Preexisting Factors, but Not Logistical Barriers, Inhibit Timely Use of Prenatal Care

Despite wide societal agreement that prenatal care should begin during the first trimester many low-income Californian women initiate prenatal care late or do not receive it at all. Potential logistical barriers to timely receipt of care identified in previous studies include child care or transportation problems lack of appreciation for the importance of early prenatal care and negative attitudes about the pregnancy or personal stress. To examine which has the greatest impact among the logistical barriers 3071 women were interviewed about their attitudes beliefs and perceptions. Overall it was found that logistical barriers played relatively little role in the failure to receive prenatal care. When controlling for the effects of a range of factors that might serve as barriers to prenatal care women with unwanted or unplanned pregnancy were roughly 35-40% more likely than those with a wanted pregnancy to have received no prenatal care in the first trimester. In addition those with no regular health care provider before conception were nearly 40% more likely than women with regular source of care and those with no post-high school education were 40-70% more likely than those with a higher education to have waited until the second trimester or later to initiate prenatal care. This suggests the importance of reducing barriers to effective family planning by increasing the proportions of nonpregnant women who have a regular source of health care and reducing the disadvantages associated with a lack of education beyond high school.