Pregnancy Intentions, Pregnancy Attitudes, and the Use of Prenatal Care in Missouri
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Objectives: This study uses data from 2378 mothers of live-born infants from the NICHD/Missouri Maternal and Infant Health Survey to examine the relationship between pregnancy intention and adequacy of prenatal care. Methods: Pregnancy intention was measured using traditional classifications of mistimed and unwanted pregnancies as well as additional measures of women's attitudes about their pregnancies. Odds ratios for inadequate prenatal care and its component parts (initiation of care and receipt of services) were calculated using multiple logistic regression in separate models and in a combined model for the measures of intention and attitude. Results: Women's attitudes about their pregnancies were associated with inadequate prenatal care, including both inadequate initiation of care and inadequate receipt of services. Traditional measures of intendedness were significantly related only to inadequate initiation of care. Women who were unhappy about the pregnancy (OR = 1.44), unsure that they wanted to be pregnant (OR = 2.81), or denied their pregnancies (OR = 4.82) were more likely to have inadequate prenatal care than women who did not have these attitudes. Women who were unhappy about being pregnant (OR = 1.86), unsure that they wanted to be pregnant (OR = 3.44), or who denied the pregnancy (OR = 6.69) were more likely to have inadequate initiation of care. Women who were unsure that they wanted to be pregnant (OR = 1.95) or who denied their pregnancies (OR = 2.47) were more likely to have received inadequate care once they had entered care. Conclusions: This study suggests that attitudes about pregnancy may be a psychosocial barrier to women obtaining early and continuous prenatal care. Pregnancy attitudes should be assessed and appropriate services provided to improve women's utilization of prenatal care. New measures of pregnancy attitude, beyond the traditional intention measures, can be useful in assessing pregnancy wantedness and identifying women to target for these services.
- Henshaw, SK: Unintended pregnancy in the United States. Fam Plan Perspec 1998;30(1):24–29, 46.
- Piccinino LJ. Unintended pregnancy and childbearing. In: Wilcox LS, Marks JS, editors. From Data to Action. CDC's public health surveillance for women, infants, and children. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, 1994;73–82.
- Institute of Medicine. Preventing Low Birthweight. Brown SS, editor. Washington DC: National Academy Press, 1985:132–149.
- Institute of Medicine. Prenatal Care: Reaching Mothers, Reaching Infants. Brown SS, editor. Washington DC: National Academy Press; 1988.
- Sable MR, Stockbauer JW, Schramm WF, Land GH. Differentiating the barriers to adequate prenatal care in Missouri, 1987–88. Pub Health Rep 1990;105:549–555.
- Kiely JL, Kogan MD. Prenatal care. In: Wilcox LS, Marks JS, editors. From Data to Action. CDC's public health surveillance for women, infants, and children. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, 1994;105–118.
- Institute of Medicine. Consequences of unintended pregnancy. In: Brown SS, Eisenberg L, eds. The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. Washington DC: National Academy Press, 1995;50–90.
- Lia-Hoagberg B, Rode P, Skovholt C et al. Barriers and motivators to prenatal care among low-income women. Soc Sci Med 1990;30:487–495.
- Joyce TJ, Grossman M. Pregnancy wantedness and the initiation of prenatal care. Demography 1990;27:1–17.
- Marsiglio W, Mott FL. Does wanting to become pregnant with a first child affect subsequent maternal behaviors and infant birth weight? J Marr Fam 1988; 50:1023–1036.
- Weller RH, Eberstein IW, Bailey M. Pregnancy wantedness and maternal behavior during pregnancy. Demography 1987;24:407–412.
- St. John C, Winston TJ. The effect of social support on prenatal care. J Appl Behav Sci 1989;25:79–98.
- London K, Peterson L, Piccinino L. The National Survey of Family Growth: Principal source of statistics on unintended pregnancy. In: Brown SS, Eisenberg L, eds. The Best Intentions. Washington DC: National Academy Press, 1995;286–295.
- Adams MM, Shulman HB, Bruce C, Hogue C, Brogan D. The pregnancy risk assessment monitoring system: Design, questionnaire, data collection and response rates. Paediatr Perinat Epidemiol 1991;5:333–46.
- Kaufmann RB, Morris L, Spitz AM. Comparison of two question sequences for assessing pregnancy intentions. Am J Epidemiol 1997;145:810–816.
- Sable MR, Spencer JC, Stockbauer JW, Schramm WF, Pierson VH, Herman AA. Pregnancy wantedness and adverse pregnancy outcomes: Differences by mother's race and Medicaid status. Fam Plan Perspect 1997;29:76–81.
- Pierson VH, Schramm W, Stockbauer J, Land G, Hoffman H, Herman A. Prenatal care access and pregnancy outcomes in Missouri. Mo Med 1994;91:624–628.
- Sable MR, Herman AA. The relationship between prenatal health behavior advice and low birth weight. Pub Health Rep 1997;112:332–339.
- Kotelchuck, M. An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. Am J Pub Health 1994;84(9):1414–1420.
- Kotelchuck, M. Adequacy of Prenatal Care Utilization Index. SAS Computational Program, Version 3, September, 1994.
- Hosmer DW, Lemeshow S. Applied Logistic Regression. New York: John Wiley & Sons, 1989.
- SAS for Windows, Version 6.12. Cary, NC: The SAS Institute.
- Wilkinson DS, Korenbrot CC, Greene, J. A performance indicator of psychosocial services in enhanced prenatal care of Medicaid-eligible women. MCHJ 1998;2(3):131–143.
- Pregnancy Intentions, Pregnancy Attitudes, and the Use of Prenatal Care in Missouri
Maternal and Child Health Journal
Volume 2, Issue 3 , pp 155-165
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links
- Prenatal care
- unwanted pregnancy
- unintended pregnancy
- family planning
- maternal behavior
- pregnancy intention
- Industry Sectors