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From Data to Action: Prenatal Care |
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Using Surveillance To Promote Public Health
Examples from the Pregnancy Risk Assessment Monitoring System (PRAMS)
EXECUTIVE SUMMARY PUBLICATION YEAR 2002
Prenatal
Care
Prenatal care is recommended all pregnant women because of its potential
to improve the health of mothers and infants. Inadequate use of prenatal
care has been associated with increased risk for low infant birth weight,
premature births, neonatal mortality, infant mortality, and maternal
mortality.3
Colorado
A study by the Colorado Department of Public Health and
Environment used 1997–1998 PRAMS data to examine the level of prenatal care
and selected birth outcomes among documented and undocumented immigrant
women in Colorado. Undocumented women could not receive prenatal care
through Medicaid, but could receive emergency care for labor and delivery.
The results of the study described the lack of prenatal care and the higher
prevalence of negative birth outcomes among undocumented women. These data
were included as part of a larger report to the state legislature. As a
result, the Colorado state legislature passed a bill in the 2000 session
allowing undocumented women to enroll in a Medicaid health maintenance
organization (HMO) and receive prenatal care services at any time during
pregnancy. Although no funds were allocated in the legislation, Medicaid
health care providers can now provide prenatal care to undocumented women
through a pilot project that is monitored and evaluated by the Colorado
Department of Health Care Policy and Financing.
 Washington
Washington State Department of Health (DOH) used PRAMS data to
monitor prenatal care provider discussion about maternal risk behaviors.
Findings from PRAMS data suggested that providers do not always provide all
pregnant women with information about important prenatal care procedures,
such as genetic testing; maternal risk factors, such as family history of
birth defects or genetic diseases; and alcohol-related birth defects. Based
on these data, Washington State DOH took several actions:
-
 Informed
perinatal health care providers statewide and nationally about these
issues through publications and presentations.
- Developed a “Genetics and Your Practice” CD-ROM and distributed it to
health care providers. The CD addresses the issue of providing
differential counseling to clients based on race, ethnicity, or other
demographic factors.
- Used PRAMS data to increase the visibility of these issues through
development of new maternal and child health performance measures focused
on provider education.
 In
addition, using PRAMS data on prenatal care provider discussion, the
Washington State Chapter of the March of Dimes collaborated with the Swedish
Medical Center on a successful grant application. They were awarded $100,000
per year for 3 years from the National March of Dimes Foundation to develop
and implement a statewide project to improve preconception and prenatal
health education offered to women by their health care providers.
Return to Table of Contents
Page last reviewed: 3/24/06
Page last modified: 3/24/06
Content source: Division
of Reproductive Health,
National Center for Chronic Disease
Prevention and Health Promotion
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