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

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.