THE IMPACT OF EXTENDED MATERNITY SERVICES ON PRENATAL-CARE USE AMONG MEDICAID WOMEN

The goals of this study were to examine the use of maternity support s ervices (MSS) and maternity case management (MCM) by Medicaid-eligible low-income pregnant women in Washington state, and to determine wheth er receipt of the services was associated with improved prenatal care use. We obtained data from linked birth certificates and Medicaid elig ibility and claims files for women delivering between August 1989 and December 1991. Unconditional logistic regression was used to assess th e programs' effects independent of other variables associated with pre natal care adequacy. The percentage of women receiving MSS and MCM was highest among women with demographic risks for adverse birth outcomes . Women receiving prenatal care from health departments or community c linics were more likely to receive MSS and MCM than those seen by priv ate physicians or midwives. After adjustment for multiple confounding factors, we found that recipients of MSS, but not MCM, were significan tly less likely than other women to receive an inadequate number of pr enatal visits. Our findings suggest that public policies that pay for support services to low-income pregnant women can improve the use of p renatal care.