Black women in double jeopardy: a perspective on birth control.
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Major factors impacting on antepartum care in the twenty-first century were reviewed in this article, including the impact of managed care and collaborative health care teams, the malpractice crisis, antepartum visits and the quality of care, increased use of the Internet and computer technology, the increasing age of childbearing, advances in genetic and prenatal diagnosis, the importance of evidence-based medicine, the goals of Healthy People 2010 [11], the Safe Mother Initiative, and the use of complementary and alternative medicine. Recommendations for antepartum care in the twenty-first century include; the formation of integrated collaborative health care teams to deal with the effects of managed care; development of a more sensitive health care system to assist all parties involved with medical malpractice; increased expertise in the use of the Internet and computer technology; acknowledging and preparing for the increased population of older gravidas; becoming aware of advances in genetic and prenatal diagnosis; increasing the ability to critically evaluate research and incorporate well-founded study findings into clinical practice; incorporating the goals of Healthy People 2010 [11] when providing care to antepartum patients; contributing resources and manpower to the Safe Mother Initiative to decrease maternal mortality in developing countries; becoming knowledgeable, obtaining adequate training, and utilizing or performing evidence-based studies to validate the use of complementary and alternative medicine in antepartum practice; and finally to find a balance between the factors impacting on prenatal care and the ability to continue to provide safe, high-quality, continuous, sensitive, and humane antepartum care.
SBHCs are filling a gap in health care needs for many of our nation's children. They provide services to an underserved population of children and adolescents, focusing on provision of health services and the promotion of health through population-based education programs. Schools with SBHCs are finding that significant physical, mental, and dental health issues are being addressed during the school day, allowing children to remain in school. The mission of SBHCs to contribute to the health of children by providing access to primary health care and preventive health care services is being actualized.
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