Melanie Droubay and Dr. Rosanne Schwartz, Nursing
Prenatal care is a significant indicator of health care. Women who receive both early and adequate prenatal care have less problems with their pregnancy as well as decreased neonatal, infant and maternal mortality (Kiely & Kogan, 2000). Because Utah has a proportionally high volume of pregnancies, prenatal care is a major concern for this state. Through this research, the adequacy of prenatal care was studied as well as any possible barriers to receiving prenatal care for first-time mothers living in Utah County.
The nation has set a goal to increase the number of women receiving early and adequate prenatal care to 90 percent. As of 1999, only 51 percent of women in Utah County were receiving adequate prenatal care and 79 percent were receiving early care (Utah Department of Health, 2000). Both of these statistics indicate the need to increase prenatal care in the Utah County area. My hypothesis in approaching this research was that a variety of barriers exist for women living in this area that prevent them from receiving the prenatal care they need.
In order to assess these barriers, prenatal questionnaires were handed out to mothers willing to participate on the mother/baby units of American Fork Hospital and Utah Valley Regional Medical Center following the delivery of their first child. In this research, first time mothers were chosen because I hypothesized that they would be more likely to find barriers to prenatal care than mothers who had previously been through a birth and pregnancy. All mothers participating in the study were also required to live in Utah County and to speak/read English fluently. Topics on the questionnaire included the demographics of the mother, pre-pregnancy, first prenatal visit, pregnancy, health care providers, costs, barriers to prenatal care and birth outcomes.
The findings from this research were particularly interesting. Only one out of the twenty women or 5 percent of the subjects studied found a barrier to receiving prenatal care. The only barrier this participant found was difficulty in scheduling an appointment with her doctor due to the doctor’s busy schedule. No other barriers were indicated.
Of the women studied, 95 percent began their prenatal care early or within their first trimester. This statistic is not consistent with previous findings by the Utah Health Department. A possible inference from this may be that other women than those studied are the ones not receiving adequate prenatal care in this county and causing the statistics for this area to be low. The demographics of the women in this study include the following: 1) their ages ranged from 19-28 years, 2) a majority were white and all women spoke and read English fluently, 3) 90 percent were married, 4) all participants except for one had some college education, and 5) all women were first-time mothers.
Women who are younger than 18 and women who do not speak English may be more probable to find barriers to prenatal care and thus not receive adequate care during their pregnancy. Also, it is possible that mothers who have already had a lot of children may feel they do not need a great deal of prenatal care due to their previous experiences and prior knowledge. Further research on this topic should focus on studying these groups of women.
The data gathered from the questionnaires also yielded some other interesting findings. Five out of the twenty women studied had unplanned pregnancies. Only 1/3 of the subjects used their doctor as their primary source of information during the pregnancy. The other participants acknowledged parents, other relatives, friends, books, or the Internet as their primary source. In addition, many women stated that they did not enjoy having to rotate through a clinic and see a handful of different doctors. This is significant because it is a common practice in this area for a group of obstetricians to work together in a clinic and for pregnant women to rotate their care through the different doctors. However, all of the women said that they would use the same health care provider for future pregnancies. Finally, over half of the women in this research used either Baby Your Baby or the WIC programs with their pregnancy. Conclusively, these programs are very valuable and play an important role in many pregnancies in this area.
Although the results of my study did not turn out the way I hypothesized, this research was an invaluable experience for me. Not only have I gained the knowledge of how to perform research, but this study has also helped me to work with women in the field where I hope to be a nurse in. As mentioned previously, future research in this topic is of great need. Other groups of women should be included in the study as well as a larger number of first-time mothers. I hope that with further research, we may discover which women are not receiving adequate care and why and begin trying to help these women to increase their prenatal care and the statistics for prenatal care in Utah County.
References
- Keily, J. L., & Kogan, M. D. (2000). Prenatal care. CDC’s Public Health Surveillance for Women, Infants, and Children. Retrieved January 23, 2001 from the World Wide Web: http://www.cdc.gov/nccdphpdrh/datoact/pdf /rhow8.pdf
- Utah Department of Health. (2000). Utah’s vital statistics births and deaths 1999. Salt Lake City, UT: Author.