Anatomy of Good Prenatal Care: Perspectives of Low Income African-American Women on Barriers and Facilitators to Prenatal Care
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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.
KeywordsPrenatal 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 was obtained from all individual participants included in the study.
- 1.Mathews TJ, MacDorman MF, Thoman EB. Infant mortality statistics from the 2013 period linked birth/infant death data set. Natl Vital Stat Rep. 2015;64(9):1–30.Google Scholar
- 9.Minino AM, Murphy SL. Death in the United States, 2010. NCHS Data Brief. 2012;99:1–8.Google Scholar
- 18.Riley L, Stark A. Guidelines for perinatal care. 7th ed. AAP Committee on Fetus and Newborn and ACOG Committee on Obstetric Practice; 2012.Google Scholar
- 19.Department of Health & Human Services. Healthy people 2020. 2013.Google Scholar
- 23.U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Child health USA 2014. 2014.Google Scholar
- 24.Boyatzis RE. Transforming qualitative information: thematic analysis and code development. Thousand Oaks: SAGE; 1998.Google Scholar
- 25.Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. 4th ed. Los Angeles: SAGE; 2014.Google Scholar
- 27.Salm Ward TC, Mazul M, Ngui EM, Bridgewater FD, Harley AE. “You Learn to Go Last”: prenatal care experiences in a sample of low-income African-American women in Milwaukee. Matern Child Health J. 2013;17(10):1753–9.Google Scholar
- 29.Kalmuss D, Fennelly K. Barriers to prenatal-care among low-income women in New York City. Fam Plan Perspect. 1990;22(5):215-218-231.Google Scholar
- 42.Pawasarat J, Quinn LM. Wisconsin’s mass incarceration of African American males: Workforce challenges for 2013. 2013.Google Scholar
- 43.Wilson V. Projected decline in unemployment in 2015 won’t lift Blacks out of the recession-carved crater. 2015;393.Google Scholar
- 44.Spatial Structures in the Social Sciences, Brown University. US2010 segregation sorting. http://www.s4.brown.edu/us2010/SegSorting/Default.aspx. Updated 2010.
- 54.Lu MC, Kotelchuck ML, Hogan V, Jones L, Wright K, Halfon N. Closing the Black-White gap in birth outcomes: a life-course approach. Ethn Dis. 2010;20(1 Suppl 2):62–76.Google Scholar