Pregnancy Study: Medicaid Comparable to Private Care

Women at low risk for complications during pregnancy who were insured by Medicaid, the federal-state insurance program for the poor, received the same quality of prenatal care as their privately insured counterparts, a federally funded study of more than 2,000 women in Washington state has found.

Sharon Dobie and her colleagues at the University of Washington School of Medicine compared obstetrical care received by randomly selected low-risk patients.

Low-risk patients were defined as those between the ages of 18 and 34 who had at least one prenatal visit during the first trimester. In addition, they had no more than three previous live births, no stillbirths, no prior obstetrical complications such as gestational diabetes, no history of drug or alcohol abuse, and no major medical conditions such as hypertension.

Of the 2,054 women studied, about 13% received Medicaid. Women on Medicaid were younger--their average age was 22.5 years compared with 26.9 for private patients--and were more likely to be unmarried.

Both groups had similar outcomes. There were no differences in the rates of Caesarean sections, the Apgar scores (which measure the condition of newborns after birth), birth weight or the percentage of low-birth-weight babies.

Dobie and her coauthors noted that their study does not support other research showing that Medicaid patients receive poorer care than privately insured women. Future studies should examine the care of higher-risk patients, they wrote.

The study, which was funded by the Agency for Health Care Policy and Research, was published in the January issue of the American Journal of Public Health.