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36 childbearing years, especially during pregnancy; in the full report, several more specific topics are suggested. Messages based on these themes should be developed and market tested to ensure their acceptability to a wide variety of audiences. Television, radio, and the print media should be used ex- tensively, as should educational materials prepared for use in health care settings and schools. The committee urges that particular attention be given to the possibility of integrating health-related messages into the story lines of television shows; many high-risk women are members of groups that are known to watch daytime television, especially soap operas. This public information program clearly needs an organizational home and strong leadership. The committee urges that the leadership responsibil- ity be assumed by the Healthy Mothers, Healthy Babies Coalition, a 4-year- old consortium of voluntary, professional, and governmental groups. The coalition should establish a formal executive secretariat to provide stability and permanence. Both public and private funds should be provided to the coalition in amounts adequate to the task of leading a major public informa- tion campaign. Activities should include the production and distribution of high-quality, well-tested public information materials. The committee emphasizes that this public information initiative should be only one element in a more comprehensive program to reduce low birthweight. Public messages stressing the importance of prenatal care must coincide with a commitment to making prenatal care more accessible, just as messages to decrease smoking in pregnancy must be reinforced and elabo- rated in individual office and clinic settings. To be successful, the informa- tion campaign must carry scientifically accurate messages and receive full social and political support. REFERENCES 1. Public Health Service: Promoting Health/Preventing Disease: Objectives for the Nation. Washington, D.C.: U.S. Government Printing Office, Fall 1980. 2. Low JA and Galbraith RS: Pregnancy characteristics of interauterine growth retardation. Obstet. Gynecol. 44:122-126, 1974. 3. Fuhrmann K, Reiher H. Semmler K, Fischer F. Fischer M, and Glockner E: Prevention of congenital malformations in infants of insulin-dependent mothers. Diabetes Care 6:219- 223, 1983. 4. Bakketeig LS, Hoffman H], and Harley EE: The tendency to repeat gestational age and birthweight in successive births. Am. ]. Obstet. Gynecol. 135:1086-1103, 1979. 5. Kass EH, McCormack WM, Lin IS, Rosner B. and Munoz A: Genital mycoplasmas as a cause of excess premature delivery. Trans. Assoc. Am. Physicians 94:261-266, 1981. 6. Taffel SM and Keppel KG: Implications of mother's weight gain on the outcome of pregnancy. Paper presented at the annual meeting of the American Statistical Associa- tion, Philadelphia, Pa., August 13-16, 1984. Forthcoming in Proceedings of the American Statistical Association, Winter 1984-1985. 7. Stein Z and Kline ]: Smoking, alcohol and reproduction. Am. ]. Public Health 73: 1154- 1156, 1983. ~See the full report of the Committee to Study the Prevention of Low Birthweight for additional references.
37 8. Mills JL, Graubard BI, Harley EE, Rhoads GG, and Berendes HW: Maternal alcohol consumption and birthweight: How much drinking during pregancy is safe? J AMA 252:1875-1879, 1984. 9. Flaksman R], Vollman JH, and Benfield DG: Iatrogenic prematurity due to elective termination of the uncomplicated pregnancy: A major perinatal health problem. Am. J. Obstet. Gynecol. 132:885-888, 1978. 10. Hack M, Fanaroff AA, Klaus MH, Mendalawitz BD, and Merkatz IR: Neonatal respiratory distress following elective delivery: A preventable disease? Am. l. Obstet. Gynecol. 126:43-47, 1976. 11. Maisels M], Rees R. Marks K, and Friedman Z: Elective delivery of the term fetus: An obstetrical hazard. J AMA 238:2036-2039, 1977. 12. Tamby Raja R and Hobel C]: Characteristics of 24 hour uterine activity (UA) in the second half of pregnancy. Abstract No. 516, p. 280. Fifteenth Annual Meeting, Society for Gynecological Investigation, Washington, D.C., March 17, 1983. 13. Stein Z. Susser M, Saenger G and Marolla F: Famine and Human Development: The Dutch Hunger Winter of 1944-1945. New York: Oxford University Press, 1975. 14. Kleinman JC, Machlin SR, Cooke MA, and Kessel SS: The relationship between delay in seeking prenatal care and the wantedness of the child. Paper presented at the 112th Annual Meeting, American Public Health Association, Anaheim, Calif., November 11-15, 1984. 15. The Alan Guttmacher Institute: Questions and answers about Title X and family plan- ning. Public Policy Issues in Brief 4:1-4, March 1984. 16. Korenbrot CC: Risk reduction in pregnancies of low income women: Comprehensive prenatal care through the OB Access Project. Mobius 4:34-43, 1984. 17. Slome C, Wetherbee H. Daly MN, Christensen K, Meglen M, and Thiede H: Effectiveness of CNMs: A prospective evaluation study. Am. ]. Obstet. Gynecol. 124:177-182, 1976. 18. National Institutes of Health: Diagnostic Ultrasound Imaging in Pregnancy. Report of a Consensus Development Conference. NIH Pub. 84-667. Public Health Service. Washing- ton, D. C.: U. S. Government Printing Office, 1984. 19. Committee to Study the Prevention of Low Birthweight: Efforts to change smoking and drinking behavior in pregnant women. Unpublished paper by S Wilner. Washington, D. C.: Institute of Medicine, 1984. 20. Kennedy ET, Gershoff, S. Reed R. and Austin JE: Evaluation of the effect of WIC supplemental feeding on birthweight. J. Am. Dietetic Assoc. 80:220-227, 1982. 21. Kotelchuck M, Schwartz JB, Anderka MT, and Finison KS: WIC participation and preg- nancy outcomes: Massachuestts statewide evaluation project. Am. J. Public Health 74:1086-1092, 1984.
