Disparities in reported prenatal care advice from health care providers among women of Mexican origin in California.

Abstract

Poorer birth outcomes have been documented among U.S.-born women of Mexican descent when compared with Mexican immigrant women. Behavioral changes that are associated with acculturation may contribute to these deteriorating outcomes. Prenatal health promotion advice can alter prenatal risk behaviors. The growing diversity of the U.S. population during the 1990s heightens the importance of examining the cultural relevance of current health promotion practices. This study examines disparities in the reported receipt of health behavior advice during pregnancy among U.S.-born women of Mexican origin and Mexican immigrant women in California. Data for the analysis are from the 1994-95 California Pregnancy Risk Assessment Monitoring System. The study sample includes 1,423 women of Mexican descent. All participants had a live birth in California between January 1994 and December 1995. Women were interviewed about the prenatal counseling they received related to diet, smoking, and alcohol use. Logistic regression was used to analyze the likelihood of reporting advice after controlling for sociodemographic and health system characteristics. Immigrant women were more likely than the U.S.-born to report receipt of prenatal advice on smoking, alcohol, and diet (OR = 1.83, p < .05) despite evidence of the lower prevalence of related health risks among Mexican-born women. Culturally appropriate prenatal counseling would emphasize the maintenance of traditional protective behaviors among less acculturated foreign-born women, and the prevention or cessation of those risk behaviors among the more acculturated women.