The Maternal H
CLEVELAND'S "MATERNITY & INFANT
The Maternal and Infant Care Project, known as "M & I" is America's public health program for mothers and infants. Its origins were in the 1800's when babies were dying from drinking unpasteurized contaminated milk and pasteurized milk distribution centers were set up in a few large cities. In 1961, the Kennedy administration, alarmed about the high incidence of birth defects, revived the idea of a Federal preventive care project and laid the ground work legislation for the federally funded M & I program,
The Cleveland M & I project offers a range of services to mothers unavailable anywhere else. These services were designed for low income women who live in the Cleveland census tract areas which have the highest incidences of high risk pregnancies and infant and maternal fatality and injury. You will find however, that the personnel of the project welcome any mothers in need of their services whether or not they live in the city of Cleveland.
SERVICES
1. Low income women are eligible for four days free care in Metropolitan General Hospi tal for themselves and the child.
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2. Free tests, medicine, dental care and consul tation with specialists when there is a need. 3. Free supervised child care at the clinics during appointments with free snacks for children.
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4. Help in preparing the home for the child. Bi-lingual social workers and community aides will help obtain stoves or regrigerators, layettes, cribs or help resolve difficult living arrangements.
5. Nutritionists help every woman plan an adequate diet, individualized according to her needs.
6. Lamaze classes, child care training and hospital delivery room tours (with free transportation and lunch) are offered.
7 Free health care after the birth includes a horne visit 10 days after the mother has returned home from the hospital, a medical checkup at the clinic 4 to 6 weeks later, farruly planning assistance and home visits when medical problems arise.
in addition to all these services, each mother is assigned a team of professionals who follow her progress. The chief member is her nurse practitioner who acts as her counsellor as well her nurse by explaining and giving all her tects, telling her what to expect during her pregnancy and helping her to understand the changes taking place in her body. Other members of the team are the doctor, a nutritionist,
a dental hygienist, a social worker and some. times a midwife.
What She Wants interviewed two sister pro fessionals who work in the program in order to learn about how the program functions in reality. On the negative side were the overcrowding of facilities and financial problems
page 6/What She Wants/May, 1975
which plague the program. They felt that often the human touch was lacking especially during the hospital stay and that there was not enough time to get to know each other either on the patient or worker level or on the worker to worker level.
THE "WOMEN INFANTS & CHILDREN" (WIC) SUPPLEMENTAL FOOD STAMP PROGRAM
Financial problems are worst in the food program, funded by the Agriculture Department and administered by the State Welfare Department. The WIC program has a quota while M & I does not. There have been waiting lists as long as 900 people at times. Also the State Department has recently dropped their own $20.00 food stamp supplement for pregnant women on welfare. Then there are crimerelated problems. Milk cannot be delivered to homes as it is in other Ohio cities for the M & I program because the dairies refuse to deliver in these neighborhoods. And there is the fear that often other people are eating the food intended for the mothers and babies.
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There is something which resembles a ban on publicity. There is the fear that if all the eligible women knew about the program the service would be hopelessly swamped with requests. So they get patients by word of mouth and agency referals and hundreds of eligible women never learn of the program or receive their benefits. The hush up is so effective that What She Wants was surprised to learn that even experienced welfare caseworkers interviewed had little or no knowledge of M & I services. Women who work at M & I fear reprisal for merely communicating the
extent of benefits publicly. What She Wants readers you now hold valuable contraband information.
On the positive side is the excellent array of services which are offered and the satisfaction which comes from being officially valued as a professional worker in a medical team. Although nurses and professionals feel a lack of time with their patients, we cannot help noting that they spend much more time and enjoy much more professional freedom to help people than they would if they worked for a private clinic or physician. All of the women respected the competence of their fellow team members. In addition, they enjoy on the job programs for professional upgrading and the opportunity to follow their patients progress from beginning to end. And since they are not a teaching facility they assured us that they knew of no experimental research being done on their patients.
So much for evaluating the success of the program on an individual and personal level. But what of the overall effectiveness in reaching their goals of preventing deaths and birth defects? Can a "public health" program which is a closely guarded secret change our poor health patterns? Can a program such as this continue to exist in the face of government apathy and scorn for the problems of mothers and children? Yet what alternative is there? Clearly not our private enterprise medical setup. Private physicians, while they make substantial incomes, cannot afford to hire teams of professionals to monitor their patients much less carry out coordinated national programs to deliver care where it is needed most (assuming that they were even
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