256948 Factors Influencing Entry into Prenatal Care in Rural Haiti

Tuesday, October 30, 2012 : 11:10 AM - 11:30 AM

Kristen Pepin, BS , School of Medicine, University of Connecticut, Farmington, CT
Judy Lewis, MPhil , Department of Community Medicine, University of Connecticut, Farmington, CT
Bette Gebrian, BSN, MPH, PhD , Haitian Health Foundation, Jeremie, Haiti
     
Relevance: Early prenatal care improves birth outcomes for mothers and infants. This research examined women's decisions about entry into prenatal care in Haitian Health Foundation (HHF) programs, where prenatal care is provided at one urban, Center of Hope (COH), and multiple rural health sites.

Methods: Interviews with 130 women—65 at COH (35 urban, 30 rural) and 65 at health posts. Structured interviews collected demographic, reproductive health, and pregnancy outcome history.

Data/Results: Participant mean age was 27, with 6.4 years of education. Entry month was not related to age, education, number of previous pregnancies or complications. Pregnancy was viewed as private, and disclosure, even to close friends, as potentially harmful; 1/3 said this kept women from first trimester care. Younger women and women with more education told more people they were pregnant (R= -.453, p=<.0001; R= .218, p=.013). Women who were unhappy about their pregnancy (62%) told a broader range of people (R=.338; p=<.0001). Women with more pregnancies disclosed to fewer people (R=-.462, p=<.0001). 23% saw a “Dr. Fey,” herbal healer; these visits were earlier (2.9 months) than HHF (3.7).

Discussion: Little research has been directed at understanding women's views of privacy and disclosure during pregnancy. Education about importance of prenatal care may not be enough when strong cultural beliefs are present. Women everywhere make decisions about who to tell and when. Further research is needed to understand how this influences care-seeking, especially in rural areas where privacy about going for prenatal care is limited.

Learning Areas:
Diversity and culture
Public health or related research

Learning Objectives:
1. Describe the importance of early entry into prenatal care. 2. Discuss how privacy concerns can affect the delivery of prenatal care in developing countries. 3. Identify factors that make women less likely to disclose their pregnancy to others. 4. Discuss the impact of disclosure and cultural beliefs on entry into prenatal care.

Keywords: Prenatal Care, International

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a medical student at the University of Connecticut, this is the first research project that I have developed. Prior to attending medical school I trained at the National Institute of Health as a Postbacclaureate Intramural Research Training Award recipient. My areas of research interest include global health, women’s health, obesity, and exercise science.
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.

Back to: 4129.0: Increasing access and utilization of antenatal services