Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 245
Index
Adolescents, see Teenagers
Aid to Families with Dependent
Children, S. 58, 61~2
Alabama
barriers to prenatal care use in,
73-74
free prenatal care, 63
prenatal care use in, 42
American Academy of Pediatrics, 26,
139
American College of Obstetricians and
Gynecologists, 8, 26, 27, 67, 102,
139, 145, 167
American Indian women, prenatal care
use, 3, 33, 35-36
Arizona
barriers to prenatal care use in, 110
prenatal care use in, 42, 105
Arkansas
Medicaid enrollment of pregnant
women, 71
prenatal care use in, 42
Asian/Pacific Islander women
cultural barriers to prenatal care, 76
prenatal care use, 33
961-BABY Telephone Information and
Referral Service (Detroit,
Michigan), 122, 194-195
245
Barriers to prenatal care
attitudes about pregnancy, 7, 9, 76-77,
81, 94-96, 99, 101, 107, 109-111
child care, 6, 70, 73, 74, 81, 94-96,
99, 102-103, 108, 109, 112
communication problems between
client and providers, 7
coordination deficiencies among
prenatal services, 6-7, 7~76, 77,
81
cultural, 7, 70, 73, 75-76, 78, 81, 103
depression, denial and concealment, 8,
80, 81, 100, 101
elimination of, see Programs for
improving prenatal care use;
Recommendations; Strategies for
improving prenatal care
fear, 7, 8, 33, 78-79, 81, 94-97, 99,
101-103, 182
financial, 4-6, 8-10, 12, 21, 50,
54-63, 81, 82, 89, 92, 93, 95-97,
99-102, 107-113, 118, 157-158,
161, 172, 194; see also Health
insurance (private); Medicaid
inadequate information on services, 7,
76, 81, 110, 161
inhospitable institutional practices, 7, 8,
9, 70, 73-75, 81-82, 93-97, 99,
101, 103, 125, 157, 161, 184, 195
OCR for page 246
246
knowledge of pregnancy, 93, 95, 96, 99
language, 7, 73, 76, 81, 182
life-style, 7, 77, 79-80, 100
limited provider availability, 8, 50,
94-96, 99, 119
missed menstrual period waiting time,
75
negative valuation of prenatal care, 77,
81, 93, 95-97, 994103, 10~110,
112, 113, 147
personal, 7, 9, 77-78, 147
providers' perspectives on, 8, 102-103,
113
ranking of, 95-96, 99
research recommendations, 157-158,
161
service hours of providers, 6, 8
stress, 80, 81, 97
studies of women's perceptions of,
89-102
system capacity inadequacies, 6, 9, 10,
12, 50, 63-69, 81~2, 157, 161
transportation problems, 6, 8, 45, 70,
73-74, 81, 93, 95_97, 99,
101-103, 108, 109-111, 113
women's perceptions of, 7 - , 9, 88-102
Better Babies Project (District of
Black women
Columbia), 122, 127, 18~191
payment means of, 60
perceptions of high~risk behavior, 78
prenatal care use, 3, 4, 17, 3~33,
35-40, 47, 49-51, 58, 167, 181
risk factors for insufficient prenatal care.
4,31,35-40,51, 107, 109, 111
sources of care used by, 64, 176
teenagers, 17, 34
California
availability of obstetrical care in, 69
barriers to prenatal care use in, 98-99,
170
charges for clinic visits in, 63
clinic availability in, 67
demand for prenatal clinics in, 66
Medi-Cal and prenatal care use, 58-S9,
78-79, 170
Obstetrical Access Pilot Project, 119,
17~171
physician acceptance of Medi-Cal
patients in, 67, 170
INDEX
physician/patient ratios, 67
prenatal care use in, 42
Casefinding
for adolescents, 196, 204
baby showers, 121, 169, 20~201
961-BABY Telephone Information and
Referral Service (Detroit,
Michigan), 122, 169, 194-195
Better Babies Project (District of
Columbia), 122, 127, 188-191
cash/service incentives to pregnant
women, 11, 121, 126, 169, 190,
20~201
Central Harlem Outreach Program,
122, 126, 185-186
CHOICE hotline, 122, 195-197
Community Health Advocacy Program
(New York City), 122, 187-188
cost-effectiveness, 1~11, 186
cross-program referrals, 11, 15, 116,
121, 127, 151-154, 169, 189
definition, 2, 19, 135
evaluation of programs, 125-126
free pregnancy testing/prenatal care
advocacy program (Tulsa,
Oklahoma), 122, 197-199
hotlines, 11, 15, 116, 12~122,
126-127, 151, 155, 169, 192-197
Maternity and Infant Outreach Project
(Hartford, Connecticut), 122,
191-192
methods, 9, 1~11, 15, 22, 120~122,
126, 151-154
need for, 13, 126, 161
Pregnancy Healthline (New York
City), 122, 192-194
programs, 12~122, 185-201
public information efforts, 121, 152
recommendations on, 15, 133, 151-154
staging, 11, 120, 126, 128, 130,
152-155, 186, 188
target populations, 15, 152
value, 11, 121-122, 151, 157, 159,
195, 196
Central Harlem Outreach Program, 122,
126, 159, 185-186
Child Survival Project, Columbia-
Presbyterian Medical Center (New
York City), 120, 125, 182-184
Clinics
capacity inadequacies in, 5, 6, 8, 59, 63
OCR for page 247
INDEX
charges for services, 63
demand for prenatal services at, 6,65,
66,176
enlargement of, 10, 119, 124
foreign, 220-221
free, 63
funding of, 129,144
hospital, 65
hours of operation, 74,81,195
language barriers at, 76
liability insurance, 69
negative attributes of, 76,81
procedural reforms, 14,179
public health, 66,70,75
satellite, 177-178,179
school-based, 144,153
State Health Agency, 65
value of, 64-65
waiting times, 6,8,59,64,66,74,75,
81,101,103
see also Prenatal services
Colorado
barriers to prenatal care use in, 95,
111
prenatal care use in, 42,90,106
Community Health Advocacy Program
(New York City), 122, 187-188
Community Health Centers
inadequacies in, 6,64
liability insurance, 69
value of, 65
Concern for Health Options:
Information, Care and Education
(CHOICE) (Philadelphia,
Pennsylvania), 122,195-197
Connecticut
barriers to prenatal care in, 101
Maternity and Infant Outreach Project
(Hartford), 122,191-192
pregnancy testing and prenatal visits
in, 71
prenatal care use in, 42,44,48,91
Consolidated Omnibus Budget
Reconciliation Act of 1985,61
Deficit Reduction Act of 1984,61
Delivery services
barriers to receipt of, 20-21
funding for, 21
importance, 20
District of Columbia
247
barriers to prenatal care use in, 74,79
Better Babies Project, 122,188-191
institutional reforms in, 74-75
liability insurance Costs, 69
prenatal care use in, 42,44,47,49
Employee Retirement Income Security
Act, 143
Europe (Western)
infant mortality, 18
low birthweight rates, 18
maternity systems, 2,18; see also
International perspectives on
prenatal care
Evaluation of prenatal care
from birth certificate data, 28,29,166
data sources on use, 27-28,166
definition of visits, 27
Kessner index for, 29,90,91,180,181
methodological problems, 59~0, 102,
117-118,121-122,157
multivariate analysis/predictors of use,
8-9,12,39,77-78,103-112
qualitative measures, 29,34,90-91
quantitative measures, 27-29,90-91,
178
recommendations, 157,158-159,162
studies of women's perceptions of
barriers, 89-107
time-of-onset measure of use, 28-29,
90,91
Fair Labor Standards Act, 143
Family planning services, 77,140,
148-149,153-154,161,192
Florida
availability of obstetrical care in, 69
barriers to prenatal care use in, 96,
98-99
Medicaid enrollment of pregnant
women, 71
prenatal care use in, 42,49,91,106
Grannies Program (Bibb County,
Georgia), 123,127,206-207
Health care financing, see Medicaid
Health insurance (private)
characteristics of women with, 60
cost-sharing by patient, 56,58,143
eligibility for coverage, 56-57
OCR for page 248
248
employer subsidization trends, 56-57
group, 56
outreach program coverage, 19
percentage/number of women covered
by, 55, 56
and prenatal care use, 4, 19, 55-56,
59, 61, 63, 81, 92, 101, 108-110
recommended reforms in, 143
risk factors for insufficient prenatal
care, 39, 57
scope and depth of coverage, 50,
55-57, 101, 143
waiting periods, 56, 57, 143
see also Uninsured women
Healthy Mothers, Healthy Babies
Coalition, 168
Healthy Start Program (Massachusetts),
119, 165-167
Hispanic women
cultural barriers to prenatal care, 76
prenatal care use, 3, 4, 32, 36, 38, 40,
51
risk factors for insufficient prenatal
care, 4, 32-33, 36, 38, 40, 111
sources of care used by, 64
Homeless women, barriers to prenatal
care, 7, 79-80, 82, 194
Hospitalization
barriers to admission, 20-21
see also Delivery services
Illegal immigrants, fears and prenatal
Illinois
care use, 78-79, 182, 188
barriers to prenatal care use in, 95
prenatal care use in, 42, 90
Improved Child Health Project
(Mississippi), 120, 181-182
Improved Pregnancy Outcome Project
(North Carolina), 120, 181
Indiana, prenatal care use in, 42, 49
Infant Health Improvement Projects, 168
Infant mortality
and prenatal care use, 18
programs to reduce, 88, 165-169,
171-172, 179, 180
Insurance, see Health insurance (private)
International perspectives on prenatal
care
continuity of care, 225
countries studied, 211-213
INDEX
data adequacy on, 213-214
demographic considerations, 214-216
health care financing, 218-219
home deliveries, 224
home visiting, 222-223
hospital deliveries, 223
incentives to participate in prenatal
care, 223
income considerations, 217-218
maternity-related benefits, 225-226
maternity-related services, 219-225
number of prenatal visits, 221
public clinics, 22~221
teenage childbearing, 216-217
Japan, maternity system, 2, 18; see also
International perspectives on
prenatal care
Low birthweight
and prenatal care use, 18, 171
prevention programs, 176-178
in Western Europe, 18
Maine
barriers to prenatal care use in, 110
prenatal care use in, 42, 49, 106
Massachusetts
barriers to prenatal care in, 9S, 101,
108
Healthy Start Program, 119, 124,
165-167
prenatal care use in, 39, 42, 49, 90,
104
Maternal and Child Health Services
Block Grant, 70, 119, 141, 143,
176
Maternal mortality
focus of efforts to lower, 27
and prenatal care, 18
Maternity and Infant Care projects, 64,
119, 120, 168, 179-181
Maternity and Infant Outreach Project
(Hartford, Connecticut), 122,
191-192
Maternity care systems
access problems, 13, 161
capacity inadequacies, 63-68
context for improving, 21
continuity of, 225
deficiencies, 12, 45
OCR for page 249
INDEX
definition, 20
design strategies, 137-138
financing of services, 139, 165
foreign, 18, 219-225
home deliveries, 224
home visiting, 222-223
hospital deliveries, 224
in Japan, 18
long-term reform goals, 136-140, 161
national standards needed for, 140
reform recommendations, 13-14,
136-142, 161
short-term reform goals, 140-142
underfinancing of, 232-233
in Western Europe, 18
see also Clinics
Maternity costs, 54
Medicaid
application procedures, 71-73, 183
barriers to prenatal care, 58-62, 67,
70, 72-73, 81, 183
case management, 155
characteristics of recipients, 60, 64
claims processing, 67
confidentiality concerns, 78
eligibility, 5, 50, 58, 61-62, 70, 72-73,
125, 136, 142, 145-146, 165
enrollment process, 5, 6, 59, 81,
145-146, 183
enrollment rates, 71
fines for enrollment errors, 72
information dissemination on, 146
and minority access to prenatal care, 58
notification of eligibility, 73
percentage of women covered by, 55
physician acceptance of, 5, 6, 59, 64,
67-68, 81, 170
preeligibility funding through state
programs, 165, 168
prenatal care financing with, 5
and prenatal care use, 58, 61, 63, 81,
107-108, 110, 111
presumptive eligibility, 73, 146
recommended changes, 142, 144,
14~146
reforms, 58, 61-62, 73, 119, 136
reimbursement, 67-68, 144, 145, 166,
170
separation from welfare, 61-62, 139
state variation in, 73
transportation cost coverage, 74
249
Medical malpractice insurance crisis
award size and, 230-231
causes of cost increases in, 229-233
for clinics and health centers, 69
contingency fees for lawyers and, 231
costs, 68, 69
effect on prenatal care availability, 50,
68~9, 23~239
grants to underwrite premiums, 168
locality rule, 230
medical advances and, 230
national standards in, 140
physician/obstetrician response to
increases, 23~239
profit motive of insurance companies
and, 232
public funding, 145
recommended approaches to resolving,
144, 145
state responses, 239-240
substandard physicians and, 231
underfinancing of maternity care and,
232-233
Medicare Catastrophic Coverage Act of
1988, 61
Michigan
baby showers, casefinding through,
122, 169, 200-201
961-BABY Telephone Information and
Referral Service (Detroit), 122,
169, 194-195
barriers to prenatal care use in, 108
Healthy Mothers, Healthy Babies
Coalition, 168
Maternity and Infant Care Projects,
168
prenatal care use in, 42, 104
Prenatal-Postpartum Care Program,
119, 167-169
Migrant and Rural Health Centers, 64,
65, 70
Minorities
access to prenatal care, 14, 58
programs that improve use of prenatal
care, 166
see also American Indian women;
Asian/Pacific Islander women;
Black women; Hispanic women
Mississippi
Improved Child Health Project, 120,
181-182
OCR for page 250
250
Medicaid enrollments of pregnant
women, 71
physician/patient ratios, 67
prenatal care use in, 42
National Center for Health Statistics, 45,
58
National Health Interview Survey, 60 61
National Health Service Corps, 144
National Medical Care Utilization and
Expenditures Survey, 64
National Natality Survey, 34, 38
National Survey of Family Growth, 38,
59, 64
New Mexico
Perinatal Program (Lea County), 88,
119, 171-174
prenatal care use in, 42
New York City
barriers to prenatal care use in, 76,
79-80, 96, 97-100, 109
Central Harlem Outreach Program,
122, 126, 159, 18~186
Child Survival Project,
Columbia-Presbyterian Medical
Center, 120, 125, 182-184
Community Health Advocacy Program,
122, 187-188
delayed care among Medicaid
recipients, 59
demand for prenatal services in, 66
physician/patient ratios, 67
Pregnancy Healthline, 122, 192-194
prenatal care use in, 91, 105
New York State
availability of obstetrical care in, 69
Prenatal and Infancy Home Visiting
Program (Elmira), 123, 20~206
Prenatal Care Assistance Program, 119,
174-176
prenatal care use in, 42
Prevention of Low Birthweight
Program (Onondaga County),
119, 17~178
North Carolina
barriers to prenatal care use in, 96,
98-99, 109
Improved Pregnancy Outcome Project,
120, 181
Maternity and Infant Care Project,
179-181
INDEX
Medicaid enrollments of pregnant
women, 71
prenatal care use in, 42, 44, 46, 91,
104
Obstetrical Access Pilot Project
(California), 119, 17~171
Ohio
barriers to prenatal care use in, 95
Maternity and Infant Care Project,
120, 179-181
prenatal care use in, 42, 90
Oklahoma
barriers to prenatal care use in, 95,
108-109
free pregnancy testing/prenatal care
advocacy program (Tulsa), 122,
197-199
prenatal care use in, 42, 90, 104,
105
Omnibus Budget Reconciliation Acts of
1986 and 1987, 61
Oregon
availability of obstetrical care in, 69
prenatal care use in, 42, 49
Outreach programs
and access to maternity care services,
13, 126, 161
definition, 2, 19, 135
evaluation of, 116, 186
funding for, 19, 168
goals and content, 20, 12~123, 161
insurance coverage of, 19
international perspective, see
International perspectives on
prenatal care
recommended role, 149-151
status as a health service, 19
value, 13, 19, 133
see also Casefinding; Social support
services
Pennsylvania
Concern for Health Options:
Information, Care and Education
(Philadelphia), 122, 19~197
prenatal care use in, 42
Perinatal Program (Lea County, New
Mexico), 88, 119, 171-174
Physicians, obstetricians, and other
providers
OCR for page 251
INDEX
acceptance of Medicaid-enrolled
pregnant women, S. 6,59,64,
67-68,81,168
advance payment requirements, S8,
172
attitudinal issues, 75,108,109
availability for low-income women, 6,
8,56,64,94-96,99,124-125,
165-166,169,173,238-239
casefinding role, 153
cessation of obstetrical practice,
233-234
charges for maternity services, 67-68
geographic distribution of, 66-67
grants to underwrite liability
premiums, 168
malpractice insurance problems, 6,50,
68-69,229-241
nurse-practitioners and
nurse-midwives, 68,76,125,131,
144,167,172-175,177,183
professional societies' role in
overcoming care barriers,
144-145
rejection of high-risk women, 235-238
socioeconomic status and utilization
of, 64
substandard physicians, 231
views on barriers to prenatal care, 8,
102-103
Pregnancy Discrimination Act of 1978,
56,57,143
Pregnancy Healthline (New York City),
122,192-194
Prenatal and Infancy Home Visiting
Program (New York State), 123,
205-206
Prenatal care
access to, 13
adequacy, 1, 29,41; see also
Evaluation of prenatal care
cost-effectiveness, 18,11,137
definition, 24
financial assistance programs,
164-169; see also Medicaid
geographic pockets of need, 41-45
major risk factors for nonuse, 17
pregnancy testing and, 71,81,121,
127,153, 154, 197-199
schedule of recommended visits, 27,
28
251
value, 2,8,17-18,23-24,26,27,137
Prenatal Care Assistance Program (New
York State), 119, 174-176
Prenatal care use
age and, 3,5,9,17,30-31,34,37-41,
50,60,64,81,101-102,108-111,
178
barriers to, see Barriers to prenatal care
birth certificate data on, 28,29
birth order (parity) and, 3,9,36-37,
50,81,108-112,153
birthplace of pregnant woman and,
33-34
connection to health care system and,
71
current patterns, 29-39
delayed (second trimester), 1, 28,29,
101
drug abuse and, 79,100,109,130
early (first trimester), 1, 3,5,17,28,
29,32-33,38,39,47,49,58-60,
101,158-159,169,175,178,180,
185
educational attainment and, 3,5,9,
31,33,34-37,39-41,50,56,59,
60,81,108,109,111,112
emotional support network and, 80,
81,100,108,109
episodic, 34
geographic correlates, 4,9,12,39-49,
51,60,81,110,111
health insurance and, 19, 50,55-59,
81,92,101,108-111
income and, 4,9,31,33,38-40,44,
50,56,60,108-109,111
and infant mortality rates, 18
international comparisons, 2,18
late (third trimester), 1-2,3,17,28,
29,31-33,36,38-48,50,77-78,
89-97,101,169,175,176,178
and low birthweight, 18
Kessner index of, 29,90,91,104
marital status and, 3-4,5,9,31,
37-41,50,57,60,81,108,110,
111,112
and maternal mortality rates, 18
measures of, 28,90-91,104-106
minority status and, 3,17,30-41,49,
50,60,64,81,107,109,111
multivariate analysis/predictors of, 8-9,
12,39,77-78,103-112
OCR for page 252
252
none, 1-2, 3, 29, 31-33, 36, 3~45,
47, 48, 50, 97-100, 176, 178
pregnancy outcomes and, 26, 27
reasons given by women for
insufficient use of, 89-102
socioeconomic status and, 18-19, 50,
57, 81, 97, 109, 111-112
strategies for improving, 9-12, 20,
21-22; see also Outreach
programs; Programs for improving
prenatal care use; Strategies for
improving prenatal care use
studies of, 10~106
time-of-onset measure of, 28-29, 34
trends, 17, 10, 4~51
U.S. Surgeon General's goals, 18
Prenatal-Postpartum Care Program
(Michigan), 119, 167-169
Prenatal services
evaluation of, 9-10, 23, 24; see also
Evaluation of prenatal care
federal programs, 70
funding, 70, 143
goals and content, 26-27
hospital outpatient departments, 64,
65
information dissemination on, 146,
147-148
links with other services, 65
local health departments, 65 66
nutritional supplementation and
education, 70
in organized settings, 64~6
payment sources; see Medicaid
public health departments, 64, 66
reforms needed in, 12-13, 14; see also
Recommendations
school-based, 64
see also Clinics; Community Health
Centers; Maternity care systems
Prevention of Low Birthweight Program
(Onondaga County, New York),
119, 176-178
Programs for improving prenatal care use
961-BABY Telephone Information and
Referral Service (Detroit,
Michigan), 122, 169, 194-195
Better Babies Project (District of
Columbia), 122, 127, 188-191
Central Harlem Outreach Program,
122, 126, 185-186
INDEX
Child Survival Project,
Columbia-Presbyterian Medical
Center (New York City), 120,
182-184
CHOICE hotline, 122, 19~197
Community Health Advocacy Program
(New York City), 122, 187-188
free pregnancy testing/prenatal care
advocacy program (Tulsa,
Oklahoma), 122, 197-199
Grannies Program (Georgia), 123, 127,
20~207
Healthy Start Program
(Massachusetts), 119, 165~167
Improved Child Health Project
(Mississippi), 120, 181-182
Improved Pregnancy Outcome Project
(North Carolina), 120, 181
Maternity and Infant Care Projects
(Ohio, North Carolina), 64, 119,
120, 179-181
Maternity and Infant Outreach Project
(Hartford, Connecticut), 122,
191-192
Obstetrical Access Pilot Project
(California), 119, 17~171
Perinatal Program (Lea County, New
Mexico), 88, 119, 171-174
Pregnancy Healthline (New York
City), 122, 192-194
Prenatal and Infancy Home Visiting
Program (New York State), 123,
20~206
Prenatal Care Assistance Program
(New York State), 119, 174-176
Prenatal-Postpartum Care Program
(Michigan), 119, 167-169
Prevention of Low Birthweight
Program (Onondaga County, New
York), 119, 17~178
Resource Mothers Program (South
Carolina), 123, 202-203
see also Casefinding; Outreach
programs; Social support services;
Strategies for improving prenatal
care use
Recommendations
access to maternity services, 13, 14
design of maternity care system, 13-14
evaluation of programs, 16
OCR for page 253
INDEX
goals of programs for increasing
prenatal care use, 14, 136-142
federal and state responsibilities, 14
funding, 159-161
institutional practices at care delivery
site, 14, 145-147
outreach programs, IS, 149-155
planning and needs assessment, 15,
155-157
public information campaign, 14,
147-149
removal of financial barriers, 14, 15,
142-143
research, 16, 157-159
system capacity improvements,
143-145
Resource Mothers Program (South
Carolina), 123, 202-203
Rhode Island, prenatal care use in, 42,
61
Risk factors for poor use of prenatal care,
81, 191
Social support services
for adolescents, 123, 203-205
case management, 155
definition, 2, 19, 135
financing, 155
Grannies Program (Georgia), 123, 127,
206-207
home visiting, IS, 154, 173-174
need for, 13, 154
obstetric care provider role, 155
Prenatal and Infancy Home Visiting
Program (New York State), 123,
205-206
programs, 122-123, 201-207
purpose, 9, 116
recommendations, 15, 133, 154-155,
161
Resource Mothers Program (South
Carolina), 123, 202-203
value, 11, 127, 133
Socioeconomic status and prenatal care
use, 18-19, 50, 57, 64, 81, 97,
109, 111-112
South Carolina
barriers to prenatal care use in, 95,
101
prenatal care use in, 42, 49, 90, 104
Resource Mothers Program, 202-203
253
South Dakota, prenatal care use in, 42,
105, 110
Special Supplemental Food Program for
Women, Infants, and Children,
11, 70-71, 81, 109, 121, 122,
127, 167, 176-177, 189, 199-200
Strategies for improving prenatal care use
abortion issue in, 131
basis, 54
bureaucratic difficulties, 13~131
community-based, 19
components, 14, 23, 158-159
coordination with other health
services, 12
costs, 159, 166
data sources on, 118, 163-164
design and management, 112, 127-128
education/public information about
services, 12, 14, 141
effectiveness of, 123-127, 133, 167,
169, 171, 173-174, 178, 18~182,
185
evaluation of, 9-10, 11-12, 13, 15-16,
123-124, 132-133, 157, 162,
166-167, 171, 173-174, 178,
180-182
federal role, 14, 141
financial/community support for, 128,
129-130
funding, 128, 129-130, 160, 172-173
implementation and maintenance
problems, 11-12, 128-132, 156,
160
institutional modifications, 6, 10, 12,
14, 120, 125, 141, 178-185, 204
long-term nature of, 156, 160
manpower, 10, 130, 131
outreach component, 19; see also
Outreach programs
perinatal system development
(Tennessee), 120, 184-185
planning and needs assessment, 15,
131, 155-156
positive attributes of, 127-128
recommendations, 12-13, 14-16,
140-141, 155-157, 158-160
removal of financial barriers, 10, 12,
14, 118-119, 124, 133, 140-141,
164-169
state role, 14, 141-142
start-up time, 131
OCR for page 254
254
system capacity increases, 12,14,119,
124-125,133,141,169-178
see also Casefinding; Outreach
programs; Programs for improving
prenatal care use; Social support
services
Teenagers
adequacy of prenatal care, 34
barriers to prenatal care, 78,96
casefinding for, 153,204
. . . .
Improving ~nst~tutiona arrangements
for, 204
international perspectives on
childbearing, 216-217
minorities, 31,34
pregnancy testing and prenatal care
initiation, 71,153
prenatal care use, 3,17,31,38,51,
153
programs that improve prenatal care
use by, 166
risk factors in insufficient prenatal
care, 39
social support programs for, 123,
204-205
views on barriers to prenatal care, 8,
101-102
Tennessee
perinatal system development in
Shelby County, 184-185
prenatal care use in, 43,91
Texas
availability of obstetrical care in, 69
barriers to prenatal care use in, 9S, 98,
111
Medicaid enrollments of pregnant
women, 71
perinatal system development (Shelby
INDEX
County, Tennessee), 120,
184-185
prenatal care use in, 43,90,106
Uninsured women
characteristics of, 57,60,62-63
financial assistance programs,
164-169; see also Medicaid
number/percentage, 5-6,55,62
obstacles to obtaining prenatal care,
62-63,67
prenatal care use by, 61
U.S. Department of Health and Human
Services
Expert Panel on the Content of
Prenatal Care, 26
Preventive Services Task Force, 26
U.S. Surgeon General, goals for prenatal
care use, 18
Utah, prenatal care use in, 43,49
War on Poverty, 1S3
West Virginia
barriers to prenatal care use in, 73
demand for prenatal care clinics, 66
prenatal care use in, 43
WIC, see Special Supplemental Food
Program for Women, Infants, and
Children
Wisconsin
barriers to prenatal care use in, 110
prenatal care use in, 43,106
Women's perceptions of barriers to care
adolescents, 101, 102
open-ended questions, 9~92,98
self-administered checklists, 9~92, 95,
98
women with insufficient care, 89-97
women with no care, 97-100
Representative terms from entire chapter:
improving prenatal
