Friday, September 4, 2009

The truth about preconception care

Did you know women who are on Medicaid because they're pregnant get kicked off after 60 days? Yes, after you've made that cute little baby and gotten your one postpartum visit, you no longer need medical care. Even if you've just delivered a preterm baby - putting you at high risk for having another one - you're off. Even if you're still poor and now unable to afford family planning services - putting you at high risk for a short birth interval and even HIGHER risk for a repeat preterm birth - sorry! The Pump Handle discusses Preterm Births and Changing Minds, highlighting work at Emory University to reduce preterm births in high-risk mothers by (gasp!) getting them comprehensive interconception medical care!

The surprise was just how unhealthy some of these women giving birth to preterm infants really were. Nearly one-fourth of the mothers were sick when the program began. They had severe hypertension, sickle-cell disease or uncontrolled heart problems. Even though they would have automatically become eligible for Medicaid once they were pregnant, for these most at-risk women, “pregnancy is too late,” Brann says."

The point of preconception (and interconception) care is that in many ways, you're wasting your money on prenatal care. You can't fix a lot of medical problems in 7-8 months of prenatal care. If you want healthy baby and healthy mom, you need a healthy population of moms. And since 50% of pregnancies are unplanned, ALL women of childbearing age need to get adequate care to be as healthy as possible. I will admit, when I first started hearing about "preconception care", I was squicked out. Women are not potential baby vessels who only deserve health care so they'll turn out better babies. Women deserve health care because they are human, and health care is a human right. But if we can get health care for all by pointing the wasted money and waste of life, then to the barricades for preconception care.

Just don't let anyone tell you that "preconception care" is a visit to the doctor before you start trying to conceive. See above re: how long it takes to fix medical problems and the 50% unplanned pregnancies. Preconception care is, quite simply, good health care throughout a woman's reproductive life.


MomTFH said...

This is a point I try to make to people who seem to think our safety net is already working for people. I have heard even halfway decent journalists discussing the current health care debate who assume that Medicaid covers all of the poor adequately, when that is far from the truth.

publichealthdoula said...

SO far from the truth. I have worked in states where it is basically impossible to get on Medicaid unless you are pregnant, a child, or almost literally penniless.