The aim of the proposed research is to examine the adequacy of prenatal care and to determine its effectiveness in improving birth outcomes among women with varying degrees of medical risk. The study contributes to the body of research on prenatal care in that some of the prenatal care components, e.g., blood pressure screening, will be analyzed, thereby disaggregating the content of care. The analysis is plan is first to categorize pregnant women according to the presence of medical and behavioral risk factors for poor birth outcomes. The birth outcomes under consideration are birthweight and length, gestational age, presence of congenital defects, and fetal death. The research will examine the components of prenatal care provided to each group of women to discover whether they are receiving the surveillance, advice, treatment and referral during pregnancy that is appropriate to their level of need. Second, the study will examine the effect that prenatal care has upon the women's level of risk, and on the occurrence of poor birth outcomes. Socio-demographic factors will be studied and controlled for as necessary in the analysis. Data for the study come from the 1980 National Natality Survey (NNS), the 1980 National Fetal Mortality Survey (NFMS) and the 1980 American Hospital Association Survey (AHAS). The NNS is based on a complex random sample of live births registered in the United States during 1980. The NFMS is based on a complex random sample of the late fetal deaths that were reported in the U.S. during 1980. From those different points of origin, the NNS and NFMS are parallel surveys, with both containing information from the vital records, the mothers, the providers of prenatal care, and the staff of the hospitals where deliveries occurred. The AHAS add information on the hospitals of delivery.
