Prenatal Care Choice Among Low-income Latina Women in Atlanta – Georgia Restricted; Files Only

Ulloa Arevalo, Monica (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/rx913q78f?locale=en
Published

Abstract

Background: Every day, approximately 830 women die worldwide from causes related to pregnancy and childbirth. Most of these deaths are preventable. Prenatal care is a tool that can help in the prevention of maternal and neonatal mortality. Women in the US have a higher chance to die from pregnancy and childbearing causes compared to other women from high-income countries. The situation can be even worse for minority women, especially low-income Latina women who unfortunately face poorer maternal health outcomes compared to white women.

Goal: The main goal was to identify the more salient factors that influence the choice of where low-income Latina women in Atlanta seek prenatal care.

Methodology: In this qualitative study, surveys and in-depth interviews were used to collect data. 125 women were recruited and surveyed (1 survey per woman). 13 in-depth interviews were conducted. Women were eligible to participate if they (1) self-identified as “Hispanic” or “Latina,” (2) were in the first or second trimester of pregnancy (less than 24 weeks gestation), (3) were above the age of 18, and (4) spoke Spanish or English. Data collection occurred at CIMA (Centro Internacional de Maternidad) and at Grady Memorial Hospital, both located in the Atlanta metropolitan area. Modified Grounded Theory was used to collect and analyze the data.

Results: During the in-depth interviews, four main themes emerged: access to prenatal care, quality of prenatal care, cultural norms and migratory challenges. Women identified specific barriers and facilitators (language and distance to a prenatal care facility) influencing their prenatal care choice and mentioned perceived high-quality prenatal care as an important factor in their seeking behavior. Also, participants mentioned the importance of finding culturally-sensitive care and the influence of their social group in their decision of where to find prenatal care. Finally, some women mentioned migratory challenges during their prenatal care search.

Conclusion: Providing culturally-sensitive care to Latina women during pregnancy and encourage involvement of family members is critical to increase prenatal care utilization among low-income Latina women. Additionally, expanding health care access to all pregnant women regardless of immigration status and train providers to care for immigrant populations might also be essential to enhance prenatal care use.

Table of Contents

1. LITERATURE REVIEW ……………………………………………………………….…..................…1

1.1 Sexual and reproductive health of women …………………………………………………..........1

Maternal health and prenatal care in the context of population health…………………………..2

Importance and significance of prenatal care……………………………………………….….….......4

Sexual and reproductive health among low income Latina women in the US…………………….6

1.2 Social determinants of health and reproductive health among low-income Latina women.

Immigration to the US and Atlanta among low income Latina women……………………….…...9

Access to health and prenatal care among low income Latino women………………….……......10

Factors affecting the utilization and choice of prenatal care among Latina women…………….12

Social support and Latin paradox…………………………………………………………….............…..14

1.3 Access to prenatal care among low income Latina women in Atlanta…………………….......15

Goals ……………………………………………………………………………………….……....................16

Significance …………………………………………………………………….……………..…..................16

2. METHODS ………………………………………………………………………………......................…17

IRB approval…………………………………………………………………………………….....................17

Study Population………………………………………………………………………………..................…18

Settings and location……………………………………………………………………………..................18

Recruitment and screening………………………………………………………………………...............19

Informed consent………………………………………………………………………………....................19

Field work and data collection procedures………………………………………………………............20

Codebook development ……………………………………………………………………................…….22

Data Analysis……………………………………………………………………………………....................23

3.RESULTS…………………………………………………………………………..………….......................24

4. DISCUSSION………………………………………………………………………………........................37

5. PUBLIC HEALTH RECOMMENDATIONS……………………………………………........................44

REFERENCES…………………………………………………………………………………........................46

APPENDICES……………………………………………..……………………………………......................55

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