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THIS SIDE up The "Back to Sleep" Campaign CHAPTER 18 pomnievic Maternal and Child Health as a Social Problem KEY TERMS Congenital anomalies Contraception Prematurity Pronatal BRE Sudden infant death syndrome

THIS SIDE up The "Back to Sleep" Campaign CHAPTER 18 pomnievic Maternal and Child Health as a Social Problem KEY TERMS Congenital anomalies Contraception Prematurity Pronatal BRE Sudden infant death syndrome

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How can we summarize chapter 18?
ODD THIS SIDE The "Back to Sleep" Campaign Maternal and Child Health as a Social Problem ayriqon KEY TERMS Congenital anomalies Contraception Developmental disabilities Family planning Immunization Infant mortality rate (IMR) Maternal mortality rates Prematurity Prenatal care Preterm birth Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) CHAPTER 18 The health of pregnant women and children is traditionally one of the highest priorities of public health. In a society concerned with the welfare of its population, everyone should be guaranteed adequate conditions for the best possible start in life. The fetal and infant stages of development provide the foundations of good health throughout life. A growing body of evidence indicates that conditions in utero and during early life play a powerful role in increasing individuals' susceptibility to the chronic diseases that plague American adults, including high blood pressure, obesity, car- diovascular disease, and diabetes. Moreover, because children are the most vulnerable seg- ment of the population, like canaries in the coal mine, they are the first to suffer from any adverse conditions that affect human health in general. 291 370W Sudden infant death syndrome (SIDS) Supplemental Nutrition Assistance Program (SNAP) Teratogen 291209 105m spread Children's health first became a public concern in the United States at the end of the 19th century, prompted by alarm at the high infant and child death rates in the summer from diarrheal diseases.2 Heat, poor sanitation, and lack of refrigeration contributed to heavy microbial contamination of milk, which was sickening poor children. In 1893, New York City established milk stations that provided safe milk; similar programs soon followed in other cities. The success of the milk programs in improving children's health inspired the formation of voluntary infant welfare societies with the mission of teaching poor and immi- grant mothers about nutrition and hygiene. The federal government got involved in 1912 with the establishment of the Children's Bureau, which was mandated to "investigate and report on all matters affecting children 263
Transcribed Image Text:ODD THIS SIDE The "Back to Sleep" Campaign Maternal and Child Health as a Social Problem ayriqon KEY TERMS Congenital anomalies Contraception Developmental disabilities Family planning Immunization Infant mortality rate (IMR) Maternal mortality rates Prematurity Prenatal care Preterm birth Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) CHAPTER 18 The health of pregnant women and children is traditionally one of the highest priorities of public health. In a society concerned with the welfare of its population, everyone should be guaranteed adequate conditions for the best possible start in life. The fetal and infant stages of development provide the foundations of good health throughout life. A growing body of evidence indicates that conditions in utero and during early life play a powerful role in increasing individuals' susceptibility to the chronic diseases that plague American adults, including high blood pressure, obesity, car- diovascular disease, and diabetes. Moreover, because children are the most vulnerable seg- ment of the population, like canaries in the coal mine, they are the first to suffer from any adverse conditions that affect human health in general. 291 370W Sudden infant death syndrome (SIDS) Supplemental Nutrition Assistance Program (SNAP) Teratogen 291209 105m spread Children's health first became a public concern in the United States at the end of the 19th century, prompted by alarm at the high infant and child death rates in the summer from diarrheal diseases.2 Heat, poor sanitation, and lack of refrigeration contributed to heavy microbial contamination of milk, which was sickening poor children. In 1893, New York City established milk stations that provided safe milk; similar programs soon followed in other cities. The success of the milk programs in improving children's health inspired the formation of voluntary infant welfare societies with the mission of teaching poor and immi- grant mothers about nutrition and hygiene. The federal government got involved in 1912 with the establishment of the Children's Bureau, which was mandated to "investigate and report on all matters affecting children 263
272 never been pregnant, but is much less effective in women who have given birth, 34 The "morning-after pill," a form of emer- gency contraception, can be taken as long as five days after unprotected intercourse to preventing by prevent pregnancy. It works the release of a woman's egg for longer than usual and is at least 85% effective. Consider whether these medications should be available able controversy arose in the 2000s regarding Chapter 18 Maternal and Child Health as a Socld organizations. As of 2019, 29 states required insurance policies that cover prescription drugs to provide coverage for the full range of FDA-approved contraceptive drugs and devices. In 2017, the Donald Trump admin- istration issued new rules allowing insurers and employers to opt out of the contracep- tion coverage mandate for religious or moral reasons; in 2019, this rollback of the mandate was blocked by a federal judge. The fate of the mandate remains to be seen." 10 to without a prescription, especially are available age girls, but now most brands are over over the counter- gs, Du34-36 In 2017, some universities vend- eing the morning-after pill in students raised concerns began offering ing machines after of sity 343 about difficulty or confusion in obtaining the medication. Stanford University, the Univer- F California, Davis, and the University of California, Santa Barbara, are among the schools that installed the option.37 The avail- ability of emergency contraception presum- ably has contributed to the reduction in the number of abortions in recent years. Insertion of an IUD within five days of intercourse is 99.9% effective as an emergency contraceptive. This device is relatively expen- sive and needs to be inserted by a healthcare provider, but it can be left in place for years to serve as ongoing birth control. unprotected Public health programs specifically aimed at preventing teenage pregnancy include com- prehensive sex education in the schools, which has been found to be effective in delaying young people's initiation of intercourse and increasing their use of contraception when they do have sex.37 The exact message that should be conveyed in pregnancy prevention programs remains a topic of debate, however. The federal welfare reform bill implemented in 1998 included funding for programs that teach sexual abstinence only. Many states were reluctant to apply for this money because they believe such programs are much less effective than those that include education on contra- ception as well. A 2004 congressional review found that commonly used abstinence-only curricula contained "multiple scientific and Female sterilization and vasectomy for men are the most effective methods of contra- ception and are commonly used in the United include States, but they are permanent and therefore inappropriate for young people. Other highly effective methods for women-incl intrauterine devices (IUDs) and some hor- monal implants and patches. These methods have a failure rate of less than 1 pregnancy per 100 women per year. Equally effective when used correctly are combination oral contraceptives-t aceptives-the Pill-and other hor- monal contraceptives, such as Depo-Provera shots and the hormone-laden vaginal ring. Pills must be taken every day, however, and the other hormonal methods must be renewed at regular intervals. The effective- ness of hormonal methods may be reduced in women who are taking certain medica- tions and supplements. 34 All of these methods have drawbacks, although the general public tends to overes- Emate their health risks. Barrier methods, cluding the male and female condoms and e female diaphragm, can be fairly effective used correctly (failure rates of 2 to 6 preg- cies per 100 women per year), and con- ms have the added advantage of reducing risk of sexually transmitted diseases. How- - barrier methods are often used inconsis- y and incorrectly. Spermicides used alone s, creams, and jellies) have failure rates pregnancies per 100 women per year for t use and much worse failure rates for use. The cervical cap has a failure rate Oregnancies per 100 women who have example, medical inaccuracies,"37(p 2014) For they teach that condoms are ineffective. Some of these programs encourage teenagers to sign virginity pledges; studies have shown that those who do sign may delay sex, but when they do initiate intercourse, they are less likely to use protection.38 Abstinence-only advocates took credit for the significant decline in adolescent pregnancy rates since 1991 described pre- viously. However, despite hundreds of mil- lions of dollars of federal funds spent on abstinence-only programs each year, stud ies have found no measurable impact on sexual behavior. An analysis of data from national surveys of young women teen ages 15 to 19 found t decline in pregnancy that only 14% of the could be attributed to Nutrition of Women and Children infants the healthiest start in life, reducing risks of infectious diseases, ear infections, respiratory infections, obesity, and chronic diseases such as asthma and allergies. Med- ical and public health organizations recom- mend that infants he exclusively breastfed for the first 6 months of their lives, and that breastfeeding should continue at least until their first birthday as new foods are intro- duced. The CDC tracks rates of breastfeed- ing at discharge from the hospital and at follow-up times through telephone surveys. The percentage of infants who were ever breastfed increased from 54% in 1986-1988 to 84% in 2016: in addition, in 2016. 57% of infants were still breastfed at 6 months and 36% were still breastfed at 12 months. How- ever, these rates vary depending on the age d education of the mothers, from a rate of only 72% among women with a high school diploma or less, to a rate of 88% women with at least a bachelor's degree. among Approximately 69% of women younger than age 20 initiate breastfeeding. The rate of breastfeeding in 2016 for white mothers was 78%, compared to 60% for black mothers and 85% for Hispanic mothers.40.41 and delayed initiation of sexual activity, while 86% of the decline was due to increased use of contraceptives. 5.38 The authors con concluded that "abstinence promotion is a worth- while goal, particularly among younger teenagers. "39p 155)-but it is insufficient help adolescents prevent unintended preg- nancies and sexually transmitted diseases. "Public policies and programs should vigorously promote provision of accurate information on contraception and on sexual behavior and relationships, support increased availability and accessibility of contraceptive services and supplies for adolescents, and promote the value of responsible and protec- tive behaviors, including condom and contra- ceptive use and pregnancy planning."39(p. 155) 273 During the Great Depression of the 1930s, the federal government established several food assistance programs to ensure adequate nutrition for poor families. They formed the basis of current federal programs, run by the U.S. Department of Agriculture (USDA), which originated in the 1960s.42 The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides vouchers for milk, fruit juice, eggs, cereals, and other nutritious foods for pregnant women, lactating moth- ers, infants, and children up to five years old. Nutrition education is also provided, and WIC centers often become a source of many support services for poor, young fam- ilies. The USDA has evaluated the WIC pro- gram and found it to be effective in saving medical costs for the women and infants who participated. Nutrition of Women and Children Since the establishment of milk stations in the 1890s, nutrition has been an important component of maternal and child health pro- grams. At first, the emphasis was on breast- feeding and the safety of milk and baby foods. Public health is still concerned with promoting breastfeeding, which offers most
Transcribed Image Text:272 never been pregnant, but is much less effective in women who have given birth, 34 The "morning-after pill," a form of emer- gency contraception, can be taken as long as five days after unprotected intercourse to preventing by prevent pregnancy. It works the release of a woman's egg for longer than usual and is at least 85% effective. Consider whether these medications should be available able controversy arose in the 2000s regarding Chapter 18 Maternal and Child Health as a Socld organizations. As of 2019, 29 states required insurance policies that cover prescription drugs to provide coverage for the full range of FDA-approved contraceptive drugs and devices. In 2017, the Donald Trump admin- istration issued new rules allowing insurers and employers to opt out of the contracep- tion coverage mandate for religious or moral reasons; in 2019, this rollback of the mandate was blocked by a federal judge. The fate of the mandate remains to be seen." 10 to without a prescription, especially are available age girls, but now most brands are over over the counter- gs, Du34-36 In 2017, some universities vend- eing the morning-after pill in students raised concerns began offering ing machines after of sity 343 about difficulty or confusion in obtaining the medication. Stanford University, the Univer- F California, Davis, and the University of California, Santa Barbara, are among the schools that installed the option.37 The avail- ability of emergency contraception presum- ably has contributed to the reduction in the number of abortions in recent years. Insertion of an IUD within five days of intercourse is 99.9% effective as an emergency contraceptive. This device is relatively expen- sive and needs to be inserted by a healthcare provider, but it can be left in place for years to serve as ongoing birth control. unprotected Public health programs specifically aimed at preventing teenage pregnancy include com- prehensive sex education in the schools, which has been found to be effective in delaying young people's initiation of intercourse and increasing their use of contraception when they do have sex.37 The exact message that should be conveyed in pregnancy prevention programs remains a topic of debate, however. The federal welfare reform bill implemented in 1998 included funding for programs that teach sexual abstinence only. Many states were reluctant to apply for this money because they believe such programs are much less effective than those that include education on contra- ception as well. A 2004 congressional review found that commonly used abstinence-only curricula contained "multiple scientific and Female sterilization and vasectomy for men are the most effective methods of contra- ception and are commonly used in the United include States, but they are permanent and therefore inappropriate for young people. Other highly effective methods for women-incl intrauterine devices (IUDs) and some hor- monal implants and patches. These methods have a failure rate of less than 1 pregnancy per 100 women per year. Equally effective when used correctly are combination oral contraceptives-t aceptives-the Pill-and other hor- monal contraceptives, such as Depo-Provera shots and the hormone-laden vaginal ring. Pills must be taken every day, however, and the other hormonal methods must be renewed at regular intervals. The effective- ness of hormonal methods may be reduced in women who are taking certain medica- tions and supplements. 34 All of these methods have drawbacks, although the general public tends to overes- Emate their health risks. Barrier methods, cluding the male and female condoms and e female diaphragm, can be fairly effective used correctly (failure rates of 2 to 6 preg- cies per 100 women per year), and con- ms have the added advantage of reducing risk of sexually transmitted diseases. How- - barrier methods are often used inconsis- y and incorrectly. Spermicides used alone s, creams, and jellies) have failure rates pregnancies per 100 women per year for t use and much worse failure rates for use. The cervical cap has a failure rate Oregnancies per 100 women who have example, medical inaccuracies,"37(p 2014) For they teach that condoms are ineffective. Some of these programs encourage teenagers to sign virginity pledges; studies have shown that those who do sign may delay sex, but when they do initiate intercourse, they are less likely to use protection.38 Abstinence-only advocates took credit for the significant decline in adolescent pregnancy rates since 1991 described pre- viously. However, despite hundreds of mil- lions of dollars of federal funds spent on abstinence-only programs each year, stud ies have found no measurable impact on sexual behavior. An analysis of data from national surveys of young women teen ages 15 to 19 found t decline in pregnancy that only 14% of the could be attributed to Nutrition of Women and Children infants the healthiest start in life, reducing risks of infectious diseases, ear infections, respiratory infections, obesity, and chronic diseases such as asthma and allergies. Med- ical and public health organizations recom- mend that infants he exclusively breastfed for the first 6 months of their lives, and that breastfeeding should continue at least until their first birthday as new foods are intro- duced. The CDC tracks rates of breastfeed- ing at discharge from the hospital and at follow-up times through telephone surveys. The percentage of infants who were ever breastfed increased from 54% in 1986-1988 to 84% in 2016: in addition, in 2016. 57% of infants were still breastfed at 6 months and 36% were still breastfed at 12 months. How- ever, these rates vary depending on the age d education of the mothers, from a rate of only 72% among women with a high school diploma or less, to a rate of 88% women with at least a bachelor's degree. among Approximately 69% of women younger than age 20 initiate breastfeeding. The rate of breastfeeding in 2016 for white mothers was 78%, compared to 60% for black mothers and 85% for Hispanic mothers.40.41 and delayed initiation of sexual activity, while 86% of the decline was due to increased use of contraceptives. 5.38 The authors con concluded that "abstinence promotion is a worth- while goal, particularly among younger teenagers. "39p 155)-but it is insufficient help adolescents prevent unintended preg- nancies and sexually transmitted diseases. "Public policies and programs should vigorously promote provision of accurate information on contraception and on sexual behavior and relationships, support increased availability and accessibility of contraceptive services and supplies for adolescents, and promote the value of responsible and protec- tive behaviors, including condom and contra- ceptive use and pregnancy planning."39(p. 155) 273 During the Great Depression of the 1930s, the federal government established several food assistance programs to ensure adequate nutrition for poor families. They formed the basis of current federal programs, run by the U.S. Department of Agriculture (USDA), which originated in the 1960s.42 The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides vouchers for milk, fruit juice, eggs, cereals, and other nutritious foods for pregnant women, lactating moth- ers, infants, and children up to five years old. Nutrition education is also provided, and WIC centers often become a source of many support services for poor, young fam- ilies. The USDA has evaluated the WIC pro- gram and found it to be effective in saving medical costs for the women and infants who participated. Nutrition of Women and Children Since the establishment of milk stations in the 1890s, nutrition has been an important component of maternal and child health pro- grams. At first, the emphasis was on breast- feeding and the safety of milk and baby foods. Public health is still concerned with promoting breastfeeding, which offers most
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