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Maternal health: does prenatal care make a difference?

Author

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  • Karen Smith Conway

    (Department of Economics, Durham, NH, USA)

  • Andrea Kutinova

    (Department of Economics, Durham, NH, USA)

Abstract

This research attempts to close an important gap in health economics regarding the efficacy of prenatal care and policies designed to improve access to that care, such as Medicaid. We argue that a key beneficiary - the mother - has been left completely out of the analysis. If prenatal care significantly improves the health of the mother, then concluding that prenatal care is 'ineffective' or that the Medicaid expansions are a 'failure' is premature. This paper seeks to rectify the oversight by estimating the impact of prenatal care on maternal health and the associated cost savings. We first set up a joint maternal-infant health production framework that informs our empirical analysis. Using data from the National Maternal and Infant Health Survey, we estimate the effects of prenatal care on several different measures of maternal health such as body weight status and excessive hospitalizations. Our results suggest that receiving timely and adequate prenatal care may increase the probability of maintaining a healthy weight after the birth and, perhaps for blacks, of avoiding a lengthy hospitalization after the delivery. Given the costs to society of obesity and hospitalization, these are benefits worth exploring before making conclusions about the effectiveness of prenatal care - and Medicaid. Copyright © 2006 John Wiley & Sons, Ltd.

Suggested Citation

  • Karen Smith Conway & Andrea Kutinova, 2006. "Maternal health: does prenatal care make a difference?," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 461-488.
  • Handle: RePEc:wly:hlthec:v:15:y:2006:i:5:p:461-488
    DOI: 10.1002/hec.1097
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    File URL: http://hdl.handle.net/10.1002/hec.1097
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    References listed on IDEAS

    as
    1. Joyce, Theodore, 1999. "Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City," Journal of Health Economics, Elsevier, vol. 18(1), pages 31-67, January.
    2. Chou, Shin-Yi & Grossman, Michael & Saffer, Henry, 2004. "An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System," Journal of Health Economics, Elsevier, vol. 23(3), pages 565-587, May.
    3. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    4. Karen Smith Conway & Lisa DeFelice Kennedy, 2004. "Maternal Depression and the Production of Infant Health," Southern Economic Journal, Southern Economic Association, vol. 71(2), pages 260-286, October.
    5. Conway, Karen Smith & Deb, Partha, 2005. "Is prenatal care really ineffective? Or, is the 'devil' in the distribution?," Journal of Health Economics, Elsevier, vol. 24(3), pages 489-513, May.
    6. Corman, Hope & Grossman, Michael, 1985. "Determinants of neonatal mortality rates in the U.S. : A reduced form model," Journal of Health Economics, Elsevier, vol. 4(3), pages 213-236, September.
    7. Currie, Janet & Gruber, Jonathan, 2001. "Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions," Journal of Public Economics, Elsevier, vol. 82(1), pages 63-89, October.
    8. Avery, Christopher & Heymann, S Jody & Zeckhauser, Richard, 1995. "Risks to Selves, Risks to Others," American Economic Review, American Economic Association, vol. 85(2), pages 61-66, May.
    9. Geoffrey Warner, 1998. "Birthweight Productivity of Prenatal Care," Southern Economic Journal, Southern Economic Association, vol. 65(1), pages 42-63, July.
    10. Currie, Janet & Grogger, Jeffrey, 2002. "Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?," Journal of Health Economics, Elsevier, vol. 21(2), pages 313-335, March.
    11. Hope Corman & Theodore J. Joyce & Michael Grossman, 1987. "Birth Outcome Production Function in the United States," Journal of Human Resources, University of Wisconsin Press, vol. 22(3), pages 339-360.
    12. Janet Currie & Jonathan Gruber, 1997. "The Technology of Birth: Health Insurance, Medical Interventions, and Infant Health," NBER Working Papers 5985, National Bureau of Economic Research, Inc.
    13. Rivers, Douglas & Vuong, Quang H., 1988. "Limited information estimators and exogeneity tests for simultaneous probit models," Journal of Econometrics, Elsevier, vol. 39(3), pages 347-366, November.
    14. Warner, Geoffrey L, 1995. "Prenatal Care Demand and Birthweight Production of Black Mothers," American Economic Review, American Economic Association, vol. 85(2), pages 132-137, May.
    15. Hope Corman & Theodore J. Joyce & Michael Grossman, 1985. "Birth Outcome Production Functions in the U.S," NBER Working Papers 1729, National Bureau of Economic Research, Inc.
    16. repec:aph:ajpbhl:2002:92:2:288-293_5 is not listed on IDEAS
    17. Jonathan Gruber, 1997. "Policy Watch: Medicaid and Uninsured Women and Children," Journal of Economic Perspectives, American Economic Association, vol. 11(4), pages 199-208, Fall.
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    Citations

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    Cited by:

    1. Nancy Reichman & Hope Corman & Kelly Noonan & Ofira Schwartz-Soicher, 2010. "Effects of prenatal care on maternal postpartum behaviors," Review of Economics of the Household, Springer, vol. 8(2), pages 171-197, June.
    2. Ji Yan, 2015. "The Earlier and the More, the Healthier? The Effects of Prenatal Care Utilization on Maternal Health and Health Behaviors," Working Papers 15-08, Department of Economics, Appalachian State University.
    3. Olena Y. Nizalova & Maria Vyshnya, 2010. "Evaluation of the impact of the Mother and Infant Health Project in Ukraine," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 107-125, September.
    4. Sankar Mukhopadhyay & Jeanne Wendel, 2008. "Are prenatal care resources distributed efficiently across high-risk and low-risk mothers?," International Journal of Health Economics and Management, Springer, vol. 8(3), pages 163-179, September.
    5. Elvin Afandi & Nazim Habibov, 2016. "Social trust and use of banking services across households in 28 transitional countries," International Journal of Social Economics, Emerald Group Publishing, vol. 43(4), pages 431-443, April.
    6. repec:bla:ijhplm:v:32:y:2017:i:1:p:e17-e38 is not listed on IDEAS
    7. Andrea Kutinova, 2006. "The Effects of Unemployment on Childbearing," Working Papers in Economics 06/12, University of Canterbury, Department of Economics and Finance.
    8. Rainer Winkelmann, 2012. "Copula Bivariate Probit Models: With An Application To Medical Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 21(12), pages 1444-1455, December.
    9. Liu, Tsai-Ching & Chen, Bradley & Chan, Yun-Shan & Chen, Chin-Shyan, 2015. "Does prenatal care benefit maternal health? A study of post-partum maternal care use," Health Policy, Elsevier, vol. 119(10), pages 1382-1389.
    10. Swati Mukerjee & Michael A. Quinn, 2008. "Federal Medicaid Assistance To States: Impact On Prenatal Care," Contemporary Economic Policy, Western Economic Association International, vol. 26(3), pages 380-397, July.
    11. Rashad, Ahmed Shoukry & Sharaf, Mesbah Fathy & Mansour, Elhussien I., 2016. "Does public health insurance increase maternal health care utilization in Egypt?," Frankfurt School - Working Paper Series 223, Frankfurt School of Finance and Management.
    12. Nazim Habibov & Elvin Afandi, 2016. "Does Life Satisfaction Determine Subjective Health?," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 11(2), pages 413-428, June.
    13. Andrea Menclova, 2013. "The Effects of Unemployment on Prenatal Care Use and Infant Health," Journal of Family and Economic Issues, Springer, vol. 34(4), pages 400-420, December.

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