Beyond Inadequate Prenatal Care Utilisation in French Guiana: Role of Education, Isolation and Pregnancy Experiences

Abstract

Introduction: The link between women’s educational level and their adequate use of prenatal care is documented as well as the link between inadequate prenatal care and adverse birth effects, such as prematurity, that have consequences for the future health of children. Methods: A questionnaire study was carried out among a sample of women having delivered in the three maternity wards of French Guiana during 2017-2018. The questionnaire was available in various languages and native-speaking interviewers helped the women answer. The women were asked about their educational level, nationality, maternal language, social conditions of life, histories of pregnancies and deliveries, how they felt during their last pregnancies and their uses of psychoactive substances. Results: Among the 809 women who answered the questionnaire, 785 gave birth to singletons and were included in this study. The educational levels of the mothers were significantly linked, along a gradient, to their uses of prenatal care, their number of previous pregnancies and also their maternal language. An inadequate level of prenatal care utilisation was declared by 60% of the women who did not attend school versus 21% of those having a Baccalaureate or higher. Controlling for education level, residence, nationality and income, poor pregnancy monitoring was 3.5 times more frequent for women with no education. Conclusion: In French Guiana, education level is a key variable for explaining the low level of prenatal care utilisation and its consequent influence on adverse health events such as prematurity or miscarriage.