Identifying perceived barriers to prenatal care among women of low socioeconomic status

The purpose of this thesis was to identify perceived barriers to the initiation and continuation of prenatal care in vulnerable childbearing women. This study was exploratory and descriptive in nature of a convenience sample of 28 pregnant, low-income women meeting selected criteria using (a) selected demographic information obtained through medical chart reviews and (b) taped in-home interviews to identify perceived barriers reported by women who registered for prenatal care in each of the three trimesters and a selection of women who received no prenatal care. Basic descriptive statistics were used to delineate the prenatal care registrants at both of the clinic sites and the study sample. Transcribed interviews were analyzed by extracting significant statements that were clustered into 23 themes: (a) 3 structural barriers and (b) 9 nonstructural barriers. Field notes from the interviews were reviewed and coded to assist with the verification of themes and to give a global sense of each participant's experience. A complex picture of the women's experiences with living in poverty while trying to obtain adequate prenatal care emerged as the data were analyzed. Women initially tended to identify and describe structural barriers as their primary problems, but also recognized the impact nonstructural barriers had on their ability to obtain care later in the interviews. Participants with inadequate care were relatively unable to perceived available options outside of a very limited set of choices. In the face of insufficient knowledge and resources, the participants perceived multiple barriers to adequate prenatal care. In general, the greater the numbers of obstacles present for each participant, the less likely they were able to overcome them and the more likely they were to enter prenatal care late. Many of the barriers were interrelated, creating a self-perpetuating cycle the inhibited the women's ability to overcome these barriers and to obtain adequate prenatal care.