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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
5019.0: Wednesday, December 14, 2005 - Board 7

Abstract #116250

Late Entry Prenatal Care: Fighting the Challenge

Marlene D. Allison, RN, MPH, Office of Clinical Affairs, New York City Health & Hospitals Corporation, 125 Worth Street, Suite 427, New York, NY 10013, 212 788 3397, allisonm@nychhc.org and Consuelo Dungca, RN, EdD, Office of Clinical Affairs, NYC Health and Hospitals Corporation, Office of Clinical Affairs, Central Office, 125 Worth Street , Suite 427, New York, NY 10013.

Early entry prenatal care is associated with improved pregnancy outcomes such as increases in birth weight and decrease in preterm delivery. However, late (third trimester) entry into prenatal care is usually associated with poor pregnancy outcomes and remains a challenge for health care providers at NYC Health and Hospitals Corporation (HHC).

NYCHHC, a public benefit corporation has 11 acute care hospitals with perinatal centers, 4 long term care facilities, 6 diagnostic and treatment centers, a health and home care agency and a managed care agency. HHC provides health care services to a largely disadvantaged, uninsured, multicultural and multiethnic population.

In 2004 HHC hospitals delivered 25,046 women; 66% had first trimester prenatal care, 21% second trimester, 11% third trimester; and 2% delivered with no prenatal care. Despite community outreach programs, little progress was made towards achieving the Surgeon General's goal of 90% pregnant women entering first trimester prenatal care. The National Vital Statistics report indicates progress towards that goal as the proportion of mothers w/late or no prenatal care decreased since 1990 from 6.6 to 3.6 percent in 2002 and first trimester entry improved from 75.8 to 83.7% .

To meet the challenge of the 90% goal, HHC hospitals conducted a study in 2004 to identify reasons for late entry into prenatal care. Reasons cited include: not knowing she's pregnant; undecided to keep pregnancy; fear due to illegal immigrant status. Initiatives/programs were implemented and measures established to monitor compliance rates. Findings from these initiatives/programs are anticipated by the middle of 2005.

Learning Objectives: At the conclusion of this presentation the learner will be able to

Keywords: Prenatal Care, Low-Income

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Evidence-based Approaches to Understanding and Improving Pregnancy Outcomes

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA