Effects of prenatal care on maternal postpartum behaviors

Abstract

Most research on the effectiveness of prenatal care has focused on birth outcomes and has found small or no effects. It is possible, however, that prenatal care is “too little too late” to improve pregnancy outcomes in the aggregate, but that it increases the use of pediatric health care or improves maternal health-related parenting practices and, ultimately, child health. We use data from the Fragile Families and Child Wellbeing birth cohort study that have been augmented with hospital medical record data to estimate effects of prenatal care timing on pediatric health care utilization and health-related parenting behaviors during the first year of the child’s life. We focus on maternal postpartum smoking, preventive health care visits for the child, and breastfeeding. We use a multi-pronged approach to address the potential endogeneity of the timing of prenatal care. We find that first trimester prenatal care appears to decrease maternal postpartum smoking by about 5 percentage points and increase the likelihood of 4 or more well-baby visits by about 1 percentage point, and that it may also have a positive effect on breastfeeding. These findings suggest that there are benefits to standard prenatal care that are generally not considered in evaluations of prenatal care programs and interventions.

Does prenatal care benefit maternal health? A study of post-partum maternal care use

“…Second, education and counseling during prenatal care help pregnant women maintain a healthy diet and lifestyle, which naturally can promote infant health and early childhood development as well as decrease post-partum maternal health problems. While these potential benefits most likely foster the health of both the mother and child, surprisingly, the literature has largely focused on the determinants of their utilization and the effects on newborns [5][6][7][8], with only a few studies investigating the impact of prenatal care on maternal health [9,10].…”

“…However, their study does not control for mode of delivery (vaginal delivery versus cesarean section) and hence the risk of delivery, which is highly related to the hospital length of stay. Another study by Reichman et al [10] investigates the effects of prenatal care on maternal post-partum parenting behaviors, finding that first-trimester prenatal care not only increases the likelihood of more well-baby visits and breastfeeding, but also reduces the prevalence of post-partum maternal smoking. The lack of a general measure of maternal health, however, prevents them from analyzing the effects of prenatal care on maternal health.…”

Prenatal Care and Subsequent Birth Intervals

“…One randomized controlled study found that prenatal breastfeeding education and counseling increased rates of breastfeeding among urban black low-income women, 14 and another recent study using econometric techniques to address potential omitted variables bias found that first trimester prenatal care decreases maternal postpartum smoking and appears to increase breastfeeding. 15 …”

“…25,26 Another used econometric techniques to address potential omitted variables bias and had similar findings vis-à-vis well-child visits. 15 Connection to the health care system may provide access to, and encourage the use of, family planning services.…”

Association between Support from a Health Professional and Breastfeeding Knowledge and Practices Among Obese Women: Evidence from the Infant Practices Study II

“…Providing evidence-based education to women about the maternal and infant health benefits of breastfeeding, as well as advice about how to address important barriers to breastfeeding, is potentially one part of a multipronged approach to promote breastfeeding. Other potentially important ways to improve breastfeeding initiation and duration in the United States include improving the quality of prenatal care (Reichman, Corman, Noonan, & Schwartz-Soicher, 2010), increasing hospital practices that support breastfeeding (Perrine et al, 2011), and state and federal policies that require workplace support for lactation (Abdulloeva & Eyler, 2013). The Affordable Care Act requires insurance coverage of comprehensive breastfeeding support during and after pregnancy, as well as requiring insurance coverage of Notes: Breastfeeding support from a physician defined as a respondent reporting at 1 month postpartum, that her doctor or her infant's pediatrician favored exclusive breastfeeding.…”