Strategy: Prenatal Care and Drug Abuse Treatment for Pregnant Women

Strategy

Prenatal care and drug abuse treatment programs for pregnant women and teenagers can help ensure healthy babies and prevent the developmental and behavioral problems caused by alcohol and other drugs.

Community Problem Addressed

The incidence of infant mortality and drug- and alcohol-addicted babies is linked to the quality of prenatal care the mothers received. Low-income families sometimes do not have ready access to-or they do not seek-health care. Birth defects, developmental problems, and behavioral problems occur in many children whose mothers have not received adequate prenatal care. Prenatal health-care programs for women in low-income communities can help prevent the occurrence of developmental problems that contribute to low academic achievement and the likelihood of delinquent behavior.

Key Components

Community-based clinics that run prenatal infant- and mother-care programs are often supported by funds and other resources from a combination of sources, including local and federal government agencies, private corporations, and nonprofit organizations.  These facilities convey key messages-including the importance of early prenatal care and risk factors associated with low birth weight and using alcohol, drugs, or smoking during pregnancy-to pregnant women and teens through aggressive outreach into targeted communities. Treatment and prevention programs typically use health professionals to educate and treat the mothers.

Key Partnerships

Most programs using this strategy are administered and supported through local, county, state, and federal agency partnerships that coordinate needed health services in targeted communities, refer clients, and deliver follow-up services to infants and mothers. Coordinating services benefits each participating agency by helping to ensure efficient delivery of services to the women and children most in need.  The key to client acceptance of the program is involving women from the targeted community as outreach workers. Such staff can build relationships with the mothers while treating their drug problems and providing them with vital health information. Local corporations can donate funds for transportation, educational materials, and publicity.

Potential Obstacles

A key obstacle to successfully implementing prenatal health and treatment programs is getting information to women most in need and convincing them to follow this urgent medical advice. Some women who have already used drugs or alcohol while pregnant may be reluctant to receive help because of fear or shame. Others who need and want services require transportation or childcare support in order to access them. Community residents trained as outreach workers can overcome some potential clients' fears and concerns, helping them understand the need for prenatal care and coordinating transportation to ensure they receive that care.

Examples of Success and Results

The Healthy Start program was launched in 1991 by the Health Resources and Services Administration (HRSA) of the U.S. Public Health Service to demonstrate innovative ways to reduce infant mortality in some communities with the highest infant mortality rates in the country.

HRSA chose 13 urban areas and two rural areas in which to implement a five-year Healthy Start demonstration of community-based approaches to reducing infant mortality.

Now proven effective through extensive research and evaluation, the components of the Healthy Start program include community involvement through a consortium and other community empowerment strategies; outreach and case management to identify women, bring them into care, refer them to appropriate services, and track them as they obtain services, generally using lay workers for many functions; a variety of other non-traditional support services, such as transportation and nutrition education; enhanced clinical services, building on an existing delivery system; and community-wide public information campaigns. Healthy Start has demonstrated that local communities can, with substantial federal funding, develop and implement innovative approaches to reducing infant mortality. The program is designed as a long-term rather than a short-term strategy for reducing infant mortality and deterring delinquent behavior in children.

A local example of a similar program is Elmira, New York's [population 33,724], Home Visitation Program, which uses nurses who work to develop individualized and respectful relationships with the parent(s). The program has been effective with parents identified as high-risk participants: young, unmarried and poor. Among that group, the program is credited with a 75 percent decrease in reports of child abuse and neglect and a 56 percent reduction in the number of visits to the emergency room for illness or accidents.