Factors that Prevent Women of Low Socioeconomic Status from Seeking Prenatal Care

Abstract

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)

Understanding delayed access to antenatal care: a qualitative interview study

“…Practical barriers to care have been widely reported in other studies [17,32-34], however only one of the women interviewed expressed any problems relating to their home circumstances or financial background that had prevented them from accessing care, again suggesting that most were well supported. The women’s responses suggested rather a differing set of priorities, a consideration of convenience and an assessment of the value of early care, linked to location, health and past experience.…”

“…As other authors have observed, each pregnancy is a social phenomenon as well as a biological one and women need a certain amount of approval and social support before their pregnancy (and the need for antenatal care) can be acknowledged and accepted, both by the woman herself and her social network [27,29,32,33]. Access to antenatal care is heavily influenced by a woman’s willingness to embrace her pregnancy and particularly the social aspects of the pregnancy [17].…”

New Mexico women with no prenatal care: Reasons, outcomes, and nursing implications

“…One of the first studies on women receiving no prenatal care showed that 15 women had internal and external barriers to care similar to those described by women receiving inadequate prenatal care (Johnson, Primas, & Coe, 1994). Because of this small sample size, further research needed to be conducted with a larger sample of women who had no prenatal care.…”

Reasons, Health Behaviors, and Outcomes of No Prenatal Care: Research That Changed Practice

“…The attitudinal barriers included the psyche of the pregnant woman regarding pregnancy denial and beliefs affecting pregnancy and childbearing (McClanahan, 1992). Johnson, Primas, and Coe (1994) conducted one of the rst studies of women who received no prenatal care. They interviewed 15 postpartum Hispanic and non-Hispanic White women who received no care in Tucson.…”