This grounded theory study was conducted to explore how women utilize health care during pregnancy. The 27 women who were interviewed had sought prenatal care early, late or not at all. Transcriptions from the interviews were subjected to constant comparative analysis. The major concern of the women was seeking safe passage through pregnancy and childbirth. Processes used to achieve safe passage were searching for care, consulting, transferring, waiting, contingency planning and self-care. Discussed in this paper is the role that choice plays in utilizing care and transferring some elements of prenatal care to women to manage themselves.

Whether or not a woman enrolls in prenatal care in a timely fashion is a major predictor of pregnancy outcome. In this review, we consider maternal demographic, situational and psychosocial factors which have been studied with relation to enrollment in prenatal care. Paying increased attention to some situational barriers such as problems with child care or transportation, and a number of psychosocial factors such as unplanned pregnancy and negative feelings about medical care, holds promise in achieving improved utilization of prenatal care.

A first attempt was made to provide norms for intravaginal pressure in normal women measured by the Kegel perineometer. Data obtained from 78 white females and 64 black females indicate that resting pressure approximates 5 mm Hg and pressure with appropriate pelvic musculature contracted reaches an average of 15 mm Hg. The difference between resting and contracted pressures is unrelated to the former. There is a moderate negative correlation between number of vaginal births and contracted pressure in the white sample.

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Women's ability to contract pelvic musculature voluntarily was related to reports of ability to have orgasm, parity, and urinary leakage problems. Data collected from 92 women presenting for routine pelvic examinations provided no evidence of a general relationship between strength of voluntary pelvic muscle contractions and orgasmic function. There were negative relationships between strength of voluntary pelvic muscle contractions and parity, weight of the largest baby, and a woman's age.