Prenatal Care Utilization in a Dedicated Refugee Clinic

PURPOSE: We partnered with the only U.S. clinic exclusively focusing on reproductive health needs of refugee women. To inform this clinic's outreach strategies, we examined patients' prenatal care utilization patterns and identified patient characteristics associated with inadequate utilization. BACKGROUND: Evidence suggests refugee women are at higher risk for inadequate prenatal care utilization and poor obstetric outcomes. The Refugee Women's Health Clinic (RWHC) was founded in 2008 to address disparities in reproductive health outcomes among the growing refugee population in Phoenix, Arizona. RWHC has identified their patients' inadequate prenatal care utilization as an area they would like to address. METHODS: We reviewed medical records of all adult RWHC patients seen since 2008. We assessed for associations between the Adequacy of Prenatal Care Utilization Index and patient characteristics using chi-squared tests and logistic regression. RESULTS: 132 refugee adult women presented to RWHC between 2008 and 2011. The majority of women were from Africa (61%), 25-29 years old (30%), married (83%), and multiparous (68%). 53% of women had inadequate utilization and 59% initiated care beyond the first trimester. No associations were observed between utilization and patient age, region of origin, marital status, or parity. CONCLUSIONS: Even in a clinic tailored to meet refugee women's needs, greater than 50% of refugee women had inadequate utilization and significantly less utilization compared to the general U.S. population (26%) as well as other immigrants (32%). This study constitutes a resource for women's health in refugee communities that will lead to further research and program development.