European Stars And Stripes (Newspaper) - January 5, 1988, Darmstadt, Hesse Bradley asked the Magazine s readers la a Cut a Coupon and mail it to he h they agreed thai medicaid he government health program for he poof should to expanded to cover More Low income uninsured pregnant women. He has received More than 6.000 responses Man with tellers attached. They Tell of unemployment minimum wage jobs and Lack of insurance of hospitals and doctors who refuse treatment unless patients up up hundreds of dollars up front of babies born prematurely a 2 or 3 pounds and spending months to intensive care units of a system that denies s40q for prenatal checkups but shells out the 114.000 plus in the average Tow birth weight baby the Nabon has made virtually no Progress toward meeting goals Sel by the surgeon general to reduce the incidence of Tow Birl weight babies and increase Early prenatal care by 1990 in 1985, As to i960 when the goals were set Nesly percent of live births were Low birth weight and 76 percent of pregnant women received first trimester care. The goals ate 5 percent and 90 Peic enl respectively. Historically. Medicaid assistance Haa been tied to welfare eligibility Levels Sel by the slates Bui. As one doctor testified recently on Capitol Hill the trouble Wilh medicaid is that far too Lew of the poor thai s because in most Stales. The income required to get welfare is wed Beta the Federal poverty Standard of $s,73b Lor a family of three. And half Tho slates do not offer welfare at All to families with iwo parents no Mailer How Low the household income. Under a Law passed last year Szalc were allowed to extend medicaid to All uninsured pregnant women and Young children with incomes up to 100 percent of the Federal poverty line regardless of family status or welfare eligibility. Two California and Minnesota already were doing so and another 25 have decided 10 expand coverage As a result of the now Law. Bradley and rep Henry Waxman d-calif., Are trying to go even furl or his year by raising the eligibility level to 85 percent above the Federal poverty line net plan would also require Stales to provide coverage of youngsters in Low income uninsured two Parent families. Tha congressional budget office estimates the Bradley Waxman proposal would add 79.000 pregnant women and 239.000 children under age s to the medicaid roster in its lire year. The Cost to the Federal government which pays 50 to 80 percent of medicaid costs would be $65 million Tor the first Lull year of coverage. Anal Kcf part of this year s infant mortality initiative involves an extra $30 million Lor Community and migrant health centers specifically to curb infant deaths flip centers Are intended for Low income areas with few physicians and High infant modality Rales. The Reagan administration Early this year proposed an $35 million plan to reduce infant nor tally but would have financed in by reducing outlays Lor medicaid family planning services. Tho Folce of management and budget has taken no position on the congressional initiative which is burned in a much larger Money my. An administration Olli Cial contended recently thai Money is not a major Factor in reducing infant mortality. Money alone does nol produce Good outcomes Robert Helms assistant Secretary of health and human service told a House hearing. How. What and when services Are delivered is far More Bradley disagrees and the general accounting Ollice reported at the same hearing that its research showed Hal Lack of Money was a major reason pregnant women received tale prenatal Case or none at pit. An Arkansas farm wife pregnant and absolutely broke Afler two years of drought wrote Bradley she simply hoped Lor the Best when she discovered Thuro was no Piena Lal care available to her i Hough he county or stale Twenty eight weeks into the pregnancy she won into taboo for 47 minutes. Her daughter born in a Hospital emergency room weighed 2 pounds 4 ounces. After almost five months hospitalization and thousands of dollars on medicaid we brought Homo a Pound 11-ounce baby Iho woman wrote ii Only i could have received a Small amount of medical Alton Tinl tragedy in in interview Bradley said the letters he received vividly demonstrate the overwhelming need for this kind of Caro efforts to reduce infant mortality associated Pressi n North Carolina they Call in baby in Kansas Connecticut and Massachusetts it s healthy in Illinois it s "9 by 90" and in California Tho Businesslike of from television advertisements to counselling hot lines Many Stales Are striving to reduce their infant death rates. And on Capitol Hill a new National commission to prevent infant mortality is scrutinizing the results with an Eye toward making recommendations Lor a National drive we re trying to get away irom the idea that people have to invent something new in order to make a difference. They clearly do says Raa Brad executive director of the commission a government Agency. We need to do what we know How to do and the problem will be the Lime lbs led remedy is prenatal and preventive care As the commission is discovering in an examination of maternal and child health reports dating Horn 1920. It s just like they used a ditto Sheet says Grad. From 1920 to 19b7 we see the exact same strategies promoted Over and Over and Over while the goal continues to be Early and continuing care of women during their pregnancies states Are trying innovative ways to reach High risk women and allocate limited resources. A brochure promoting North Carolina s baby love medical assistance program urges Low income pregnant women to Call a toll free remember from Day one Tife 3 begun the brochure says. Take care of yourself and your baby with baby Utah and Montana residents can Call the pregnancy risk line for counselling and informal Lon about environmental threats to the fetus. In South Carolina All Low income pregnancy patients Are screened for potential complication and those at High risk Are is Surraj proper Caio including help with transportation and rescheduling missed appointments some slates like Kentucky Hava earmarked Elia Money to strengthen and expand existing prenatal services. Others have undertaken ambitious initiatives such As "9 by 90" in Illinois a reference to the surgeon general s goal of lowering the infant death rate to nine per t ,000 by 1990, the current Rale is 10.8. The "9 by 90" plan adopted in 1985, Aims to Ollor a new nutrition program expand the state s parents too soon program and increase Public funds Lor regional perinatal care networks Day care prenatal care family planning follow up nursing services for newborns substance abuse realm enl and prevention and medical services Lor poor infants and children. In Arizona the slate is helping to pay for a Newborn intensive care program a maternal transportation program and outreach and services to High risk pregnant women. Conne Licul has doubled the amount medicaid will pay for obstetrical care. Maine s health Bureau is sponsoring a television and Campaign urging Early prenatal care California has expanded an outreach Pilot program of Access irom 13 counties to the whole state. Massachusetts expanded nutrition and health programs Tor pregnant women and children and launched a multilingual Media Campaign to encourage Early pro naval care. All the Stales Aro doing Grad says. Often what they do is try to gel a Little squeeze of Money wherever they can. Many states put Money into programs without a cute Lilloo catchword. It s not always the catch phrase that s indicative of what s going new method to detect birth defects by Larrv Doyle United press International placental sampling is a promising new method of detecting genetic abnormalities Early in pregnancy but it has not Yel Bee proven effective and questions remain Abou lits safety. A panel assembled by the american medical association said studies Are under Way to determine whether the technique called Cho ionic villus sampling is As Sale As a procedure now commonly used to determine abnormalities Aboul 15 weeks into a pregnancy. Ii the safety questions Are answered satisfactorily Iho new method could be a major Advance since in can be done As Early As nine weeks into a pregnancy and theoretically should produce be Ler results than the fluid sampling method thai constitutes said or William Scot a member of the medical association s Council on scientific affairs and associate professor of obstetrics at the University of Arizona in Tucson what we re saying is this appears very promising but opinion is divided and not All the facts Are in said Scott. Whether a woman should undergo this procedure or not would depend on a number of individual factors. You can t make a Blanket tuesday january s. with More older women becoming pregnant doctors have begun to test amniotic fluid routinely to determine whether a fetus has genetic abnormalities such As Iri Somy 21. Which causes Down s syndrome. The detection of serious defects May prompt a decision to abort the fetus. In an attempt to discover such detects earlier making an abortion in necessary far less complicated scandinavian researchers in Tho late 1960s began using an ultrasound guided Catheter to remove a Small lha Chorion the outermost membrane of the fetal Placenta. The procedure has been refined in the last two decades. At least 6,000 such tests have been performed in the United states with More than 21,000 conducted internationally. Thirty one experts on an american medical association panel split evenly on the technique s effectiveness 15 of them deeming it established 15 saying it is Stilt in investigate stages and one timing the evidence inconclusive. The panel was concerned by the High 4 percent Rale of spontaneous abortion alter the procedure. But the experts noted that Tho technique is olten performed on women Over 35, who have a naturally High spontaneous abortion Rato of 4.5 percent to 61 percent. It is not Clear if the technique. Contributes to any excess fetal Thoy concluded. 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