Anatomy of Good Prenatal Care: Perspectives of Low Income African-American Women on Barriers and Facilitators to Prenatal Care

  • Mary C. MazulEmail author
  • Trina C. Salm Ward
  • Emmanuel M. Ngui



Although early, consistent prenatal care (PNC) can be helpful in improving poor birth outcomes, rates of PNC use tend to be lower among African-American women compared to Whites. This study examines low-income African-American women’s perspectives on barriers and facilitators to receiving PNC in an urban setting.


We conducted six focus groups with 29 women and individual structured interviews with two women. Transcripts were coded to identify barriers and facilitators to obtaining PNC; codes were reviewed to identify emergent themes.


Barriers to obtaining PNC included structural barriers such as transportation and insurance, negative attitudes towards PNC, perceived poor quality of care, unintended pregnancy, and psychosocial stressors such as overall life stress and chaos. Facilitators of PNC included positive experiences such as trusting relationships with providers, respectful staff and providers, and social support.


Findings suggest important components in an ideal PNC model to engage low-income African-American women.


Prenatal care Qualitative study Infant mortality Racial disparity 



We gratefully acknowledge the generous women who were willing to share their stories with us; Samantha J. Perry, MPH, CHES; Farrin Bridgewater, MA; David Frazer, MPH; and Amy Harley, PhD for their contributions to this project; funding from the Children’s Community Health Plan; and resources from the Center for Urban Population Health and the YWCA of Southeast Wisconsin.

Compliance with Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


This study was funded in part by Children’s Community Health Plan.

Conflict of Interest

Author A declares that he/she has no conflict of interest. Author B declares that he/she has no conflict of interest. Author C declares that he/she has no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2016

Authors and Affiliations

  • Mary C. Mazul
    • 1
    • 2
    Email author
  • Trina C. Salm Ward
    • 3
    • 4
  • Emmanuel M. Ngui
    • 1
    • 4
  1. 1.Joseph J Zilber School of Public HealthUniversity of Wisconsin-MilwaukeeMilwaukeeUSA
  2. 2.Wheaton Franciscan HealthcareGlendaleUSA
  3. 3.The University of GeorgiaAthensUSA
  4. 4.Center for Urban Population HealthMilwaukeeUSA

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