Challenges to maternal and child health in upstate New York: Perspectives of low income women

Background: Low income women in rural communities and small urban centers are at risk of poor pregnancy and parenting outcomes due to high rates of teen parenting, poverty, and poor access to services. There is insufficient research describing barriers to healthy pregnancy and parenting among this population. Methods: 46 qualitative interviews were conducted with pregnant women and new mothers from communities with socioeconomic and health indicators suggesting disproportionate risk of poor birth outcomes. Interviews focused on access to and perceptions of care, readiness for parenting, attitudes, and social supports. Results: The mean age of participants was 25. 43% had 2+ children; 11% had 5 children. 55% had their first child before age 20. They reported that teen parenting was common and not stigmatized: “There's a lot more, ‘Congratulations,' versus … what are you going to do?” “Usually it'd be [high school] seniors or juniors, but now it's freshmen and sophomores.” Although most had familial support, depression and anxiety levels were high, with stressors that included poor health, dysfunctional relationships, poverty, and lack of opportunity: “Me and my mom had wound up getting into it, me and the baby's father had wound up getting into it, and I just felt like I was alone.” “He just lost his unemployment … I dwell on that all day long.” Conclusions: Low income women in rural communities and small urban centers face significant challenges to their own and their children's well-being, including personal, social and economic stressors. They may benefit from diverse supportive services.