Relationship between physical abuse & access to prenatal health care: Findings from Hawaii's Pregnancy Risk Assessment Monitoring System

Background. The receipt of prenatal health care (PNC) is associated with positive health outcomes among mothers and babies. There is limited knowledge regarding Asian and Pacific Islander (API) women's access to PNC especially among those who are victims of partner abuse. Specific Aim. Determine the role of physical abuse in accessing PNC among women. Methods. We analyzed 2004-06 data from Hawaii's Pregnancy Risk Assessment Monitoring System, a population-based survey that includes maternal experiences on pregnancy (n=5,432). A majority of the respondents were API (73.5%) and barriers to accessing PNC were evaluated. Multivariate logistic regressions assessed each PNC barrier (yes; no) adjusted for age, ethnicity, socio-economic, marital, and health insurance. Preliminary Results. Women experiencing physical abuse from their husband/partner during pregnancy (compared to no abuse) were significantly more likely to report the following barriers to accessing PNC: no transportation (AOR=3.5, 95% CI: 1.9, 6.2); no child care (AOR=2.5, 95% CI: 1.2, 5.3); doctor/health plan would not start PNC as early as wanted (AOR=2.2, 95% CI: 1.1, 4.4); too busy (AOR=2.2, 95% CI: 1.2, 3.8); and kept pregnancy a secret (AOR=2.1, 95% CI: 1.1, 3.9. Discussion. Some “technical barriers” (e.g. transportation; child care) were identified limiting access to PNC services among women who are victims of physical abuse. Future programs should address these technical barriers, and as part of routine PNC, women at risk for intimate partner violence should be screened for potential access barriers and offered appropriate services to ensure consistent participation in PNC, a healthy pregnancy and quality of life.