Abstract

Context: Prenatal care is commonly understood to have a beneficial impact on pregnancy outcome. Child survival is directly dependent on good maternal health and nutrition. Aim: To study the variation in counseling of prenatal care measures at different sources of care. Materials and Methods: A cohort of 5,380 observations from the New York State Pregnancy Risk Assessment Monitoring System were analyzed to study the relationship between site/source of prenatal care and quality/content of prenatal care, and the influence of maternal characteristics therewith. Statistical Analysis Software, version 8 (SAS-V8) was used for analysis. Results: The most common source of care was doctor of medicine/health managed care organization (75.89%) followed by hospital clinic (11.22%), community health center (6.5%), health department clinic (4.05%), and others (2.3%). Health department clinic showed a greater prevalence proportion for counseling in all of the five prenatal care measures (talked about breastfeeding, illegal drugs, nutrition, baby's growth, and smoking) when compared with the remaining four sources of care. Majority of private clinic attendees were whites (87.8%), older mothers (20.7%), and/or high income groups (67.8%). Young mothers preferred visiting health department clinic (22.5%). Average income mothers preferred accessing healthcare from the community health center (26.9%). Conclusion: Variation in quality of care among various sources of care is likely to occur. Maternal characteristics could also influence the selection of source of care.

Highlights

  • As per World Health Organization (WHO) estimates, worldwide about 358,000 women die during pregnancy and childbirth every year.[1]

  • The annual rate of decline in maternal mortality is less than half of what is needed to achieve the Millennium Development Goal (MDG) target of reducing the maternal mortality ratio by 75% between 1990 and 2015

  • The relationship of source of prenatal care (SPC) with quality/content of prenatal care (QPC) was analyzed for the 5,380 Pregnancy risk assessment monitoring system (PRAMS) respondents

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Summary

Introduction

As per World Health Organization (WHO) estimates, worldwide about 358,000 women die during pregnancy and childbirth every year.[1] The annual rate of decline in maternal mortality is less than half of what is needed to achieve the Millennium Development Goal (MDG) target of reducing the maternal mortality ratio by 75% between 1990 and 2015. This will require an annual decline of 5.5%. Prenatal care is commonly understood to have a beneficial impact on pregnancy outcome. It provides an opportunity for healthcare providers to counsel mothers about behaviors that increase the likelihood of favorable maternal and fetal outcomes, and about adverse pregnancy outcomes such as maternal morbidity/mortality, preterm birth, low birth weight, small-for-gestational age, and still birth

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