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The June 24, 2022 US Supreme Court decision in Dobbs v Jackson Women's Health Organization resulted in an expansive restriction on abortion access that had been constitutionally guaranteed for nearly half a century. Currently, 14 states have implemented complete bans on abortion with very limited exceptions, and an additional 7 states have implemented abortion bans at 6 to 18 weeks' gestation. It has been well demonstrated that restrictive policies disproportionately limit abortion access for minoritized people and people of low socioeconomic status; the financial and geographic barriers of these post- Dobbs restrictions will only exacerbate this disparity. Proponents of abortion restrictions, who identify as pro-life, assert that these policies are essential to protect children, women, and families. We examine whether the protection of these groups extends past conception by evaluating the association between state abortion legislation and state-based policies and programs designed to provide medical and social support for children, women, and families. We found that states with the most restrictive post- Dobbs abortion policies in fact have the least comprehensive and inclusive public infrastructure to support these groups. We suggest further opportunities for advocacy. (Am J Public Health. 2024;114(10):1043–1050. https://doi.org/10.2105/AJPH.2024.307792) [ABSTRACT FROM AUTHOR]

The author addresses ways to move forward to achieve optimal nutritional status during the first 1000 days, which is critical because children experience more growth and development in that time period. Topics discussed include main themes that emerged in a series of international articles that drew attention to the critical impact of maternal and child nutrition during the first 1000 days, and barriers and opportunities to be considered in advancing the quality of nutrition during that period.

Objectives. We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions. Methods. Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4000000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged >28 days and <1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles. Results. During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile. Conclusions. During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions. {Am J Public Health. 2009;99:1220-1226. doi:10.2105/AJPH.2008.143578) [ABSTRACT FROM AUTHOR]

Objectives. We sought to provide a national profile of rural and urban American Indian/ Alaska Native (AI/AN) maternal and infant health. Methods. In this cross-sectional study of all 1989-1991 singleton AI/AN births to US residents, we compared receipt of an inadequate pattern of prenatal care, low birthweight (< 2500 g), infant mortality, and cause of death for US rural and urban AI/AN and non-AI/AN populations. Results. Receipt of an inadequate pattern of prenatal care was significantly higher for rural than for urban mothers of AI/AN infants (18.1% vs 14.4%, P ≤ .001); rates for both groups were over twice that for Whites (6.8%). Al/AN postneonatal death rates (rural = 6.7 per 1000; urban = 5.4 per 1000) were more than twice that of Whites (2.6 per 1000). Conclusions. Preventable disparities between AI/ANs and Whites in maternal and infant health status persist. (Am J Public Health. 2002;92:1491-1497) [ABSTRACT FROM AUTHOR]

Objectives. This study sought to identify characteristics of high-risk pregnant women that predicted long-term participation in a home visitation program. Methods. Data regarding sociodemographic characteristics, perceived needs, psychological functioning, substance use, and informal social support were collected prospectively from 152 short-term and 221 long-term program participants. Results. In comparison with short-term participants, long-term participants were more likely to have been African American, married, nonsmokers, and enrolled in the program during their second trimester of pregnancy, and they were more likely to have had emotional and instrumental support needs. Conclusions. Women with greater social support needs and healthier behaviors were more receptive to long-term home visitation than other women. (Am J Public Health. 2000;90:121-124) [ABSTRACT FROM AUTHOR]

Background. Care coordination is an important component of the enhanced prenatal care services provided under the recent expansions of the Medicaid program. The effect of maternity care coordination services on birth outcomes in North Carolina was assessed by comparing women on Medicaid who did and did not receive these services. Methods. Health program data files, including Medicaid claims paid for maternity care coordination, were linked to 1988 and 1989 live birth certificates. Simple comparisons of percentages and rates were supplemented by a logistic regression analysis. Results. Among women on Medicaid who did not receive maternity care coordination services, the low birth weight rate was 21% higher, the very low birth weight rate was 62% higher, and the infant mortality rate was 23% higher than among women on Medicaid who did receive such services. It was estimated that, for each $1.00 spent on maternity care coordination, Medicaid saved $2.02 in medical costs for newborns up to 60 days of age. Among the women who did receive maternity care coordination, those receiving it for 3 or more months had better outcomes than those receiving it for less than 3 months. Conclusions. These results suggest that maternity care coordination can be effective in reducing low birth weight, infant mortality, and newborn medical care costs among babies born to women in poverty. [ABSTRACT FROM AUTHOR]

Abstract: We evaluated a comprehensive program of prenatal and postpartum nurse home visitation for socially disadvantaged women bearing first children. Eighty-five per ¢ of the participating women were either teenagers (< 19 years at registration), unmarried, or of low socioeconomic status. Women were randomly assigned to either nurse home visitation or comparison services (free transportation for prenatal and well-child care and/or sensory and developmental screening for the child). During the first four years after delivery of their first child, in contrast to their counterparts in the comparison group, nurse-visited White women who had not graduated from high school when they registered in the study returned to school more rapidly; nurse-visited, poor, unmarried White women showed an 82 per ¢ increase in the number of months they were employed, had 43 per ¢ fewer subsequent pregnancies, and postponed the birth of second children an average of 12 months longer. [ABSTRACT FROM AUTHOR]

The article emphasizes the major policy issues which were met in the development and administration of the maternal and child health programs in the U.S. The legislative history of the Maternity and Infancy Act pf 1920-1929 made it clear that it was the intent of the Congress that the findings of its studies and reports should be used to help state and local groups to take appropriate action to improve the care of pregnant women and children. It has been debated on whether the country have a national social policy for children that is the basis for the development and continued support of child health and welfare services.

The Bohol Project (1975-1979) sought to improve maternal and child health and to increase the use of family planning among a rural Philippine population of 400,000. Research indicated that maternal and child health (MCH) services did become more available during the Project period and coverage of the priority populations improved. Family planning (FP) use, particularly of less effective methods, increased and fertility declined although some change could have been expected even without the Project. Deaths due to neonatal tetanus were almost eliminated but mortality rates did not decline for a number of reasons, including the fact that services were probably not tailored closely enough to local health problems, especially respiratory diseases. The Project showed that it was possible to increase health and family planning services by using low-cost strategies (such as setting up community drug stores) and by employing paramedical workers, in this case, midwives. Preventive MCH-FP services were not overwhelmed by curative services as had been feared. Perhaps the most significant contributions of the Project were the lessons learned about delivering health and family planning services and conducting evaluation research. In general, if developing countries could maintain well-evaluated field laboratories for working out health and family planning delivery approaches before going nationwide, it is likely that time and money would be saved in the long run. [ABSTRACT FROM AUTHOR]

The article presents a study that compared the health at birth of the index infant and the health of infants born to school age mothers In New Haven, Connecticut. Around 350 special programs have been established which offers medical, educational and social services to school age parents. The medical component of the program varies considerably where some programs merely refer clients for medical care and some provide obstetric or pediatric care along with educational and social services. The Young Mother Program provided educational and special services through the Polly T. McCabe Center as well as obstetric and social services.

The concept of central place theory is examined and a method is described for determining the optimal locations for Maternal and Infant Care Projects so that health services are accessible to and utilized by the greatest number of eligible persons. [ABSTRACT FROM AUTHOR]

The article presents some selected substantive results from a study of the delivery of health services in New York City. Focus has been given on the stratification of births into ethnic groups to observe populations with different demographic characteristics, risks, and patterns of medical care. The study make use of a limited number of outcome indicators such as birth weight, gestation, and infant mortality. Results of the study indicated concentrations of sociodemographic and medical-obstetric risks in the Puerto Rican and African groups, resulting in a more low birth weight infants than the white native-born and foreign-born groups.

The article discusses the development of health care services for mothers and children in the U.S. In 19th century, social action for the welfare of children has led to the concept of maternal and child health services. Several organizations were formed to improve the condition of abused children. Due to the desire to improve children welfare, advances in medicine especially in pediatrics and obstetrics and in medical education were developed. Then, the state established several health departments that provide governmental framework for maternal and child health programs.

Costs and savings of child health services were studied in a private mining company in Peru. Despite considerable outlays for medical services, few children under age 5 were vaccinated, and half of their illnesses went untreated. Children who were attended at the company clinic usually received unnecessary medication. As a result of the study, the company hired additional staff to provide integrated maternal-child preventive health care and family planning and contracted for intensive training and periodic on-site supervision. In less than 2 years, vaccination coverage reached 75%, and virtually all children under age 1 were enrolled in growth monitoring. Prescriptions were reduced by 24%, including a 67% drop in antimicrobials. The cost of the new services was $13,200 for the first 2 years. Approximately $6800 has been saved in pharmaceuticals prescribed for respiratory infection and diarrhea. Recently, two more mines adopted maternal and child health and family planning services. It is hoped that cost-benefit arguments will encourage other companies to incorporate aggressive child survival measures into their health plans. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue including one that describes the birth and growth of maternal and child health services in the U.S. and another one that focuses on infant mortality.

The article presents a position paper from the American Public Health Association relative to alternatives in maternity care in the U.S. The association endorses the philosophy of family centered maternity care with full recognition of human rights. It urge to the modification of the in-hospital environment to make family- entered care available to both high-risk and low-risk mothers who desire it. In addition, the group urges to develop guidelines for promotion of mother and infant bonding. Other significant decisions of the group are presented.

The article presents an overview of China's family planning campaigns since the 1950s and offers a perspective on how the market economy has produced a fertility rate of 1.7 children per woman in 2004. Topics include the one-child policy started in 1978 which encouraged the use of birth control methods and used rewards and penalties to enforce the program and the migration of young farmers to the cities in the 1990s which changed economic patterns in China and made it more difficult for young couples to have more than one child.

Abstract: A matched pair case-control study was conducted to compare birth weights, gestations, and length of hospital stay (LOS) of 532 children subsequently reported as physically abused with comparable data from a group of control children matched on age, sex. race. and maternal education. Our results indicated a moderate association between both low birthweight and very short gestation with physical abuse. Results for LOS were inconclusive. (Am J Public Health 1985: 75:780-781.) [ABSTRACT FROM AUTHOR]

The article presents a study on the risks, medical care and infant mortality in New York City. The study examines the characteristics of prenatal care among pregnant women. Results of the study indicated that more than half of the 142,017 live births were associated with one or more social, medical or obstetric risks that could influence their survival. Of this number, 3,115 infants died during the first year of life, resulting in a cohort infant mortality rate of 21.9 per 1,000 live births. Based on the findings, the study suggested for more support in medical and health services for pregnant women particularly in some ethnic groups, who tend to have few prenatal visits.

The article provides information on the campaign for proper prenatal care undertaken by the Michigan Department of Public Health in Saginaw County, Michigan. The campaign is undertaken to control the rapid increase of infant death rates in the county which reaches at 17.6 percent for every 1,000 live births, rate that has been evaluated to be higher than the statewide average of 13.2 deaths per 1,000. Moreover, the author particularly highlights the movement initiated which give rise in the constitution of Family Health Advisory Committee that will ascertain the scope of the problem and will evaluate for a certain course of action. Furthermore, this reveals the three major objectives of the vommittee together with the detailed information on the planned campaigns for the problem.