Initiation of and Barriers to Prenatal Care Use Among Low-Income Women in San Antonio,Texas |
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Authors: | T S Sunil William D Spears Linda Hook Josephine Castillo Cynthia Torres |
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Institution: | (1) Department of Sociology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA;(2) Boonshoft School of Medicine, Wright State University, Dayton, OH, USA;(3) University Health Systems, San Antonio, TX, USA;(4) San Antonio Metropolitan Health District, San Antonio, TX, USA |
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Abstract: | Healthy People 2010 goals set a target of 90% of mothers starting prenatal care in the first trimester of pregnancy. While
there are questions about the value of prenatal care (PNC), there is much observational evidence of the benefits of PNC including
reduction in maternal, fetal, perinatal, and infant deaths. The objective of this study was to understand barriers to PNC
as well as factors that impact early initiation of care among low-income women in San Antonio, Texas. A survey study was conducted
among low-income women seeking care at selected public health clinics in San Antonio. Interviews were conducted with 444 women.
Study results show that women with social barriers, those who were less educated, who were living alone (i.e. without an adult
partner or spouse), or who had not planned their pregnancies were more likely to initiate PNC late in their pregnancies. It
was also observed that women who enrolled in the WIC program were more likely to initiate PNC early in their pregnancies.
Women who initiated PNC late in pregnancy had the highest odds of reporting service-related barriers to receiving care. However,
financial and personal barriers created no significant obstacles to women initiating PNC. The majority of women in this study
reported that they were aware of the importance of PNC, knew where to go for care during pregnancy, and were able to pay for
care through financial assistance, yet some did not initiate early prenatal care. This clearly establishes that the decision
making process regarding PNC is complex. It is important that programs consider the complexity of the decision-making process
and the priorities women set during pregnancy in planning interventions, particularly those that target low-income women.
This could increase the likelihood that these women will seek PNC early in their pregnancies. |
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