Barriers to Prenatal Care by Race/Ethnicity in Multiparous Women [27F

Abstract

INTRODUCTION: Patients who are late to prenatal care miss valuable opportunities for health interventions, and are at increased risk for pregnancy-related complications. In our study, we aimed to describe barriers to prenatal care experienced by multiparous women with an interconceptional period of less than two years by race/ethnicity. METHODS: After IRB approval, we performed a secondary analysis of the Community Child Health Research Network Study, a multi-site prospective cohort study of pregnant women from 2008 to 2012 recruited from Baltimore, Chicago, North Carolina, Los Angeles and Washington, D.C. Participants who experienced a repeat pregnancy in the two-year follow up period were asked if they encountered any of eight prespecified potential barriers to prenatal care. A multilevel mixed effects Poisson regression was performed to evaluate the association between race/ethnicity and number of prenatal barriers encountered. RESULTS: We included 298 participants in our analysis, with 151 self-identifying as African American, 72 White, and 75 Latina. The most frequent barrier was the inability to obtain an appointment. Overall, 43% of African American, 35% of Latina, 23% of White participants reported barriers to care. After adjusting for study site, maternal education, language, and maternal age, African American and Latina women reported almost twice as many barriers to prenatal care as White women (OR 1.89 [1.2, 3.0]; 2.00 [1.1,3.8], respectively). CONCLUSION: In our secondary data analysis of a multisite, longitudinal cohort, multiparous African American and Latina women reported encountering more barriers to obtaining prenatal care. Additional interventions are needed to address these barriers and achieve health equity.