While there is an international trend toward lowering infant mortality, the United States ranks 19th among industrialized nations. In Arizona, as across the nation, a large and increasing number of low birth weight (LBW) infants are being delivered. This number is viewed with alarm as LBW is associated with infant mortality; however, LBW may be preventable in many cases if mothers receive adequate prenatal care. Despite recognition that absent or inadequate prenatal care is an important risk factor, a large number of women deliver without such care. In Arizona, the percentage of women delivering at a large metropolitan public hospital without prenatal care doubled in a 2-year period, reaching 14% (764 women). The majority of these women were of low socioeconomic status. The purpose of this study was to explore the reasons given by women delivering at this hospital for not seeking prenatal care. It was determined that a qualitative methodology was most appropriate; thus, an interview guide was developed with both demographic and open-ended probing questions. Fifteen respondents--5 Caucasian, 8 Latino (5 Spanish-speaking only), 1 Afro-American, and 1 Native American--participated in the interviews. The data were transcribed from taped interviews and studied using content analysis. Eleven barriers were identified and sorted into two categories: internal and external. Internal barriers identified by the women were attitudes associated with low motivation, knowledge deficits, fear, and fatigue. External barriers elicited were finances, transportation, system difficulties, lack of support, lack of child care, missed work, and insufficient time.(ABSTRACT TRUNCATED AT 250 WORDS)

A pilot study was conducted in 1987-1988 to evaluate current health literature utilized for prenatal health education of the high risk population in County Health Departments in Arizona. Towards that end, sixty-five distinct pamphlets were obtained from Arizona's County Health Departments and assessed for reading level using the SMOG Readability Formula. The majority of the prenatal literature were found to be 10th to 12th grade reading level, higher than the typical reading level of the high risk prenatal population. A modified literature testing instrument was further utilized to test eight general prenatal pamphlets to assess the printed literature for accuracy, usability, believability, appeal, and cultural relevance. Four pamphlets of those tested, two English and two Spanish, were identified as being the most appropriate for the high risk prenatal population.

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