Percentage of Alaska women seeking prenatal care continues to drop

Posted: Thursday, February 07, 2002

ANCHORAGE (AP) -- The percentage of Alaska mothers receiving late or no prenatal care increased in 1999, continuing a trend begun in the mid-1990s, according to a report on the health of America's babies.

Reviewing information collected by states, the report determined that 4.8 percent of Alaska mothers received prenatal care only in the third trimester of their pregnancy, or no prenatal care.

That tied Alaska with Arkansas for 44th among states, according to a report by Kids Count, a state-by-state effort to track the status of children in the United States.

Kids Count is a project of the Annie E. Casey Foundation, a Baltimore-based charitable organization dedicated to helping disadvantaged children.

The numbers, however, do not jibe with the experience of the Alaska Division of Public Health.

''It's not our experience anecdotally,'' said Pam Muth, chief of the maternal child and family health section. She suspects reporting bias from rural Alaska may have contributed to the high numbers.

If pregnant women in villages received care from health aides, but not from physicians, they may been recorded as receiving no care, Muth said.

''It's clearly something we need to watch,'' Muth said. ''If it's true, we have a problem.''

In 1994, Alaska ranked ninth in the nation in the percentage of women receiving prenatal care, according to Kids Count. Just 2.8 women in 100 received no prenatal care or care only in their third trimester.

But a year later Alaska dropped to 20th and by 1998 ranked 42nd in the nation.

Bill O'Hare, Kids Count program coordinator and one of the authors of the report, said it was compiled from birth information collected from states and sent to the National Center for Health Statistics.

Mothers who receive timely prenatal care are less likely to have babies with health problems, O'Hare said. Prenatal care can help pregnant women with medical or behavioral risk factors that can affect babies, such as diabetes, anemia, smoking and inadequate nutrition.

''Women who do not get prenatal care are more likely to have children born with risks,'' O'Hare said, such a low birth weight -- under 5.5 pounds, or preterm birth -- less than 37 weeks of gestation.

Only 7.6 percent of America's babies are born with low birth weight, but they account for 65 percent of infant deaths, O'Hare said, quoting a national study.

More than 90 percent of all neonatal deaths occur among infants born preterm, and more than three-fourths of those deaths occur among those born at fewer than 32 weeks of gestation.

Preterm newborns are more likely to be born with neurological damage. Preterm delivery is associated with significant delays in motor and social development, and some studies indicate that educational disadvantages persist into adulthood.

''It's a long-term disadvantage,'' O'Hare said.

Lack of health insurance is an impediment to obtaining prenatal care, but Muth said that stumbling block should be diminishing in Alaska. The Alaska Native health system covers prenatal care costs. She also noted that the state's Denali KidCare extends Medicaid coverage to children and pregnant women in families earning as much as 200 percent of the federal poverty level.

Rhode Island ranked highest in percentage of women receiving prenatal care. Just 1.4 percent of Rhode Island women reported receiving late or no prenatal care. New Mexico, with 10 percent reporting late or no prenatal care, ranked last in the nation.

Alaska ranked higher in other categories listed in the Kids Count report.

Just 5.8 percent of Alaska's babies in 1999 were born with low birth weight, tying the state with Washington for third best in the nation.

Alaska in 1999 ranked better than the national average in percentage of preterm births, births to teen-agers, births to teen-agers who already were mothers, and births to mothers with fewer than 12 years of education.

Alaska ranked lower than the national average in the percentage of births to unmarried women and mothers who smoked during pregnancy.

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The Right Start for America's Newborns: A Decade of City and State Trends (1990-1999):

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