Improving perinatal oral health care access: Consumer suggestions for change

Oral health during the perinatal period is correlated to health of mother and child. In 2022, North Carolina (NC) legislators revised Medicaid for Pregnant Women (MPW) policies to expand oral health care coverage up to 12 months postpartum. However, usage of benefits remains low across the state. The authors sought to address low usage by means of identifying consumer-centered system-level strategies.

Using qualitative methodology, one-on-one interviews were held with 14 MPW beneficiaries selected by means of convenience sample and recruited in rural and urban NC counties. Participant transcripts were systematically analyzed for themes using MAXQDA software, Version 2022 (VERBI Software). Interviews continued until data saturation was achieved, indicating sufficient information power.

Three of 14 participants knew about their MPW oral health care coverage. Themes identified were grouped into 2 categories: barriers to usage and suggestions to improve usage. Barriers included access challenges (8/14), time constraints and lack of prioritization of oral health care (7/14), and economic challenges (6/14). Suggestions included improved education (14/14), access to care interventions (11/14), financial support (10/14), and emotional support services (5/14).

On the basis of the themes in participant responses, the authors recommend enhancement of informational resources provided by means of NC Medicaid to MPW beneficiaries, increasing funding for Medicaid caseworkers to aid MPW beneficiaries in accessing care, improving education on oral health care and MPW oral health care benefits for prenatal health care providers, and increasing accessibility of Medicaid providers. Future researchers should investigate oral and prenatal health care provider attitudes and perspectives.

The authors propose real-world implementation of these recommendations and suggest specific action steps to do so.