Racial differences in perceived barriers to prenatal care.
OBJECTIVE
It is well known that black women are less likely to receive adequate prenatal care than white women. This study examines whether there are differences in barriers to prenatal care reported by black and white mothers.


METHODS
Data from the 1988 National Maternal and Infant Health Survey were used to measure relationship between race and reported financial, service, and personal barriers to prenatal care use, adjusting for maternal age, parity, education, poverty level, and insurance coverage during pregnancy. All analyses were stratified by marital status because of substantial effect modification.


RESULTS
Among married women, 12.1% of black women reported at least one barrier to prenatal care compared to 9.8% of white women. However, after adjustment for demographic and socioeconomic factors, black women were less likely to report a barrier odds ratio [OR] of 0.8; 0.6-1.0). Unmarried black women were less likely to report any barriers to care than white unmarried women (17.9% vs. 25.6%). After adjustment, the OR was 0.4 (0.3-0.5).


CONCLUSIONS
This study suggests that though black women are less likely to receive prenatal care than white women, they are less likely to report barriers to such care. This may be due to differing expectations from the health system. The investigation of perceived barriers to care is important to the consequent understanding of what steps must be taken to assure that pregnant women do not experience obstacles to the receipt of prenatal care.
Tossounian
S A
SA
Infant and Child Health Studies Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA.
Schoendorf
K C
KC
Kiely
J L
JL
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology*; D016001:Confidence Intervals; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008393:Marriage / Q000706:statistics & numerical data; D008423:Maternal Age; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012042:Registries; D018570:Risk Assessment; D012938:Social Perception; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*