Prenatal Care among Low-Income Women

Author(s):  
Marjorie A. Schaffer ◽  
Betty Lia-Hoagberg

Forty low-income pregnant women were interviewed about the personal, family, and provider rewards and costs they experienced in obtaining prenatal care. The women identified important rewards as the health of their babies, their own health, partner's desire for a healthy baby, monitoring of the pregnancy by qualified healthcare personnel, and the evaluation of problems by health-care providers. The authors suggest strategies to strengthen personal, family, and provider rewards aimed at achieving a high level of prenatal care for low-income women.

2018 ◽  
Vol 28 (13) ◽  
pp. 2033-2047 ◽  
Author(s):  
Kyoko Wada ◽  
Marilyn K. Evans ◽  
Barbra de Vrijer ◽  
Jeff Nisker

Limited clinical research with pregnant women has resulted in insufficient data to promote evidence-informed prenatal care. Charmaz’s constructivist grounded theory methodology was used to explore how research with pregnant women would be determined ethically acceptable from the perspectives of pregnant women, health care providers, and researchers in reproductive sciences. Semistructured interviews were conducted with a purposive sample of 12 pregnant women, 10 health care providers, and nine reproductive science researchers. All three groups suggested the importance of informed consent and that permissible risk would be very limited and complex, being dependent on the personal benefits and risks of each particular study. Pregnant women, clinicians, and researchers shared concerns about the well-being of the woman and her fetus, and expressed a dilemma between promoting research for evidence-informed prenatal care while securing the safety in the course of research participation.


2021 ◽  
Vol 39 (1) ◽  
pp. 50-59
Author(s):  
Mumtahana Nabi ◽  
Abul Masud Md Nurul Karim ◽  
SM Mamun Ur Rashid

Background: Oral health care in pregnancy is often neglected by women and is also not appropriately addressed by prenatal and other health care providers and justify appropriate attention. The purpose of this cross sectional study was to describe percentage of oral disease occurrence and underlying causes in this sample of pregnant women. Methods: The study included 147 women aged between 15 to 49 years receiving prenatal care at the outdoor department of Azimpur Maternal and Child Health Training Institute in Dhaka, Bangladesh were invited to participate in this study from January 2013 to April 2013. Semi-structured interviews were conducted for data collection. Clinical exam data were recorded using validated scales in a special form. Results: Majority (72%) of the women were  between  20 to 24 years.  57%  had secondary  school  education.  88% of the women were unemployed and 52% women had very low family income of BOT s;10000. More than 90% of the women had good oral hygiene practices. However, 68% liked to  have  sugary  snacks  or  drinks  in  between  main meals, 7% visited their dentists during pregnancy , only 3% received advice  for  routine  oral  health  screening  from their prenatal care providers and only 4% women started their antenatal check-up during first trimester.  All  these negative influences might expose expecting mothers to high level of dental caries (54%), dental  erosion  (52%),  gingivitis (100%) and periodontitis (27%). This study also showed that majority of the women acquired oral health information through watching television (61%) or reading  newspaper  (12%)  while  only  4%  received  information from doctors/dent ists throughout their lifetime. Conclusion: The undertaken research highlighted the importance of using media in modifying Bangladeshi pregnant woman's behaviours toward oral health. It also emphasizes the need for inclusion of oral health preventive programme as part of pre and postnatal care. Further study in this area on a large scale will facilitate formulation of appropriate oral health policy to achieve satisfactory oral and general health outcomes during pregnancy and ensure optimum oral health conditions of their offspring. JOPSOM 2020; 39(1): 50-59


2020 ◽  
Vol 33 (2) ◽  
pp. 190-200 ◽  
Author(s):  
Lynn M. Yee ◽  
Karolina Leziak ◽  
Jenise Jackson ◽  
Charlotte M. Niznik ◽  
Melissa A. Simon

2021 ◽  
Author(s):  
Columba Mbekenga ◽  
Reuben Mutagaywa ◽  
Edda Tandi Lwoga

Abstract BackgroundPregnant women that engage in information seeking process are more likely to have a high level of knowledge about their health, be confident to discuss their health concerns with their health care providers and report better health promotion activities than individuals who do not seek health information. However, health literacy influence pregnant women’s information seeking behaviours and consequently their health knowledge and health outcomes. Limited studies have explored the effects of health literacy on the outcomes associated with the information seeking among pregnant women in Tanzania. This study investigates the relationship between health literacy and information seeking patterns and its associated outcomes among pregnant women in Tanzania. MethodsA cross- sectional survey was conducted among 260 pregnant women aged 18 and above attending selected antenatal clinics (ANC) in Tanzania. Health literacy was assessed using a REALM-SF instrument while information seeking patterns while the associated outcomes were measured using three Likert scales. Descriptive and analytic analyzes were performed using the SPSS, version 24.ResultsAmong the demographic factors, level of education was significantly associated with the level of health literacy (p<0.001). The level of health literacy was better among married pregnant women than those who were not married, and among those who have high income more than those with low-income. The number of ANC visits, gestational age and parity were significantly associated with the level of health literacy (p<0.05). A significant relationship was found between health literacy with seeking health information from village leaders (p < 0.0001) and all online information sources (p < 0.05). Pregnant women with high level of health literacy strongly agree to confirm (from health professionals) the validity of health information they receive from different sources and to recommend the importance of searching health information to others (p<0.001).ConclusionHealth literacy has great influence on maternal health behaviors and the associated outcomes. Maternal health interventions targeting both individual women and the public to ensure high health literacy levels across communities are required. An integration of online/ web-based health information in ANC health educational packages would warrant pregnant women access to high quality health information.


Author(s):  
Sallie Han

The aim of this chapter is to demonstrate the importance and necessity of bringing together the considerations of language and reproduction. While other topics of sexuality have aroused interest in sociolinguistics and linguistic anthropology, the ideas, practices, and experiences of human reproduction, notably pregnancy, remain understudied. At the same time, a discussion of language has been largely absent from the anthropology of reproduction, which has emerged in the last twenty years as an especially vibrant area of cultural and social study. The chapter examines the metaphors and discourses or the “talk about” reproduction; the interactions and “talk between” people, like pregnant women and medical health care providers, which shapes the ordinary experiences of reproduction; the “talk to” parties (specifically, fetuses and imagined children) who themselves become constituted through talk; and reproduction as literacy event or one that is mediated and experienced in relation to texts. It is asserted that language is a practice of reproduction.


2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242604
Author(s):  
Marian Loveday ◽  
Sindisiwe Hlangu ◽  
Jennifer Furin

Background There are few data on the on the care experiences of pregnant women with rifampicin-resistant TB. Objective To describe the treatment journeys of pregnant women with RR-TB—including how their care experiences shape their identities—and identify areas in which tailored interventions are needed. Methods In this qualitative study in-depth interviews were conducted among a convenience sample from a population of pregnant women receiving treatment for RR-TB. This paper follows COREQ guidelines. A thematic network analysis using an inductive approach was performed to analyze the interview transcripts and notes. The analysis was iterative and a coding system developed which focused on the care experiences of the women and how these experiences affected their perceptions of themselves, their children, and the health care system in which treatment was received. Results Seventeen women were interviewed. The women described multiple challenges in their treatment journeys which required them to demonstrate sustained resilience (i.e. to “be brave”). Care experiences required them to negotiate seemingly contradictory identities as both new mothers—“givers of life”—and RR-TB patients facing a complicated and potentially deadly disease. In terms of their “pregnancy identity” and “RR-TB patient identity” that emerged as part of their care experiences, four key themes were identified that appeared to have elements that were contradictory to one another (contradictory areas). These included: 1) the experience of physical symptoms or changes; 2) the experience of the “mothering” and “patient” roles; 3) the experience of the care they received for their pregnancy and their RR-TB; and 4) the experience of community engagement. There were also three areas that overlapped with both roles and during which identity was negotiated/reinforced and they included: 1) faith; 2) socioeconomic issues; and 3) long-term concerns over the child’s health. At times, the health care system exacerbated these challenges as the women were not given the support they needed by health care providers who were ill-informed or angry and treated the women in a discriminatory fashion. Left to negotiate this confusing time period, the women turned to faith, their own mothers, and the fathers of their unborn children. Conclusion The care experiences of the women who participated in this study highlight several gaps in the current health care system that must be better addressed in both TB and perinatal services in order to improve the therapeutic journeys for pregnant women with RR-TB and their children. Suggestions for optimizing care include the provision of integrated services, including specialized counseling as well as training for health care providers; engagement of peer support networks; provision of socioeconomic support; long-term medical care/follow-up for children born to women who were treated for RR-TB; and inclusion of faith-based services in the provision of care.


2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.


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