Saturday, February 5, 2011

The beginning of life

Yesterday I was chatting with a friend who is training to be a midwife. (She's currently a nicu nurse and her stories always fascinate me!) Since one of my classes this term is focused on atypical development from 0 to age 8 I have found that she is a wealth of information about the articles and studies I'm reading for class about prenatal care and early development. Yesterday, however, I asked her a question about development in the second trimester and she admitted that she wasn't as familiar with that time frame. The clinic where she is doing her midwife internship happens to serve a population living in low socioeconomic status (Avery similar population to the one at my school). She explained that medicaid doesn't start coverung prenatal visits until the 20th week.

Medicaid does not cover prenatal visits until the 20th week.

I can't get that out of my head. I woke up thinking about it this morning.

So all the kids I teach were not eligible for prenatal care until week 20 because their families did not have private insurance. They were too poor to be allowed to have early prenatal care.

I am sure there are studies out there that support why it is alright to wait for the 20 week line but that doesn't change the fact that we have created a huge gap in society between parents who are rich enough for early prenatal care and those who are not. Our children are starting out their earliest days of life already at a disadvantage. And the thing is their parents probably need prenatal care the most. If nothing else they need to hear from a doctor what they can and cannot eat or do. My friends who have been pregnant spent hours on the Internet looking for answers the minute they saw that positive sign. By the time they got to the doctors office they knew many of the recommendations already. They tracked their pregnancy using online programs to be sure of exactly how far along they were. Many of the families at my school do not have Internet access. They are relying only on neighbors and old wives tales to get information before that 20 week visit. They have to hope they correctly count their weeks and don't lose track so that they get to the doctors on time.

My friend also shared with me that in her community there is a distinction between the poorest families and those still on medicaid but still considered to have resources. The public health center will only accept the poorest families, leaving the rest to find a doctor that accepts Medicaid. She also mentioned that the doctors offices only get reimbursed about $25 per visit for these families although the costs are much greater. Sadly, that loss of revenue drives many doctors to not accept Medicaid, leaving an entire set of the population fighting for appointment times for their new babies. Once again, we have created a situation where our children are starting life at an immediate disadvantage from their peers.


Kelly Teaches said...

Ugh, this really is so depressing. Especially because everyone looks to education first when kids are not doing well in schools when meanwhile there are SO many other factors long before the children get to us!

Gills said...

Hi! Two quick thoughts: Medicaid will cover the whole pregnancy, but the wait to get coverage usually takes until about 20 weeks, so I rarely see people in their first trimester.

Thanks :)