Prenatal Care and Postpartum Smoking

Presenter: Hope Corman, Rider University and National Bureau of Economic Research

Abstract

Few evaluations of the effectiveness of prenatal care have considered maternal health behaviors after the child is born despite the fact that a broad goal of contemporary prenatal care is to promote the health and well-being of the entire family during the postpartum year. We use population-based data from a longitudinal birth cohort study to estimate effects of the timing of prenatal care initiation on one key health behavior--cigarette smoking approximately 1 year after the birth. Smoking cessation is a key component of standard prenatal care, and there is evidence that prenatal smokers who initiate prenatal care early during their pregnancies are more likely that those who initiate care later to both quit smoking during pregnancy and to relapse postpartum. In preliminary work, we have found that the distance (in km) from the mother's residence to the hospital in which she gave birth is a strong identifier for the timing of prenatal care. Recent trends indicate that access to hospitals in inner cities has been declining as unprofitable hospitals either close or move to more affluent areas. As such, proximity to hospitals may become an even more important determinant of prenatal care, and potentially of health care utilization more generally, over time.

Our study has the potential to identify a clear benefit to prenatal care that is generally not considered in evaluations of prenatal care programs and interventions—that earlier care reduces the likelihood that mothers will smoke when their children are one year old. This area of inquiry has important implications for the health of children, mothers, and families.