Poor Prenatal Care Utilization in a Population of DC Residents Correlates with Their Health Beliefs † 1244

Abstract

261 DC residents were identified in their post partum period as having used prenatal care poorly during pregnancy (defined as < 5 visits and/or care initiated after 24 weeks gestation). Of the mothers who received prenatal care, 31% received care with a private physician, 37% in a hospital based clinic, 20% in a public clinic, and 2% listed the ER as where they received care; 11% had received no prenatal care. When interviewed, 93% agreed that prenatal care was important, yet 56% had not initiated care until the third trimester, and 76% until the second trimester of pregnancy. Mean number of prenatal care visits was 3.7 ± 2.7, and time of initiating prenatal care was 26 ± 7 weeks gestation. The top four reasons listed for non-adherence to prenatal care schedule were lack of funds (19%), transportation difficulties (12%), the baby being in good health (7%), and lack of child care (7%). When the Health Beliefs Questionnaire was administered to these mothers, although their perception of severity of illness was relatively higher (79/96), their perception of susceptibility to illness (28/46), and efficacy of medical care (27/48) were relatively low. These findings suggest that although mothers with poor prenatal care express practical difficulties as barriers to seeking care, underlying beliefs about susceptibility to illness and the efficacy of medical care also impact on their behaviors.