Barriers to prenatal care for women with Limited English Proficiency (LEP) in Greenville, SC: A pilot study

OBJECTIVE: The Hispanic population in Greenville, South Carolina (SC) has grown by more than 800% since 1990. The provision of culturally appropriate care to this diverse group of new immigrants presents unique challenges. This study identified barriers to timely entry to prenatal care for LEP Hispanic women in our community. METHODS: 28 LEP Hispanic immigrant women participated in individual interviews in the hospital after delivery. The interview included 22 questions from the CDC's Pregnancy Risk Assessment Monitoring (PRAMS). Responses were compared to state-wide PRAMS data to determine differences between Hispanic, Black and White women. RESULTS: 28 interviews were conducted in Spanish. Median length of US residency was 48 months (range 4-104). None had health insurance or Medicaid; 79% received WIC benefits. A majority (61%) planned the pregnancy. Most (96%) recognized the pregnancy early (<13 weeks). Only 32% received prenatal care <13 weeks. Reasons LEP women did not seek care earlier included: not enough money/insurance to cover the cost of care (57%), no transportation (25%) and no childcare (25%). In contrast, Black and White SC PRAMS participants report not being able to take time off work (22%), not wanting to disclose pregnancy (20%) and money/insurance (20%) as reasons for not entering prenatal care earlier. CONCLUSION: There is a high prevalence of late entry to prenatal care for LEP women, despite relatively high rates of planned pregnancy and early recognition of the pregnancy. Barriers to prenatal care for LEP women are unique in comparison with the general population of SC.