economy is increasingly forcing the United States to specialize
in goods and services that require a highly skilled, adaptable work
force.
Beyond the
nation's economic competitiveness or the future security of
retirees, crime, disorder, and other social pathologies are being
set in motion now by what is happening to too many children.
Today's infants are literally the nation's future. Whatever America
can or will be is taking shape today in the nation's nurseries. The
underlying challenge is clear enough, and so too are the social
costs. The question of how to provide opportunity and social
protection to children is complex, for the well-being of all young
children must be a societal as well as a parental concern. Parents
have primary responsibility for their children, but we all have an
interest in healthy babies and in children's adequate nutrition and
cognitive development. Moreover, the problems of infants are
closely connected to issues we will deal with in subsequent
chapters: teen pregnancy, gaps in health insurance coverage,
joblessness, and underemployment of parents.
This chapter
develops an agenda for reform in prenatal care, preventive health
care and nutrition, early childhood development, and family support
services. It is an agenda that emphasizes larger social investments
in children at the earliest possible stages of life. These stages
represent "windows of opportunity," and they do not stay open very
long. Delay often means that by the time remedial help arrives, the
window is already shut. The panel believes that it is simple common
sense to make investments that are preventive and that capitalize
on the earliest possible opportunities.
Extending
Prenatal Care
Thanks to
modern science, childbirth is not the mystery it once was. Bringing
a healthy baby into the world is something we know how to do, but
too often in America we fail to do it. We know the basic elements
of a healthy start in life: prenatal care with regular screening to
detect health risks, counseling to educate expectant mothers about
appropriate health and nutritional habits during pregnancy, and
continued good nutrition and health care for the newborn child. We
know that pregnant women who obtain regular check-ups and periodic
examinations by an obstetrician early in their pregnancies are more
likely to have healthy babies than those who delay care until late
in their pregnancy or do not obtain it at all.
Through
measures such as these, the nation has made great strides in
prenatal care and achieved dramatic reductions in infant mortality.
The leading cause of