January 2001 - Social and Psychological Circumstances Surrounding Pregnancy Outweigh Financial Situation as Barriers to Use of Prenatal Care Among Puerto Rican Women Residing on the U.S. Mainland

Findings from a HRSA/MCHB and NICHD supported study of Puerto Rican women residing on the U.S Mainland report that barriers to prenatal care utilization are common among this group even though a single barrier did not predominate.  About half (48%) of the study participants mentioned at least one barrier and close to one-fifth (22%) mentioned at least two types of barriers that made it difficult for them to get care.  Among the most frequently mentioned barriers were those that signal uncertainty about the pregnancy, the consideration of abortion, the desire to keep the pregnancy secret, and the lack of awareness about being pregnant.  Financial and transportation considerations were mentioned as barriers but did not fare prominently; barriers related to aspects of the health care delivery system were of relatively minor importance.

The number of barriers to prenatal care were related to a host of relevant factors (i.e., pregnancy wantedness, migration status, social and financial capital, etc.) using bivariate and multinomial logistic regression models.  One variable that stands out in these analyses is pregnancy wantedness.  The odds of mentioning multiple barriers are much higher for women who did not want a baby or wanted a baby in the future than the odds for women who wanted the pregnancy at the time it occurred.  The multivariate results are less impressive for other variables, especially for indicators of migration status, financial capital and human capital. Married and cohabitating women are less likely than single mothers to mention barriers..  Access to someone who can provide emotional support and advice also reduces the likelihood of mentioning multiple barriers.

The study, "Prenatal Care Among Puerto Rican on the United States Mainland," appears in the November 2000 issue of the British Medical Journal Social Science and Medicine (Vol. 51, 1723-1739). R.S. Oropesa, N.S. Landale, M. Inkleyand B.K. Gorman are the lead authors.  Reprints of the article are available from the HRSA/MCHB Research Program Office, Telephone: (301) 443-2190, e-mail: rhaggerty@hrsa.gov.

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