The influence of attitudes about unintended pregnancy on use of prenatal and postpartum care.
OBJECTIVE
The purpose of this study was to examine the effects of feelings about pregnancy and consideration of abortion on late initiation of prenatal care and postpartum appointment.


METHODS
A descriptive study was conducted in a tertiary clinic in Detroit using a convenience sample comprised of 518 low-income pregnant and postpartum women with a large number of unintended pregnancies. A series of chi-square analyses and logistic regression models were conducted to identify variables predictive of these outcomes.


RESULTS
Teenagers were 1.8 times more likely to initiate late prenatal care versus early care (p = 0.05), and women who considered an abortion were 3.7 times more likely to initiate late prenatal care (p = 0.01). Having considered abortion but deciding against it due to psychologic/moral reasons was protective against late initiation of prenatal care (OR = 0.23; p = 0.01). Multiparity was the only predictor of a missed postpartum appointment. Multiparous women were three times more likely to miss the appointment (p = 0.05).


CONCLUSIONS
Success in improving early access to prenatal care will involve addressing the issue of unintended pregnancy. This challenge will require that health care providers assess feelings and values related to a pregnancy. Understanding women's feelings and values about the pregnancy will allow providers to more effectively assist with decision-making and positive pregnancy behaviors. In addition, community-based education related to family planning and the value of prenatal and postpartum care is needed to involve women's partners, family, and friends, because social support systems influence decisions regarding pregnancy behaviors.
Hulsey
T M
TM
College of Nursing, Center for Health Care Research, 99 Jonathan Lucas Street, Room 421, Medical University of South Carolina, Charleston, SC 29425, USA.
Laken
M
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Miller
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Ager
J
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D000029:Abortion, Legal; D000328:Adult; D001071:Appointments and Schedules; D005260:Female; D006801:Humans; D016015:Logistic Models; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011181:Postnatal Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011275:Pregnancy, Unwanted / Q000523:psychology*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013022:South Carolina