Prenatal Care and Health Care Access Term Paper

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¶ … prenatal care and health care access on infant death outcomes in five public health districts with the highest and lowest rates of infant deaths in georgia

Infant rate mortality in Georgia is extremely high and is an indicator of the overall poor status of health among women and children in this state. Between 1990 and 2000, it is reported that Georgia was among the states with the highest rate of infant deaths. In 1990 the infant morality rate in Georgia was at 12.4 deaths for each 1,000 live births and decreasing to 8.5 per 1,000 in 1998. The infant death rate among the white population is 6.1 per 1,000 while the African-American population was stated at a much greater rate of 13.5 per 1,000, which is over twice as high as infant death rates among the white population in the state of Georgia. (Georgia Department of Human Resources: Infant Mortality Fact Sheet, 2000)


The purpose of this study is to investigate Infant mortality in African-American women in Georgia for the years 2000-2005 in five public health districts with the highest rates of infant mortality and five public health districts with the lowest infant mortality rates (so we are looking at 10 public health districts total that can be found on the OASIS website) in the state of Georgia).


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It is stated by the Georgia Department of Human Resources in the work entitled: "Infant Mortality: Fact Sheet" that the primary cause of infant deaths in the state of Georgia has been found to be low birthweight, or babies who are born weighing 5.5 pounds or less. The second primary cause of infant mortality in the state of Georgia is premature birth, which is often characterized by low birthweight. Risk factors stated by the Georgia Department of Human Resources include those of:

1) Conception at a young age;

2) Poor health and/or nutritional status of the mother;

Term Paper on Prenatal Care and Health Care Access on Assignment

3) Some infections including reproductive tract infections and periodontal infections;

4) Substance abuse;

5) Closely-spaced pregnancies;

6) Inadequate prenatal care;

7) Inadequate folic acid intake; and 8) Positioning babies on their stomachs to sleep. (Georgia Department of Human Resources, 2000)

Reduction of infant mortality rates in the state of Georgia during the 1990s was accomplished through improvement of technologies and facilities in the treatment of severely underweight babies and increasing the access to quality prenatal care for women who are pregnant. Finally, raising the concern of the public about reduction of the risks contributing to SIDS has assisted in reducing infant mortality rates in the state of Georgia. While the survival of low birthweight babies is more likely in Georgia due to technological advances there is a great cost in the intensive and extended care necessary for these babies to survive. The Division of Public Health (DPH) in the state of Georgia has focused on combating low birthweight through placing an emphasis on prevention program improvement. The following table lists the infant mortality by health district for black infants during the period 1990-1997 in the state of Georgia.

Infant Mortality by Health Districts, Black Infants 1990-1997

Source: Perinatal Epidemiology, Epidemiology and Prevention Branch, Georgia Division of Public Health, November 1990-1997 Vital Records

The following chart lists the infant mortality by health district for black infants 1990-1997.

Infant Mortality by Health District, Black Infants, 1990-1997

Source: Perinatal Epidemiology, Epidemiology and Prevention Branch, Georgia Division of Public Health, November 1998, Source: 1990-1997 Vital Records

State of Georgia Infant Mortality by Race


Neonatal, Postnatal and Total Infant Mortality

Source: Perinatal Epidemiology, Epidemiology and Prevention Branch, Georgia Division of Public Health, November 1998, Source: 1990-1997 Vital Records


The five health districts in the state of Georgia with the highest infant mortality rate for the years 2000 through 2005 are those shown in the following table.

Five Health District in the State of Georgia with the Highest Infant Mortality Rate

Infant Deaths & Infant Mortality Rate (IMR), All Causes, Race: Black

2000 2001 2002 2003 2004 2005 SELECTED YEARS TOTAL DEATHS DEATHS DEATHS DEATHS DeKalb Health District 83-76 83-70 87-68-467 Crawford 0-0 1-0 0-2-3 Jones 0-0 2-3 1-2-8 Twiggs 0-2 0-3 2-1-8 Columbia 3-2 2-2 2-4-15 Jenkins 1-0 1-1 1-0-4 Screven 3-0 1-3 3-1-11 Chattahoochee 0-1 0-1 0-2-4 Harris 0-2 2-2 0-1-7 Quitman 0-0 1-0 2-1-4 Sumter 1-5 3-3-10 6-28 Calhoun 1-1 1-0 0-3-6 Early 0-2 1-4 3-0-10 Mitchell 6-2 3-4 2-3-20 Worth 1-2 0-0 0-0 3

Source: Oasis (2008)

The infant mortality rate in these health districts is extremely higher than in other Georgia Health Districts throughout the state.


The work of McDermott, et al. (1999) entitled: "Does Inadequate Prenatal Care Contribute to Growth Retardation among Second-Born African-American Babies" reports a study in which the relation between "adequacy of prenatal care and risk of delivery of full term small-for-gestational-age infants" was explored. Data was obtained from "...materially linked birth certificates for 6,325 African-American women whose first pregnancies ended in single, full live births in Georgia from 1989 through 1992." (McDermott, et al., 1999) McDermott et al. states that babies whose birth weights are less than "the 10th percentile for gestational ages are considered small for gestational age and are at risk of increased morbidity and mortality. However, being small at delivery is likely to affect health primarily if the infant's in utero growth was retarded in some way." (1999) Small Gestational Age has been linked to smoking, insufficient weight gain, and hypertensive disease and the risk of small gestational age is higher in the first pregnancy than in following pregnancies. Mothers who have a history of delivering babies that are SGA are at a higher risk of delivery SGA babies in the future. Genetics plays a role in repeated SGA deliveries and low socioeconomic status and weight loss during pregnancy has also been linked to small gestational age babies. Prenatal care generally includes interventions that address risk factors for SGA including smoking, hypertensive disease, insufficient weight gain and obstetric complications during pregnancy. Researchers state findings that "prenatal care is associated with a reducing in SGA births" (McDermott, et al., 1999) and that prenatal care has the greatest impact on babies born at 40-42 weeks gestation.

The work of Ashman (2005) entitled: "Infant Mortality and Financial Stability" relates that infant mortality "is most heavily determined by the financial stability of a family. The high mortality rate in urban Atlanta, Georgia and the low mortality rate in urban White Plains, New York exemplify the correlation between the financial income and infant mortality in the Untied States. A family's income determines access to good prenatal care." (Ashman, 2005) Ashman relates that a mother's access to prenatal care is the first consideration in seeking a solution to high infant mortality rates because without prenatal care "mothers increase their chances of engaging in unhealthy activities which will affect the health of the baby and of themselves; they increase the risk of having premature infants and of losing an infant to complications during the pregnancy." (Ashman, 2005) the prenatal visit involves weighing the patient, checking blood pressure, testing urine for possible infection and monitoring of the heartbeat of the baby and checking the growth of the baby. Furthermore, "a prenatal health care team administers various tests and gives advice to mothers.

The health care provider discusses healthy eating habits, avoiding unhealthy environments and exercising carefully with the approval of the physician." (Ashman, 2005) Ashman reports that the average costs for prenatal care include hospital costs for a delivery with no complications is approximately $6,400 however, in situations where complications exist a longer hospital stay is required for the infant resulting in "the median treatment cost of delivery averages up to $50,000." (Ashman, 2005) Ashman states that the present "inadequate financial support for mothers and their families in Atlanta results in their dependence on the federal program Medicaid. The federal government and the governments of each state have devised this medical program to pay for medical assistance for individuals and families with low incomes and resources who meet eligibility criteria. Individuals eligible for Medicaid range from pregnant women to children to the elderly." (Ashman, 2005)

Eligible women are able to access this program yet the eligibility requirements in the State of Georgia for pregnant women have undergone changes. Ashman states that under the plan developed by Governor Perdue "pregnant women and infants in households earning $34,040 or more for a family of four would not longer qualify for Medicaid." (Ashman, 2005) Ashman relates that the total eligibility income for a family of four "is barely enough for an expectant mother to survive, much less for an expectant single mother. The government estimates that 12,500 women may lose prenatal care because of their inability to afford the costs of prenatal and maternity services." (Ashman, 2005)

Ashman relates the fact that "the inconsistency of government officials in the state of Georgia affects the aid available to mothers in Atlanta. A solution capable of aiding expectant mothers… [END OF PREVIEW] . . . READ MORE

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APA Style

Prenatal Care and Health Care Access.  (2008, February 12).  Retrieved February 26, 2020, from

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"Prenatal Care and Health Care Access."  February 12, 2008.  Accessed February 26, 2020.