Clinical StudiesAssociation Between Early Prenatal Care and Mother’s Intention of and Desire for the Pregnancy
Section snippets
Methodology
This study used a nonconcurrent prospective (historical cohort) design using NSFG, 1995 (Abma et al., 1997) data to examine unintended pregnancy and unwanted pregnancy as predictors of timing of initiation of prenatal care. The national survey contains data collected by trained interviewers in face-to-face interviews with the respondents. In 2% of the cases, telephone interviews were conducted because the respondent refused to have the interviewer come into her home or to meet at a neutral
Statistical Analysis
Initially, chi-square analyses were conducted to identify independent associations between sociodemographic characteristics, employment status, previous pregnancy outcome, planned pregnancy, and desire for the pregnancy with timing of initiation of prenatal care. This was achieved using a dichotomous variable of early versus late/no prenatal care as the outcome variable. Second, independent associations of sociodemographic characteristics, employment status, prenatal care, and previous
Results
The majority of the study sample were white women (70%), with at least 12 years of education (77%), at or above the poverty level (70%), married (66%), had been pregnant once or twice before (55%), and between the ages of 20 and 35 (79%). Sociodemographic characteristics associated with late or no initiation of prenatal care included age less than 20 years, black ethnicity, single marital status, income below poverty level, and less than 12 years of education. Both unwanted pregnancy and
Study Limitations
This study was limited by the use of the timing of pregnancy question used in the NSFG survey, which this study found was an inadequate measure of planned pregnancy and of desire for the pregnancy. By using existing data, the researcher was restricted to the questionnaire design that was used to compile the data. Another potential confounder was accessibility, including reimbursement resources. It was not possible to examine access to prenatal care; however, some areas of the country may have
Conclusions
Understanding why women initiate late or no prenatal care is complex. Many risk factors for late or no prenatal care have been identified and seem to be interrelated. The ages of women who initiate late or no prenatal care and those who initiate early prenatal care differ significantly. Teenagers are most likely to initiate late/no prenatal care. This finding concurs with previous studies (Chisholm, 1989, Curry, 1990, Essex et al., 1992, McCaw-Binns et al., 1995, Petitti et al., 1990, Poland,
Clinical Implications
Because indifference is a strong predictor of late or no initiation of prenatal care, strategies to have an impact on the value of pregnancy are necessary. Interventions that target family planning and patient education are underscored. The fact that black ethnicity was a predictor of late or no prenatal care, in addition to unwanted pregnancy, indicates the importance of an increased sensitivity to cultural/ethnic differences in views about pregnancy. One suggestion for the racial disparity in
Research Implications
Future research focusing on minorities’ perceptions of treatment within the health care system is needed to provide a baseline of perceptions, underscore the problem, and evaluate and monitor efforts to diminish differential treatment. In addition, studies examining racial differences in unwanted pregnancy will be helpful in understanding differences in attitudes toward pregnancy and prenatal care. Future studies should examine differences in specific cultures within the broad definition of
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Determinants of maternal antenatal state-anxiety in mid-pregnancy: Role of maternal feelings about the pregnancy
2016, Journal of Affective DisordersCitation Excerpt :First, the literature regarding feelings about the pregnancy and its impact on maternal mental health is sparse. Second, it has been shown that women who feel less favourably about their pregnancy are less likely to seek adequate prenatal care (Augustyn and Maiman, 1994; Curry, 1990; Hulsey, 2001; York et al., 1993) and are at an increased risk of having a baby with a low birth weight (Keeley et al., 2004; Sable and Wilkinson, 2000). The main objective of this study is to identify determinants of maternal antenatal state-anxiety in the second trimester of pregnancy, with a particular focus on whether “feelings about the pregnancy” predicts state-anxiety after controlling for other covariates.
Time from pregnancy recognition to prenatal care and associated newborn outcomes
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