Thursday, April 19, 2007
The Despair in Disparities
I just spent the last two days at a "disparities in healthcare" conference. I saw some phonomenal speakers, but my favorite session was on perinatal care. There seems to be a shift occurring from a focus on 'prenatal' care to 'intraconception' care. While I think there is certainly some merit to catching at risk and other women before they become pregnant, I don't believe we've begun to explore all that prenatal care can and should be. It should be more than an hour's wait for a 5 minute BP check and pee dip. The centering pregnancy model came up and while I think that's a good start, there is a real need for innovation in prenatal care. One speaker on the perinatal panel, an epidemiologist, showed an older study he had done from 1999, that prenatal care was not impacting outcomes. It didn't bother me much that the study was old, because I know things haven't really improved. Women are disillusioned with childbirth education and with prenatal care. Both need major overhauls or risk becoming obsolete (not done away with, just lowly regarded). We really need new models of care, not just new gimmicks and clever new ways of packaging the same old, same old. Models that are inclusive, empowering, and impactful. We are in a new day, that calls for a new approach.