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background Early access to quality prenatal care is an essential component of improving maternal and neonatal outcomes as it allows for early intervention and risk stratification. Women who receive late or infrequent prenatal care are at high risk for complications including preterm birth, infant death, and stillbirth. We sought to better understand the barriers Spanish-speaking women face in accessing quality prenatal care and to identify facilitators in obtaining timely quality prenatal care. methods We recruited a homogeneous group of 11 women with Spanish as their primary language who were pregnant or had given birth within the last six months. We then conducted two focus groups in Spanish. The focus groups were recorded, translated, and transcribed, and then coded using grounded theory. results In our cohort of participants, the three major themes included desire for psychosocial support, health care system logistics, and barriers due to Latinx ethnicity. limitations Our study has several limitations, including a small sample size and single site design. conclusion Latinx women experience unique barriers to care including language barriers, a lack of cultural competency on the part of health care personnel, and ethnic discrimination. Additional research is needed to develop patient-centered interventions to address these barriers.

INTRODUCTION: Patients who are late to prenatal care miss valuable opportunities for health interventions, and are at increased risk for pregnancy-related complications. In our study, we aimed to describe barriers to prenatal care experienced by multiparous women with an interconceptional period of less than two years by race/ethnicity. METHODS: After IRB approval, we performed a secondary analysis of the Community Child Health Research Network Study, a multi-site prospective cohort study of pregnant women from 2008 to 2012 recruited from Baltimore, Chicago, North Carolina, Los Angeles and Washington, D.C. Participants who experienced a repeat pregnancy in the two-year follow up period were asked if they encountered any of eight prespecified potential barriers to prenatal care. A multilevel mixed effects Poisson regression was performed to evaluate the association between race/ethnicity and number of prenatal barriers encountered. RESULTS: We included 298 participants in our analysis, with 151 self-identifying as African American, 72 White, and 75 Latina. The most frequent barrier was the inability to obtain an appointment. Overall, 43% of African American, 35% of Latina, 23% of White participants reported barriers to care. After adjusting for study site, maternal education, language, and maternal age, African American and Latina women reported almost twice as many barriers to prenatal care as White women (OR 1.89 [1.2, 3.0]; 2.00 [1.1,3.8], respectively). CONCLUSION: In our secondary data analysis of a multisite, longitudinal cohort, multiparous African American and Latina women reported encountering more barriers to obtaining prenatal care. Additional interventions are needed to address these barriers and achieve health equity.

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