Prenatal Care Survey: Barriers to Prenatal Care in Jefferson County/Louisville, Kentucky

2.50
Hdl Handle:
http://hdl.handle.net/10755/148327
Type:
Presentation
Title:
Prenatal Care Survey: Barriers to Prenatal Care in Jefferson County/Louisville, Kentucky
Abstract:
Prenatal Care Survey: Barriers to Prenatal Care in Jefferson County/Louisville, Kentucky
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Hutti, Marianne, DNS/DNSc/DSN
P.I. Institution Name:University of Louisville
Title:Associate Professor
Early and sustained prenatal care has been found to reduce the incidence of low birth weight, prematurity, developmental delays, and infant and maternal mortality. In 1995, 85% of pregnant women in Jefferson County sought early prenatal care. The national objective in the United States is to increase the number of women who seek early prenatal care to 90% by 2010. The purpose of this study was to identify barriers to prenatal care in Jefferson County (Louisville), Kentucky. Subjects were 1304 women who delivered in the four birthing hospitals in Jefferson County between March and June, 1999. Women of color and women living in poverty comprised 23% of the sample. Participants completed a 73-item, previously pilot-tested survey based on barriers to care identified in the literature. Data were collected within 2 days of delivery, with a 61% response rate. Data were analyzed by frequencies, cross-tabs, chi-square, and t-tests of means. Geospatial analysis of zip code data was also completed. This presentation will focus on the variables that were related to late prenatal care in this sample. 1173 women received first trimester/early prenatal care, 105 received second trimester care, and 19 received third trimester care. Seven women reported receiving no prenatal care during pregnancy. Women who received late (second and third trimester) prenatal care lived in all areas of Jefferson County and were more likely to be poor, single, African-American, smokers, less educated, and rent rather than own their own homes. No differences were found in women who received early versus late prenatal care related to gravidity, number of pregnancy terminations, alcohol use in pregnancy, one and five minute Apgar scores, or gestational age at birth. Unintended pregnancy was a major barrier for women who sought late prenatal care. Only 25.3% of the women who obtained first trimester care had not planned their pregnancies, compared with 65.7% of the second trimester and 83.3% of the third trimester prenatal care groups. Of the women who received care only in the third trimester, only 11.1% reported stopping contraception to become pregnant compared with almost half of the first trimester group. Women who began care in the first trimester were three times more likely to report wanting to have a baby at the time that they became pregnant when compared with women in the third trimester care group. Women who sought late care were more likely to report depression, feeling embarrassed about the pregnancy, and being worried about their health during the pregnancy. Women in the late care groups experienced significantly more transportation problems in getting to prenatal appointments. Women who received late care were more likely to have to wait longer periods of time for their insurance to cover their pregnancies, to feel less emotionally supported by office/clinic staff, to feel less respected by office staff, to fear office procedures such as pelvic exams or the drawing of blood specimens, and were less likely to know who to call if they had questions related to their insurance. Women who received late care were more likely to be receiving WIC, to have trouble getting off work to attend prenatal appointments, and to have trouble finding childcare for their children so that they could attend prenatal appointments. They reported receiving less physical, emotional, and financial support from their baby’s father than did women who received early care. Verbal abuse was more commonly reported in the late care groups, and women who received second trimester care were almost three times as likely to experience physical abuse (6.6%) than were women who received first trimester care (2.3%). Women who received first trimester care learned about their pregnancies earlier than did women who received late care, and received more prenatal visits. No significant differences were found regarding knowing where to get prenatal care or confusion about what their insurance/Medicaid would cover related to their pregnancies. The majority of women in all three groups received their prenatal care from private physicians. Women who received early care were more likely to report satisfaction with the care they received and feel included in health related decisions than were women in the late care groups.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePrenatal Care Survey: Barriers to Prenatal Care in Jefferson County/Louisville, Kentuckyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148327-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Prenatal Care Survey: Barriers to Prenatal Care in Jefferson County/Louisville, Kentucky</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hutti, Marianne, DNS/DNSc/DSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Louisville</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mhhutt01@gwise.louisville.edu</td></tr><tr><td colspan="2" class="item-abstract">Early and sustained prenatal care has been found to reduce the incidence of low birth weight, prematurity, developmental delays, and infant and maternal mortality. In 1995, 85% of pregnant women in Jefferson County sought early prenatal care. The national objective in the United States is to increase the number of women who seek early prenatal care to 90% by 2010. The purpose of this study was to identify barriers to prenatal care in Jefferson County (Louisville), Kentucky. Subjects were 1304 women who delivered in the four birthing hospitals in Jefferson County between March and June, 1999. Women of color and women living in poverty comprised 23% of the sample. Participants completed a 73-item, previously pilot-tested survey based on barriers to care identified in the literature. Data were collected within 2 days of delivery, with a 61% response rate. Data were analyzed by frequencies, cross-tabs, chi-square, and t-tests of means. Geospatial analysis of zip code data was also completed. This presentation will focus on the variables that were related to late prenatal care in this sample. 1173 women received first trimester/early prenatal care, 105 received second trimester care, and 19 received third trimester care. Seven women reported receiving no prenatal care during pregnancy. Women who received late (second and third trimester) prenatal care lived in all areas of Jefferson County and were more likely to be poor, single, African-American, smokers, less educated, and rent rather than own their own homes. No differences were found in women who received early versus late prenatal care related to gravidity, number of pregnancy terminations, alcohol use in pregnancy, one and five minute Apgar scores, or gestational age at birth. Unintended pregnancy was a major barrier for women who sought late prenatal care. Only 25.3% of the women who obtained first trimester care had not planned their pregnancies, compared with 65.7% of the second trimester and 83.3% of the third trimester prenatal care groups. Of the women who received care only in the third trimester, only 11.1% reported stopping contraception to become pregnant compared with almost half of the first trimester group. Women who began care in the first trimester were three times more likely to report wanting to have a baby at the time that they became pregnant when compared with women in the third trimester care group. Women who sought late care were more likely to report depression, feeling embarrassed about the pregnancy, and being worried about their health during the pregnancy. Women in the late care groups experienced significantly more transportation problems in getting to prenatal appointments. Women who received late care were more likely to have to wait longer periods of time for their insurance to cover their pregnancies, to feel less emotionally supported by office/clinic staff, to feel less respected by office staff, to fear office procedures such as pelvic exams or the drawing of blood specimens, and were less likely to know who to call if they had questions related to their insurance. Women who received late care were more likely to be receiving WIC, to have trouble getting off work to attend prenatal appointments, and to have trouble finding childcare for their children so that they could attend prenatal appointments. They reported receiving less physical, emotional, and financial support from their baby&rsquo;s father than did women who received early care. Verbal abuse was more commonly reported in the late care groups, and women who received second trimester care were almost three times as likely to experience physical abuse (6.6%) than were women who received first trimester care (2.3%). Women who received first trimester care learned about their pregnancies earlier than did women who received late care, and received more prenatal visits. No significant differences were found regarding knowing where to get prenatal care or confusion about what their insurance/Medicaid would cover related to their pregnancies. The majority of women in all three groups received their prenatal care from private physicians. Women who received early care were more likely to report satisfaction with the care they received and feel included in health related decisions than were women in the late care groups.</td></tr></table>en_GB
dc.date.available2011-10-26T09:43:33Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T09:43:33Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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