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First Steps Database: The First Steps Program 1989-2004

Summary

The First Steps Program has served low-income pregnant women in Washington State for more than fifteen years, since August 1989. By the end of 2004, nearly 350,000 women had received services through this program, and Medicaid was funding 46% of all births to Washington residents. Gains in prenatal care access and birth outcomes (low birth weight and infant mortality) were clear during the first five years of the program.

This brief report addresses the current status of birth outcomes (low birth weight), risk factors for poor birth outcomes, service utilization patterns for Maternity Support Services, and future directions to maximize impact of enhanced prenatal services on birth outcomes.

Low Birth Weight Rate for Singleton Liveborn Infants to Washington Women

• For five of the six groups portrayed, the low birth weight rate is higher for 2003-04 births than for births during 1993-94. While low birth weight rates decreased after First Steps, disparities between higher income and lower income women, and between African American women and white women, have persisted. For American Indians, the disparity widened in 2003-04.
• For American Indians, the 2003-04 low birth weight rate (5.9%) is nearly as high as the 1988-89 rate of 6.1% (before First Steps). For statewide births, the 2003-04 low birth weight rate (4.7%) exceeded the 1989 rate (4.6%).
• Among Medicaid women with identified substance use problems, the 2003-04 low birth weight rate (11.9%) is slightly lower than the 1993-94 rate of 12.1%. However, if these women are identified prenatally and receive treatment for chemical dependency and/or an intensive comprehensive program before they deliver, their low birth weight rates may be considerably lower. A previous study of the Safe Babies, Safe Moms comprehensive program showed a 66% reduction in low birth weight (from 16.1% to 5.5%) associated with prenatal enrollment and a 32% reduction in low birth weight (from 13.4% to 8.9%) associated with prenatal treatment for chemical dependency.
   

Modified: Friday September 14 2007

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