Next Generation at Risk

In California 32,000 pregnant women a year go without the most basic prenatal care. Most of them are too poor to get care or too frustrated by long waits at public hospitals. Too often their babies are born weighing too little to thrive, and they often die. Those who survive often require long stays in expensive intensive-care units.

The question is not only one of humanity, it is one of money. For every $1 spent on prenatal care, it’s possible to save $3.38 in costs of intensive-care for newborns. Another $6 could be saved in costs of caring for children disabled physically or mentally because they were low birth-weight babies. Thus, the Southern California Child Health Network, which has worked actively to spotlight this problem, estimates that investment in prenatal care could save California $22 million a year on intensive-care costs or $256 million a year on all costs associated with disabled children.

Clearly, the reports by Times staff writers Claire Spiegel and Robert Steinbrook show that the prenatal-care situation in California as a whole and Los Angeles County specifically is in crisis. But is anybody out there listening?

Gov. George Deukmejian vetoed several bills this year that would have helped ease the crisis, including one to increase Medi-Cal fees for obstetrical visits and another to eliminate fees at public clinics for indigent pregnant women. The Legislature must try again. There is the chance for solid bipartisan action on the issue as people like Sens. David Roberti (D-Hollywood) and Marian Bergeson (R-Newport Beach) and Assembly members William J. Filante (R-Greenbrae), Burt Margolin (D-Los Angeles) and Bruce Bronzan (D-Fresno) have shown leadership on this issue.

The governor’s political friends on the Los Angeles County Board of Supervisors may offer the best hope of turning Deukmejian around. They, and the doctors and nurses in county hospitals, are the people with responsibility for dealing with the problem day after day.

To the county’s credit, it has added $1 million to its budget to try to reduce the backlog of prenatal-care cases. It also endorsed recommendations from the Child Health Network that, for example, the county subcontract some prenatal care to free and community clinics and establish a referral service, preferably one whose phones don’t always have a busy signal. However, endorsing recommendations is one thing, producing is another.

The Deukmejian Administration claims it needs more data to determine the priority of this problem versus other health issues. That’s nonsense. No matter how you read reports on prenatal care, it is clear that the health of the next generation of Californians is seriously at risk.