First Discussion

The federal insurance keeps on changing, and it is not clear whether the government that is in place or gets in power after an election can put in place an affordable health care act.

Currently, many states are taking a strong move on the coverage of abortions irrespective of the changes that the federal landscape takes. The state I would love to work is Texas.

In this state, they have signed a bill that generally hinders health insurance who give individuals or employer-based plans from covering abortion unless a woman faces danger. Furthermore, ten years ago, Texas joined other states in offering Medicaid specifically for family planning to low-income earning women and others who had the eligibility.

However, in 2011, the state through its policymakers sought to reverse the law with the aim of putting out the business of Planned Parenthood. This move exclude health centers from that provided safe and high-quality contraceptives to women. Starting January 2010, Texas adopted and operated the family planning program as funded by the state and no longer part of the Medicaid.

The number of maternal deaths, i.e., women dying in pregnancy or at childbirth is at an alarming rate in the state of Texas. The number is so high than in any other state, and it depicts what is not normal in such cases for developed nations (Mattie, 2017). If Texas were a country on its own, it would face the highest maternal mortality rate just like Mexico or turkey. So why has this state faced such a higher rate?

Cardiac problems and hypertension have been linked to being the cause of the high maternal mortality rate in this state. On the other hand, the infant mortality rate in Texas has been ranging below the national rate for over the past ten years. The state has operated below the healthy person 2020 which has a target of 6.0 deaths per 1,000 live births (N. Haghighat et al., 2016)

It is important to note that maternal mortality rate and infant mortality rate are much correlated. It has been discovered that increased maternal mortality rate increases the rate of infant mortality rate. There a number of ways in which the two correlate.

For instance, the main cause of maternal mortality is obstetric complications like eclampsia, sepsis, obstructed labor and hemorrhage which can put the infant at increased risk of death. Furthermore, the lack of nutritional support from breastfeeding leaves the infant very vulnerable to malnutrition.

Second discussion

Abortion forms an essential part of a woman health care. Approximately 920,000 women perform abortions every year in the United States. These numbers point to the importance of reproductive health care as well as a woman's right to decide whether they want to have children or not. With access to reproductive health care an especially costly affair, states have had to step in to put the required legislative laws to ensure women have access to this important service in terms of health insurance.

In the state of Florida, there are restrictions on abortion which took effect in April 2017. The health insurance in the state under the Affordable Care Act only covers abortion if the woman is in danger, if there is a case of incest, or if it was a rape. Apart from that, the individual can buy an additional rider at an additional cost, which may not be affordable to many. Subsequently, approximately 70% of clinics in Florida counties did not offer abortion services, with 20% of Florida women living in those counties (Vamos et al., 2017).

The statistics for the state's infant and maternal mortality rates do not make for good reading. In 2015, the ratio for pregnancy-related mortality was 16.9 per 100,000 live births (Vamos et al., 2017). While this is significantly lower than the 26.2 per 100,000 live birth in the previous year, the rates are still relatively high.

Almost 50% of those occurred while the mother was still pregnant, miscarriage and almost 10% as stillborns (Vamos et al., 2017). Considering how essential women reproductive health is, there is a need for more to be done in the state if the above rates are to be lowered. The state needs to review its laws to enable women access to insurance either for contraceptives and abortions.

As an advanced nurse, one can use Essential VI: Health Policy and Advocacy which prepares nurses to intervene at the policy level as well as employing advocacy strategies to influence health care and improve healthcare outcomes.