How social determinants of health influence access to prenatal care

Despite the clear benefits of prenatal care, the United States is one of the few industrialized countries that does not provide universal healthcare for pregnant women. Almost 4 million American women give birth every year, and approximately one third will have pregnancy-related complications (CDC). The purpose of this presentation is to discuss the findings of a study to identify personal and system barriers to early prenatal care in two rural counties in upstate New York. While neither county has a hospital located within its geographic boundaries or sufficient prenatal care providers, one county has a higher rate for prenatal care during the first trimester when compared to the other county. In this study we examine the following four questions in order to determine their effect on early prenatal care access: Do women's demographics effect early access to prenatal care? Does the health care setting effect early access to prenatal care? Do system and personal barriers have an effect on accessing services and entering care? What are the differences and similarities between these counties that effect access to early prenatal care? The study reviewed Electronic Birth Certificate data files to determine if entry into care patterns is evident for various age, racial, ethnic, educational, and/or socio-economic groups. From these findings, women at greatest risk for not starting prenatal care during the first trimester will be identified early. These findings will also assist policy makers to design programs aimed at reducing personal and system barriers to prenatal care.