Access to prenatal care during the first trimester: System and personal barriers

Despite the clear benefits of prenatal care, the United States is one of the few industrialized countries that does not provide universal healthcare for pregnant women. Almost 4 million American women give birth every year, and approximately one third will have pregnancy-related complications (CDC). Those who don't get adequate prenatal care run the risk that complications will go undetected or are not identified soon enough. Thus, a healthy first trimester is crucial to the normal development of the fetus. While the pregnancy may not be showing on the outside; inside all the major body organs and systems of the fetus are forming. The purpose of this presentation is to discuss the findings of a study to identify personal and system barriers to early prenatal care, and to identify factors that influence or discourage women from entering care within the first trimester. The study subjects will come from three counties in central New York State that have the lowest rates for women entering prenatal care during the first trimester. The study answers the following three questions: • What are the demographics of women who enter care later than the first trimester (age, race, ethnic background, education, and socio-economic factors)? • How do women access the current system? • What are the system and personal barriers to accessing services and entering care? The study reviewed Electronic Birth Certificate data files in order to determine if entry into care patterns are evident for various age, racial, ethnic, educational, and/or socio-economic groups. From this demographic information, programs will be able to identify women at greatest risk for not starting prenatal care during the first trimester. The second part of the study includes reports of survey results for both health care providers and delivered women from 2006. Provider survey responses identify systems issues, while consumer studies identify individual perceptions, issues and barriers to seeking care during the first trimester. The findings of this study will assist policy makers in New York State to design programs to reduce personal and system barriers to early prenatal care.