Medicaid Eligibility, Prenatal Care, and the Outcome of Pregnancy-Reply

Bernard Guyer, MD, MPH
JAMA. 1991;265(8):975. doi:10.1001/jama.1991.03460080044018.
Text Size: A A A
Published online

In Reply. —  Dr Jameson raises an important issue but reaches the wrong conclusion. "Policymakers in government, public health, and medicine" recognize that maternal behavior influences birth outcome.1 In fact, the recent report of the Expert Panel on the Content of Prenatal Care2 outlines a comprehensive program directed at identifying and addressing these risk factors. The interventions can only be applied, however, if women who are poor have the same access to health care as their middle-class contemporaries. The Medicaid eligibility expansions were intended by Congress to assure such access. Blaming the women who engage in these high-risk behaviors and preventing them from accessing services can hardly be expected to improve their outcomes.I agree with Dr Moore's diagnosis that the fragmented and overly complex nature of our health care system contributes to the adverse perinatal outcomes among low-income women. He provides a brief description of an innovative


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.