prenatal care powerpoint

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Barriers to Attending a Prenatal Care Program and the Health Belief Model

Jessica L. Altice, MAEdNovember 09, 2011

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What is Prenatal Care and the Purpose?

Prenatal care is care a woman receives while she is pregnant.

Is usually provided by an OB/GYN, family practice physician, nurse midwife, or other health professional.

Monitors how the pregnancy is progressing and identifies potential health problems.

Mothers are given information on prenatal tests, maternal vaccinations, healthy nutrition, alcohol and substance abuse, smoking, and environmental and reproductive hazards.

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Role of Prenatal Care Prenatal care can

reduce:› Infant Mortality› Birth Defects› Preterm Birth› Low Birthweight

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A Prenatal Care Visit http://bcove.me/khymbhlm

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2011 Premature Birth Report Card

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Women at Risk

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Importance of Prenatal Care

Kelly Thorman was born at 21 ½ weeks after conception. This picture was taken three weeks later and Kelly later

died of pneumonia.

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Health Belief Model Constructs

Perceived susceptibility Perceived severity Perceived threat Perceived benefits Perceived barriers Self-efficacy Cues to action

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Health Belief Model

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Health Belief Model Continued

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Drug Use and Limited Prenatal Care: An Examination of Reponsible

Barriers(Schempf & Strobino, 2009)Cocaine Opiates Marijuana

Perceived financial barrier did not affect

care

Perceived financial barrier did not affect

care

Perceived financial barrier did not affect

care

Attitudes toward value of care was a

barrier

Attitudes toward value of care was a

barrier

Attitudes toward value of care was a barrier

Opiate use statistically

significant to explain lack of care

Negative provider perceptions were

related to little or no care

Negative provider perceptions were

related to little or no care

Negative provider perceptions were

related to little or no care

Efficacy of care related

Efficacy of care related

Efficacy of care related

Fear of being reported relate

Fear of being reported related

Fear of being reported related

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Perceived Impediments to Prenatal Care among Low- Income Women

(Mikhail & Curry, 1999)Impediment to Care Statistically Significant

TransportationLong wait times at the clinicToo many additional problemsDid not have problems with other pregnancyAfraid doctor would find out about substance use

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Afraid they would be asked to stop smoking or drinkingFear of medical examination *Felt prenatal care was not needed *Afraid to find out she was pregnant *Already knew she was pregnant *No babysitter for other children *

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Initiation of Prenatal Care by Low-Income Hispanic Women in Houston

(Byrd, Mullen, Selwyn & Lorimor, 1996) Perceived barriers, age, country card

status, and benefits to baby explained 22% of variance in month of prenatal care initiation.

Women with fewer perceived barriers, were older, and had a country card were more likely to enter care earlier.

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Prenatal Care Utilization Among Low-Income African American Women

(Mikhail, 2000) 49.2% of the women initiated care within

3-4 months. 34% had inadequate care that was

initiated after the fourth month. Negative experiences included waiting

time, waking up early to go to the doctor, not wanting to see the doctor, having motion sickness, having an examination, and waiting for transportation.

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Access to Preventive Health Care: Is Method of Payment a Barrier for Immigrant Hispanic Women?

(Jones, Cason & Bond, 2002)

Women were divided into self-pay, commercial-pay, and government subsidized.

There were no significant differences between the three pay categories.

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Not a Separate Health Issue

CHILD

MALTREATMEANT

Alcohol and Substance Abuse

HIV/AIDS

Cardiovascular Disease

Obesity

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Moving In A New Direction

Reinvent prenatal care as a targeted intervention (risk appropriate intervention).

Factor in barriers and facilitators to care when planning interventions.

Provide prenatal care to the uninsured.