Maternal and Child Health Journal

, Volume 20, Issue 7, pp 1358–1365

Working Towards Safe Motherhood: Delays and Barriers to Prenatal Care for Women in Rural and Peri-Urban Areas of Georgia

  • Erika Meyer
  • Monique Hennink
  • Roger Rochat
  • Zoë Julian
  • Meredith Pinto
  • Adrienne D. Zertuche
  • Bridget Spelke
  • Andrew Dott
  • Pat Cota
Article

DOI: 10.1007/s10995-016-1997-x

Cite this article as:
Meyer, E., Hennink, M., Rochat, R. et al. Matern Child Health J (2016) 20: 1358. doi:10.1007/s10995-016-1997-x

Abstract

Objectives Georgia has the highest rate of maternal mortality in the United States, and ranks 40th for infant mortality. The Georgia Maternal and Infant Health Research Group was formed to investigate and address the shortage of obstetric care providers outside the Atlanta area. Because access to prenatal care (PNC) can improve maternal and infant health outcomes, we used qualitative methods to identify the access barriers experienced by women who live in rural and peri-urban areas of the state. Methods We conducted semi-structured, in-depth interviews with 24 mothers who gave birth between July and August 2013, and who live in either shortage or non-shortage obstetric care service areas. We also conducted key informant interviews with four perinatal case managers, and analyzed all data using applied thematic analysis. We then utilized Thaddeus and Maine’s “Three Delays to Care” theoretical framework structure to describe the recognized barriers to care. Results We identified delays in a woman’s decision to seek PNC (such as awareness of pregnancy and stigma); delays in accessing an appropriate healthcare facility (such as choosing a doctor and receiving insurance coverage); and delays in receiving adequate and appropriate care (such as continuity of care and communication). Moreover, many participants perceived low self-worth and believed this influenced their PNC exchanges. Conclusion As a means of supporting Georgia’s pregnant women who face barriers and delays to PNC, these data provide a rationale for developing contextually relevant solutions to both mothers and their providers.

Keywords

Prenatal care Rural Access Qualitative methods Medicaid 

Funding information

Funder NameGrant NumberFunding Note
Georgia Department of Public Health
    Georgia Obstetrical and Gynecological Society
      March of Dimes Foundation (US)
        Emory University School of Medicine (US)
          Emory University School of Public Health

            Copyright information

            © Springer Science+Business Media New York 2016

            Authors and Affiliations

            • Erika Meyer
              • 1
            • Monique Hennink
              • 1
            • Roger Rochat
              • 1
              • 2
            • Zoë Julian
              • 1
              • 2
            • Meredith Pinto
              • 1
            • Adrienne D. Zertuche
              • 1
              • 2
              • 3
            • Bridget Spelke
              • 1
              • 2
            • Andrew Dott
              • 4
            • Pat Cota
              • 4
            1. 1.Emory University Rollins School of Public HealthAtlantaUSA
            2. 2.Emory University School of MedicineAtlantaUSA
            3. 3.Department of Gynecology and ObstetricsEmory University School of MedicineAtlantaUSA
            4. 4.Georgia Obstetrical and Gynecological SocietyDuluthUSA

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