis, Sheratt, AbouZahr & Lerberghe, 2003). Prenatal Care Determining the Outcome of Pregnancy According to Young, Trotman & Thame (2007) it has been identified that pregnancies among adolescents are subjected to greater risks of unfavourable outcomes which generally leads to preterm delivery as well as perinatal loss. As adolescent mothers are most likely to generate hyper-tensive disorders of pregnancy, the rate of infant mortality becomes quite high. Hence, it is quite significant for this group of mothers to take adequate antenatal care for enabling early identification as well as management of the risk factors that is linked with adverse results. It has also been noted that adolescent girls attaining sufficient prenatal care can enjoy improved outcomes in terms of birth weights of their newborns as well as their gestational age. According to Young, Trotman & Thame (2007) there exists a close association between the inadequate prenatal care and high rate if preterm birth. It is in this context that the expectant mothers seeking for prenatal care are most likely to give birth to a fully matured baby. The weight of the baby tends to be lower in cases when the mothers do not seek for proper prenatal care because of lack adequate knowledge to take care of herself and her baby when she is pregnant. On the other hand, adequate prenatal care tends to possess a positive impact upon the pregnancy results among the teenagers as well as the women. The pregnant women attaining early as well as sufficient prenatal care might have greater chances of better pregnancy performance witnessing a lower risk of preterm delivery along with other complexities (Young, Trotman & Thame, 2007). From an overall perspective, it can be stated that there is need to adequately measure the use of the prenatal care for the purpose of identifying the trends and to evaluate the association between prenatal care services as well as pregnancy outcomes within a given regional context. There are numerous studies in United States that has demonstrated high rate of inadequate prenatal care. Hence, it is significant for the hospital authorities to pay due attention towards the prenatal care by comprehending its significance for the pregnant mothers as well as children (Heaman, Newburn-Cook, Green, Elliot & Helewa, 2008). Based on the above discussion, prenatal care can be thus considered as the prototypic class of preventive medical treatment. Hence it would be anticipated that such care tends to possess a crucial role in the services offered by the healthcare organisations. Notably, numerous studies have demonstrated the advantageous impacts of prenatal care to be strongest among the socially disadvantaged women. The significance of prenatal care as one of the public health priority has come into force in the recent times which further demonstrates the increasing awareness of such methods in the United States along with many other advanced nations. Such an initiative can help in increasing the number of people availing prenatal care and thus minimise the risks associated with pregnancy (Kiely & Kogan, 2012). Conclusion The need or rather the significance of prenatal care was identified more than 100 years ago and is considered to be one of the majorly utilised preventive healthcare services in the United States when concerning the mortality rates of infants and their mothers. It has been observed that with the pace of time, its use has been escalating in the country. Prenatal care can be defined as the care offered by the healthcare practitioners to the pregnant women prior to the birth of their child to the postnatal period, i.e. after the birth of the child. The main objective of the prenatal care has been to detect and treat preeclampsia as well as preterm birth. It assists in checking the health of the mother as well as the babies throughout the pregnancy period. Contextually, it is widely considered as quite imperative for the pregnant mother to make regular visits for prenatal care following the frequency of once a month during the first 28 weeks of pregnancy. The healthcare practitioners such as nurses, midwives, gynaecologists, as well as certified professional midwives have a greater role to play in offering the expectant women with the required information related to pregnancy and to demonstrate the significance of initiating prenatal care at an early stage. In this regard, it can be mentioned that prenatal care has been quite effective at maintaining low level of maternity mortality and minimising low weight births among the adolescent girls. Conclusively, with reference to the above discussions, it can be affirmed that throughout the pregnancy period, it is significant for the pregnant women to attain regular prenatal care. It is fundamentally owing to the fact that good parental care can assist in ensuring the health of the mother as well as her child when the risk of mortality is considered to be quite high, i.e. during the nine months of pregnancy and the preceding six months of infancy. It also tends to minimise birth defects via secondary preventions. It has often been noted that the prenatal care guidelines not only offers a scope to enhance the immediate results of pregnancy, but also assists in improving the continuing health of the women, infant and the family as a whole. Prenatal care can also help in improving the health of the child after his/her birth by offering the mothers with proper advice related to child care. Prenatal care can offer a greater scope of education thereby benefiting all the members of the family and simultaneously, supervising them to preserve proper health of both the mother and the child. It also assists in encouraging healthy behaviours such as good nutrition, regular health check-ups, home safety, immunizations and regular exercises amid the mothers. References Alexander, G. R. & Korenbrot, C. C. (1995). The role of prenatal care in preventing low birth weight. Future Child. 5(1), pp: 103-120. Alexander, G. R. & Kotelchuck, M. (2001). Assessing the role and effectiveness of prenatal care: history, challenges and direction for future research. Public Health Reports. 116(1), pp: 110-116. Barros, H., Tavares, M. & Rodrigues, T. (2010). Role of prenatal care in preterm birth and low birth weight in Portugal. Journal of Public Health Medicine. 18(3), pp: 321-328. Bernis, L. D., Sheratt, D. R., AbouZahr, C. & Lerberghe, W. V. (2003). Skilled attendants for pregnancy, childbirth and postnatal care. Oxford Journal. 67(1), pp: 39-57. Evans, W. N. & Lien, D. S. (2004). The benefits of prenatal care: evidence from the PAT bus strike. Journal of Econometrics. 125, pp: 207-239. Epigee. (2012). Prenatal health care practitioners. Retrieved from http://www.epigee.org/pregnancy/prenatal_care.html Health Evidence Network. (2012). What is the efficacy/effectiveness of antenatal care and the financial and organizational implications? Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0007/74662/E82996.pdf Heaman, M. J., Newburn-Cook, C. V., Green, C. G., Elliot, L. J. & Helewa, M. E. (2008). Inadequate prenatal care and its association with adverse pregnancy outcomes: A comparison of indices. BMC Pregnancy and Childbirth, 8(15), pp: 45-50. Kiely, J. L. & Kogan, M. D. (2012). Prenatal care. Retrieved from http://www.cdc.gov/reproductivehealth/ProductsPubs/DatatoAction/pdf/rhow8.pdf Lia-Hoaqberg, B., Rode, P., Skovholt, C. J., Oberq, C. N., Berg, C., Mullet, S. & Choi, 1990. Barriers and motivators to prenatal care among the low-income women. Soc Sci Med. 30(4), pp: 487-495. Lu, M. C., Bragonier, R., Silver, E. R. & Bemis-Heys, R. (2001).Where it all begins: the impact of preconditional and prenatal care on early childhood development. Retrieved from http://www.healthychild.ucla.edu/Publications/Documents/Whereitall%20begins0101.pdf North American Registry of Midwives. (2012). What is a CPM. Retrived from http://narm.org/ Nesbitt, T. S., Connell, F. A., Hart, L. G. & Rosenblatt, R. A. (2012). Access to obstetric care in rural areas: effect of birth outcomes. American Journal of Public Health. 80(7), pp: 812-850. Young, J., Trotman, H. & Thame, M. (2007). The impact of antenatal care on pregnancy performance between adolescent girls and older women. West Indian Ned. J. 56(5). Read More