241208 Relationship among barriers and facilitators to prenatal care access and birth outcomes in a rural county

Tuesday, November 1, 2011: 2:50 PM

Laura McDermott, PhD, FNP, RN , Decker School of Nursing, Binghamton University, Binghamton, NY
Gale A. Spencer, PhD, RN , Decker School of Nursing, Binghamton University, Binghamton, NY
In 2010, Upstate New York lagged behind national averages and Healthy People 2010 goals for early access to prenatal care with only 76.1% of pregnant women accessing prenatal care during the first trimester. Despite the expansion of Medicaid, access to prenatal care in the first trimester has not improved. The purpose of this presentation is to examine the barriers and facilitators regarding access to prenatal care in a rural county without a hospital or birthing center and with few obstetrical care health care providers. Prenatal care was studied using variables found in the 2008 Electronic Birth Certificate (EBC) data base and the Prenatal Risk Assessment Monitoring System (PRAMS) questionnaire. Anderson and Aday's (1998) Behavioral Model of Health Service Utilization was used to explain the interrelationships. The study consisted of all women who lived in Tioga County and gave birth in 2008 (n=522). The sample was primarily Caucasian (97.5%). This study utilized a descriptive correlational design. The most significant barriers to access during the first trimester were: age, marital status, source of payment, and wanting to keep pregnancy a secret. Barriers and facilitators of the study will be discussed, and results of this research will be presented.

Learning Areas:
Diversity and culture
Public health or related nursing
Public health or related research

Learning Objectives:
1. Identify the demographic characteristics of the sample. 2. Discuss at least one barrier and one facilitator regarding access to prenatal care for women who live in a rural county. 3. Analyze the impact of this study on community health nursing practice, education, research, and health care policy.

Keywords: Access to Care, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I conducted this study for my doctoral dissertation. Currently I work as a FNP in public health. Every day I am faced with the challenges of access to care issues. This study was conducted to reveal barriers and facilitators to prenatal care access and birthing outcomes in a rural county.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.