Evaluating Prenatal Care Compliance and Barriers to Prenatal Care Among Pregnant Individuals in Forsyth County, North Carolina.

Background: Individuals who gave birth from May 2021 through July 2021 at Atrium Health Wake Forest Baptist (AHWFB) Hospital were surveyed to identify barriers to prenatal care (PNC), assess adequacy of PNC, and examine how these measures relate to race, ethnicity, and income.

Methods: A survey was administered to 200 individuals giving birth at AHWFB. Eligibility included English- or Spanish-speaking, aged 18 years or older, and a gestational age of 35 weeks or greater at delivery. Primary outcomes included PNC receipt and PNC barriers. Stratification by race, ethnicity, and income were also evaluated.

Results: PNC receipt rates were 81%, 87%, and 88% in the first 28 weeks, between 28 and 36 weeks, and after 36 weeks, respectively, with 76% of individuals receiving adequate PNC throughout pregnancy. Non-White or Hispanic participants experienced lower PNC rates in the first 28 weeks, and participants reporting an annual household income of less than $20,000 experienced lower PNC rates throughout pregnancy. While 19% of participants reported at least one barrier to PNC, the number of barriers reported did not differ based on race, ethnicity, or income. However, it was found that participants who reported at least one barrier were less likely to receive PNC throughout pregnancy.

Limitations: This study was limited by convenience sampling and the potential for recall bias. Conclusions: Although race, ethnicity, and income were not associated with the number of reported barriers, they did impact the likelihood of receiving adequate PNC. As self-reported race/ethnicity in our study likely served as a proxy for racism and race-based discrimination, future research should more formally investigate the role of structural racism in the receipt of PNC.