A news release issued by the Child Death Review team, who operates under the Department of Health and Human Services, reported that between the years of 2007 and 2008 there were 551 child deaths in Nebraska (http://www.dhhs.ne.gov/newsroom/newsreleases/2011/Nov/childdeathreviewteam.htm). Of this number, over 165 of those were a result of some form of preventable measure. Who is held accountable for these deaths? The leading indicator and predictor for preventable deaths was associated with that of premature birth and associations with premature birth were related to maternal complications. These complications carry the potential to go undetected if the mother has lack of access to prenatal care and education. Disparities seen within the reported deaths also indicate deficient healthcare standards and interventions amongst populations within the state. The increase in the representation of African American children in this child death toll has increased from 11% in the years 1996 – 2001, to 14% in 2007 – 2008. The prevalence of the Hispanic representation has also vastly increased from 9% to 14% respectively. Recommendations that came from this report highlight the importance of providers and the community engaging in a comprehensive approach for the prevention of preterm delivery through education on the signs and symptoms of preterm labor and smoking cessation.
One must understand that the data reported within this release was from 2008 and does not capture those individuals that lost access to prenatal care with the termination of their Medicaid as of March 2010. The state of Nebraska has taken steps in the wrong direction by not allowing all low-income women continued access to prenatal care through Medicaid. Research has proven that those individuals who have access to health education received during prenatal care visits have reduced birth related complications related to prematurity and in fact generate an approximate 31% cost savings from the average hospital expenditure (Cramer, Chen, Roberts, and Clute, 2007). Therefore prenatal care not only plays a pivotal role in preventing premature births, birth related complications, and child mortality rates but serves as a cost savings measure. Let’s be proactive in meeting the needs of mothers and infants through the restoring of prenatal care through Medicaid instead of being reactive and attributing to increased healthcare costs.