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Researchers make case for extending Medicaid coverage to low-income mothers

According to the new study, a woman's weight before her first pregnancy may have long-term effects.
National Institute of Diabetes and Digestive and Kidney Diseases | National Institutes of Health

Intense stress faced by new moms can also affect the emotional development of their baby. That's a good reason to expand Medicaid coverage to low-income mothers, a St. Louis child psychiatrist argued Tuesday.

“If you want to have healthy infants, you have to have healthy caregivers,” Dr. Cynthia Rogers told an assembly of physicians at Washington University. “And the preterm brain is particularly vulnerable.”

A baby's last weeks of growth in a mother's womb are important. Although modern medicine has saved countless premature infants who may not have survived decades ago, that care can be traumatic for both the child and the parents.

“I don’t think unless you’ve experienced it, you can understand what it’s like to have a child born two, three or four months early… and feeling like you can’t do anything to help your child,” Rogers said. “All of that makes these parents extremely anxious, and a lot of them do have symptoms of PTSD.”

Rogers and her colleagues have taken MRI scans of premature infants in St. Louis during their first years of life, and found a correlation between the mental health of new mothers and their children. Babies whose mothers’ mental health needs went untreated had a greater risk of attention problems, anxiety or even depression as they grew up.

A myriad of factors, including a person’s environment and their genetics, can influence their mental health, Rogers said. The difference is that a parent’s mental health can be improved.

“Some of those things we cannot change, but some of them we can,” Rogers said. “The goal is to focus on the things we really can intervene on. Treating maternal mental health symptoms, and intervening before those symptoms even start, is something we can do.”

Rogers’ research shows that mental health counseling can help. The problem is, it isn’t always available.

Under Missouri law, Medicaid coverage is available to pregnant women whose incomes fall below 185 percent of the federal poverty line, or $37,777 a year for a family of three. But benefits are cut off for most new moms 60 days after they give birth. That drives up the cost of their medical care, including mental health counseling and treatment.

Maternal health advocates aren’t very hopeful that the Missouri legislature will extend Medicaid coverage, given lawmakers' history of voting down Medicaid expansion.

“I know there’s interest … but I haven’t seen any movement to actually put that into practice, or even pilot it,” said Kendra Copanas, executive director of Generate Health. "One option the state could have is to try it out in a part of the state. But given the uncertainty federally, it may not be as open to considering broadening or enhancing the services."

Follow Durrie on Twitter: @durrieB