title: Postnatal care in low-income urban African American women: relationship to level of prenatal care sought.
abstract: OBJECTIVE
  This study examined the relationship between level of prenatal care utilization and postnatal patterns of health care behavior among high-risk minority women. The primary hypothesis was that prenatal care utilization predicts subsequent levels of both the maternal and child health services used in the postnatal period.
  
  
  METHODS
  The study population consisted of 297 low-income African American women who were recruited at delivery at an urban tertiary medical center in the Mid-Atlantic region. They were followed monthly for 1 year using telephone interviews to determine their use of maternal and child health services. Four levels of prenatal care were identified retrospectively based on reviews of health records and screening interviews using the Kessner Index. Data regarding pregnancy outcomes, maternal postnatal visits, and well-child and acute care child visits were collected.
  
  
  RESULTS
  Women who sought inadequate or no prenatal care had greater infant morbidity and mortality in the postnatal period and significantly lower levels of attendance at maternal postnatal visits, well-child visits, immunization completions, and acute care visits.
  
  
  CONCLUSIONS
  This study confirms that the level of prenatal care is indicative of the level of postnatal care women seek for themselves and their children in the first year after delivery.
authors.affiliation: Division of Women's Health and Childbearing, University of Pennsylvania School of Nursing, Philadelphia 19104-6096, USA.
authors.forename: R
authors.initials: R
authors.lastname: York
authors.forename: L
authors.initials: L
authors.lastname: Tulman
authors.forename: K
authors.initials: K
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000704:Analysis of Variance; D001294:Attitude to Health / Q000208:ethnology*; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015143:Philadelphia; D011181:Postnatal Care / Q000592:standards / Q000706:statistics & numerical data*; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D012494:Sampling Studies; D014505:Urban Population