Evaluating the role of financial support on prenatal care utilization: A meta-analytic approach

Prenatal care has been promoted in the United States as a significant factor in reducing negative birth outcomes since the early 1900s (Brown, 1988). During the 1990s, prenatal care usage enjoyed a modest, but steady increase (Martin, et al., 2006). However, this increase may have reached a plateau. In both 2004 and 2005 no significant increases were reported (CDC, 2007). Further, data clearly show racial and ethnic disparities in the percentages of women receiving prenatal care. Historically, younger women (particularly adolescents) and Black women have been at greater risk for obtaining inadequate or no prenatal care. Statistics for 2003 show that 89 percent of Non-Hispanic White women began their prenatal care during the first trimester as compared with 76 percent of Non-Hispanic Black women (U.S. Department of Health, 2005). A number of financial and psychosocial barriers have been identified in individual studies that may prevent women from receiving adequate prenatal care. This paper will specifically report results of a meta-analytic study evaluating the role of financial support and prenatal care utilization across studies published between 1985 and 2007 for women in the U.S. and for some at-risk sub populations. A preliminary analysis run on a portion of available data in the study indicated that reducing financial barriers to prenatal care through insurance or other state/federal aid results in a 56% increase in prenatal care utilization (average r = .225, k = 48, N = 3,612,000). These results are timely in this era of diminishing financial resources for public programs.