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Sarah Boslaugh, PhD, Health Communications Research Laboratory, Saint Louis University, 3545 Lafayette Ave, 4th floor, St. Louis, MO 63104, 314-977-4098, boslaugh@slu.edu and Jeffrey Mayer, PhD, School of Public Health, Saint Louis University, Salus Center, 3545 Lafayette Avenue, Saint Louis, MO 63104.
Utilization of prenatal care has increased greatly in the United States since the mid-1980’s, but there has not been a corresponding improvement in birth outcomes. Attempts to explain this paradox have led to interest in studying the quality of prenatal care. We used as a measure of quality whether patients received advice in the seven content areas specified in the 1989 guidelines issued by the Public Health Service Expert Panel on the Content of Prenatal Care: vitamin/mineral supplementation, diet, breastfeeding, alcohol use, smoking, illegal drug use and weight gain. Previous studies have used these guidelines to evaluate the quality of prenatal care, but none have used recent data, and none have used psychosocial variables to predict receipt of care. Our study, based on a 1998 followback survey of women (n=2205) in Southern Illinois, found that advice received varied widely by content area, from 92.7% for vitamin/mineral supplementation to 52.3% for alcohol use. Only 34.0% of the respondents received advice in all seven content areas. A multiple regression equation predicting receipt of advice from demographic, psychosocial and health care variables found the following significant predictors: perceived health benefits of prenatal care, social support for prenatal care, race, age, education, parity, insurance, site of care, and care adequacy. Considered separately, psychosocial and demographic predicted 8.4% and 9.0% of the variance in receipt of advice. We conclude that the 1989 guidelines are not being followed and that future studies should include psychosocial variables as predictors of prenatal care quality.
Learning Objectives: At the conclusion of this session, participants will be able to
Keywords: Prenatal Care, Quality of Care
Presenting author's disclosure statement:
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.