Prenatal care: A localized view of language barriers

Background:

Women who do not seek prenatal care are at an increased risk of adverse pregnancy outcomes including miscarriage, premature birth, and small for gestational age or low birthweight. A cross-sectional study was conducted among Rockland County (NY) residents. The objectives were to: 1) assess the prevalence of not receiving prenatal care; and 2) identify subpopulations with knowledge deficiencies regarding prenatal care services.

Methods:

A survey instrument was designed to assess health services awareness, knowledge of risk factors for negative perinatal outcomes, health status, health care access, prenatal care, breastfeeding behaviors, and demographics. Face-to-face interviews in English, Spanish and Haitian Creole were administered (Nov.-Dec., 2007) in three towns in Rockland County at local businesses. Convenience sampling was employed.

Results:

Univariate analyses revealed that, of the women who had previously been pregnant or were currently pregnant (n=58), 43.1% had not received prenatal care services. Bivariate analyses of all respondents (n=293) revealed that those who spoke English at home had a 2.05 (95%CI:1.17-3.59) times higher odds of knowing that women without health insurance can receive free prenatal care, compared to those who did not speak English at home. Overall, 69.6% reported that they did not speak English at home. Race/ethnicity, gender, and age were not significant correlates of this knowledge item.

Conclusion:

There is an underutilization of prenatal care services in Rockland County. Information regarding free prenatal care services for women without health insurance should target individuals who do not speak English at home.