Compelling Reasons to Invest in Maternal and Child Health.

Business, Babies & the Bottom Line.

Prevention

More than 60 percent of private-sector pre-term births and low-birth-weight cases are preventable. 1

Twenty percent of American babies are born to women who received inadequate prenatal care. 2

More than $6 in neonatal intensive care costs could be saved for every $1 spent on prenatal care. 3

Neonatal intensive care costs in the United States range from $20,000 to $400,000 per baby. 4

Almost 60 percent of all pregnancies in the United States are unintended, either mistimed or unwanted altogether-a percentage higher than that found in several other Western democracies. 5

Risk Factors

Between 11 and 21 percent of low-birth-weight births are attributable to maternal smoking. 6

Almost 17 percent of mothers reported smoking during pregnancy, doubling their risk of bearing a low-birth-weight baby. 7

Sudden Infant Death Syndrome is more than three times as likely to occur to a child who has been exposed prenatally to smoke. 8

Only one in five women who smoke quit during pregnancy. 9

More than 20 percent of pregnant women drink alcohol. 10

Nearly 20 percent of pregnant women use one or more illegal substances at some point during the prenatal period, leaving their babies prone to serious physical and mental disabilities, behavioral problems and learning impairments. 11

Low Birth Weight

In 1994, low-birth-weight (less than 2,500 grams or 5 pounds, 8 ounces) births rose slightly to 7.3 for 1994 from 7.1 to 7.2 percent for 1992-1993 births. The percent of preterm infants remain unchanged at 11 percent. 12

Almost all low-birth-weight infants require special attention. Although many function normally during childhood and beyond, they are more likely than children of normal birth weight to experience health and developmental problems. Recent medical and technological advances have increased the survival rate for the very tiniest infants and have led to increased concern about the demands these survivors place on their families and the rest of society. 13

Low-birth-weight babies are 64 percent more likely to attend special education classes than normal birth-weight babies. 14

Total medical costs for a low-birth-weight infant average $400,000. 15

Lifetime medical costs of caring for a premature baby are conservatively projected to be $500,000 per case. 16

Cesarean Delivery

In 1994, the overall cesarean delivery rate was 21.2 per 100 deliveries, 17 the lowest since 1985 but approximately four times the rate in 1970 (5.5). 18

Of the estimated four million live births, 14.9 percent were first-time cesareans, 26.3 percent vaginal births after cesareans and 78.8 percent were other vaginal deliveries. 19

Cesarean delivery rates differed by maternal age, number of prior cesareans, region, hospital size and ownership and expected source of payment. 20

In 1993, the cost of maternity care (physician fees and hospital charges) for a cesarean delivery averaged 50 percent more than for a normal vaginal delivery -$11,000 compared to $6,400, respectively. Costs also varied considerably among regions of the country. In a MetLife study, average charges for a cesarean differed by as much as 77 percent, ranging from $13,700 in New York to $7,730 in Oklahoma. 21

Insurance

Approximately 16 percent of all children under 18 living in the United States in 1993 had no medical insurance for at least part of the year. 22

Children without health insurance often go without needed primary and preventive health care services, which can lead to the need for more costly chronic and acute care services later in life and can contribute to excessive job absenteeism among their parents. From 1989 to 1993, the percentage of children covered by employer-based health insurance decreased from 63.2 percent to 57.6 percent. 23

Only a third of $34 billion in annual costs for maternity is due to normal deliveries. The remaining costs are for cesareans, premature births, home care, diagnostic testing and pharmaceuticals. 24

Prevention

More than 60 percent of private-sector pre-term births and low-birth-weight cases are preventable. 1

Twenty percent of American babies are born to women who received inadequate prenatal care. 2

More than $6 in neonatal intensive care costs could be saved for every $1 spent on prenatal care. 3

Neonatal intensive care costs in the United States range from $20,000 to $400,000 per baby. 4

Almost 60 percent of all pregnancies in the United States are unintended, either mistimed or unwanted altogether-a percentage higher than that found in several other Western democracies. 5

Risk Factors

Between 11 and 21 percent of low-birth-weight births are attributable to maternal smoking. 6

Almost 17 percent of mothers reported smoking during pregnancy, doubling their risk of bearing a low-birth-weight baby. 7

Sudden Infant Death Syndrome is more than three times as likely to occur to a child who has been exposed prenatally to smoke. 8

Only one in five women who smoke quit during pregnancy. 9

More than 20 percent of pregnant women drink alcohol. 10

Nearly 20 percent of pregnant women use one or more illegal substances at some point during the prenatal period, leaving their babies prone to serious physical and mental disabilities, behavioral problems and learning impairments. 11

Low Birth Weight

In 1994, low-birth-weight (less than 2,500 grams or 5 pounds, 8 ounces) births rose slightly to 7.3 for 1994 from 7.1 to 7.2 percent for 1992-1993 births. The percent of preterm infants remain unchanged at 11 percent. 12

Almost all low-birth-weight infants require special attention. Although many function normally during childhood and beyond, they are more likely than children of normal birth weight to experience health and developmental problems. Recent medical and technological advances have increased the survival rate for the very tiniest infants and have led to increased concern about the demands these survivors place on their families and the rest of society. 13

Low-birth-weight babies are 64 percent more likely to attend special education classes than normal birth-weight babies. 14

Total medical costs for a low-birth-weight infant average $400,000. 15

Lifetime medical costs of caring for a premature baby are conservatively projected to be $500,000 per case. 16

Cesarean Delivery

In 1994, the overall cesarean delivery rate was 21.2 per 100 deliveries, 17 the lowest since 1985 but approximately four times the rate in 1970 (5.5). 18

Of the estimated four million live births, 14.9 percent were first-time cesareans, 26.3 percent vaginal births after cesareans and 78.8 percent were other vaginal deliveries. 19

Cesarean delivery rates differed by maternal age, number of prior cesareans, region, hospital size and ownership and expected source of payment. 20

In 1993, the cost of maternity care (physician fees and hospital charges) for a cesarean delivery averaged 50 percent more than for a normal vaginal delivery -$11,000 compared to $6,400, respectively. Costs also varied considerably among regions of the country. In a MetLife study, average charges for a cesarean differed by as much as 77 percent, ranging from $13,700 in New York to $7,730 in Oklahoma. 21

Insurance

Approximately 16 percent of all children under 18 living in the United States in 1993 had no medical insurance for at least part of the year. 22

Children without health insurance often go without needed primary and preventive health care services, which can lead to the need for more costly chronic and acute care services later in life and can contribute to excessive job absenteeism among their parents. From 1989 to 1993, the percentage of children covered by employer-based health insurance decreased from 63.2 percent to 57.6 percent. 23

Only a third of $34 billion in annual costs for maternity is due to normal deliveries. The remaining costs are for cesareans, premature births, home care, diagnostic testing and pharmaceuticals. 24

Medical insurance is five times less likely to be available to part-time employees of medium and large companies. 25

Child Care

More than 38 percent of working mothers experienced a disruption in childcare arrangements in 1993 that required an alternative arrangement. Twelve percent of these women lost time from work. 26

Footnotes

1 Kathy Marshall and Carol Kramer, "Worksite Prenatal Programs Cut Costs," Personnel Journal (October 1993), citing the American Journal of Obstetrics and Gynecology (May 1987).

2 Carnegie Corporation of New York, Starting Points: Meeting the Needs of Our Youngest Children (New York, NY: Carnegie Corporation of New York, April 1994).

3 Erik Zicklin, "Prenatal Teamwork Fosters an Employer/Employee Partnership," Business and Health (Mid-March 1992), citing Michigan Department of Health.

4 Jennifer Laman and Martha King, "Promoting Healthy Babies," NCSL Legisbrief, National Conference of State Legislators (February 1994)

5Sarah S. Brown and Leon Eisenberg, The Best Intentions (Washington, D.C.: Institute of Medicine, 1995).

6 Joseph DiFranza, M.D., and Robert Lew, Ph.D., "Effect of Maternal Cigarette Smoking on Pregnancy Complications and Sudden Infant Death Syndrome," The Journal of Family Practice (April 1995).

7 National Center for Health Statistics, Centers for Disease Control and Prevention, "Advance Report of Final Natality Statistics, 1992," Monthly Vital Statistics Report, 43, no. 5 (Supplement, October 25, 1994).

8 DiFranza and Lew, 1995.

9 Terry Feng, "Substance Abuse in Pregnancy," Current Opinions in Obstetrics and Gynecology (February 1993).

10 National Center for Health Statistics, "Advance Report of Final Natality Statistics, 1994," Monthly Vital Statistics Report, 44, no. 11 (June 24, 1996) citing A. Chandra, "Health Aspects of Pregnancy and Childbirth: United States 1992-88," National Center for Health Statistics, Vital Health Statistics, 23, no. 18, 1995.

11 U.S. Public Health Service. Healthy Start Fact Sheet. Rockville, MD, May 1992.

12 National Center for Health Statistics, 1996.

13 Linda Schuurmann Baker, Hope Corman, Eugene Lewit and Patricia Shiono, "The Direct Costs of Low Birth Weight," The Future of Children, 5, no. 1 (Spring 1995).

14 March of Dimes Birth Defects Foundation, Healthy Babies, Healthy Business, 1993.

15 Carnegie Corporation of New York, 1994.

16 Cynthia K. Walker, "Healthy Babies for Healthy Companies," Business and Health (May 1991).

17 National Center for Health Statistics, 1996.

18 National Center for Health Statistics, National Center for Disease Control and Prevention, "Rates of Cesarean Delivery-United States, 1993," Morbidity and Mortality Weekly Report, 44, no. 5 (April 21, 1995).

19 National Center for Health Statistics, 1996.

20 American Hospital Association, "Reducing Cesarean Births: Understanding the Issues," (December 1994).

21 Margaret Mushinski, "Average Charges for Uncomplicated Cesarean and Vaginal Deliveries, U.S., 1993," Statistical Bulletin, MetLife, (October-December 1994).

22 Robert Wood Johnson Foundation, Providing Universal Health Insurance Coverage to Children: Four Perspectives, Executive Summary (Princeton, N.J.: Robert Wood Johnson Foundation, March 1996).

23 National Governors' Association, "Providing Health Insurance Coverage to Uninsured Children," Issue Brief (May 1, 1995).

24 Zicklin, 1992.

25 U.S. Department of Labor, Bureau of Labor Statistics, "BLS Reports on Employee Benefits in Medium and Large Private Establishments, 1993," BLS News Release, September 30, 1994. The data were collected prior to passage of FMLA.

26 Celia Silverman, Michael Anzick, Sarah Boyce, Sharyn Campbell, Ken McDonnell, Annmarie Reilly, and Sarah Snider, EBRI Databook on Employee Benefits (Washington, D.C.: Employee Benefit Research Institute, 1995), Table 10.4.

© National Parent Information Network

Credits: The National Campaign to Prevent Teen Pregnancy