The purpose of this analysis was to critically examine health care system deficiencies with emphasis on providers and how they influence women's prenatal care. Previous studies examining systemic barriers to health care have focused on “psycho-social” constraints of patients including low socio-economic status, culture and language. Eight focus groups were conducted with African American, Mexican, Puerto Rican and white women in five community settings in Chicago (n=87). A need for a new approach to understanding obstacles to receiving prenatal care emerged through listening to primiparous women’s narratives. By placing the responsibility for the barriers on those providing the care, rather than on the pregnant women, a more comprehensive understanding of quality in health care delivery can be obtained. The focus group participants disclosed multiple incidences of hostility and neglect driven by classist and racist attitudes within the health care setting. Stereotypes were based on presumptions of women’s personal characteristics including ignorance and parental incompetence. While many women reported negative experiences, some women described an environment based on mutual respect offering an alternative to a traditional authoritarian medicalized approach. By failing to analyze the dynamics of the provider-patient encounter, past research efforts have missed a critical aspect necessary to the understanding of the social determinants of health and disease. Identifying structural barriers affords the opportunity to make significant systemic changes consequently impacting women's prenatal care experience leading to healthier families.
Learning Objectives: At the conclusion of the session, the learner will be able to: 1) identify the health care barriers related to the provider-patient interpersonal relationship during prenatal care visits and 2) recognize the strengths of using qualitative data for contextual maternal and child health services research.
Keywords: Prenatal Care, Barriers to Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: University of Illinois at Chicago Maternal and Child Community Health Science Consortium, CDC, NINR
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.