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Maternity Care Coalition
Defining Maternity Care for the Essential Health Benefits in Pennsylvania
Maternity: A Clinical Standard of Care
Since there is no current insurance standard in Pennsylvania, nor do all insurance plans
need to include maternity care, it is critical that the Essential Health Benefits adhere to
clinical standards of care, guidelines, and recommendations. Evidence-based maternity
coverage must meet the benefits defined in The American College of Obstetricians and
Gynecologists and American Academy of Pediatrics’ Guidelines for Perinatal Care, 1 including
preconception and interconception care, prenatal care, labor and delivery, and post-partum
care
Maternity Coverage as Defined by the American College of Obstetricians and Gynecologists
and American Academy of Pediatrics’ Guidelines for Perinatal Care:




Preconception care includes:
o Genetic counseling2
o Review of pre-existing conditions3
o Psychosocial support or non-biomedical factors that affect mental and
physical wellbeing4
Prenatal care includes:
o Fetal evaluation5
o Nutrition6 and parenting education7
o Coordination of prenatal care with delivery services 8
o Care for conditions that affect pregnancy, including HIV and other STDs 9
Labor and delivery includes:
o Anesthesia10
o Care in a facility appropriate for the patient’s maternal-fetal risk11
o Care for pregnancy-related complications12
Post-partum care includes:
o Family planning services13
o The option of sterilization14
1
American Academy of Pediatrics & American College of Obstetricians and Gynecologists. (2007). Guidelines for Perinatal Care- 6th Edition.
Washington, DC, 371.
2
Ibid.
3
Ibid.
4
Ibid., 124-125.
5
Ibid., 113.
6
Ibid., 85-86
7
Ibid., 119-120.
8
Ibid., 83-85.
9
Ibid., 376-377.
10
Ibid., 151-155.
11
Ibid., 140-144.
12
Ibid., 175-203
13
Ibid. 169-170.
14
Ibid.,169-170.
For more information contact: ecusack@maternitycarecoaltion.org or lthall@maternitycarecoalition.org, www.maternitycarecoalition.org
Maternity Care Coalition
 Maternity benefits must include services that span all the stages of pregnancy
(including preconception and interconception), including:
o Immunizations;
o Lab work15
o Prescription drugs16
o
Mental health services17
o Substance abuse services18
o Tobacco cessation counseling and intervention19
o Psychosocial support services including case management, home care, and
transportation20
o Genetic screening and testing21
o Oral health22
o Auxiliary services for women with physical disabilities23
o Health services for newborns24
15
Ibid.,124-125.
Ibid., 84.
17
Ibid.
18
Ibid., 96-97.
19
Ibid,, 94-96.
20
Ibid., 124-125.
21
Ibid., 108-110.
22
Ibid., 171.
23
Ibid., 87-88.
24
Ibid., 205-249.
16
For more information contact: ecusack@maternitycarecoaltion.org or lthall@maternitycarecoalition.org, www.maternitycarecoalition.org