Racial and ethnic disparities in the discordance between women's assessment of the timing of their prenatal care entry and the first trimester standard.
OBJECTIVE
The purpose of this study was to investigate whether the discordance between women's assessment of the adequacy of the timing of their prenatal care entry and the standard of first trimester initiation was associated with maternal race or ethnicity.


METHODS
A population-based surveillance system, the California Pregnancy Risk Assessment Monitoring System, provided data on a stratified random sample of 4,987 women. The women delivered live-born infants from 1994-95 in three perinatal regions. Respondents completed an in-hospital, self-administered questionnaire. Weighted data were analyzed with multiple logistic regression.


RESULTS
Twenty-two percent of the women in the sample initiated prenatal care after the first trimester of pregnancy (n = 1,097). Among the women with untimely care, 57% (n = 591) were satisfied with the time of care initiation. Discordance between the women's perception of the adequacy of the time of care initiation and the public health standard of first trimester initiation was associated with maternal ethnicity. After controlling for potential confounders, Mexican-born women with untimely care were more likely to report being satisfied with the time of initiation than were white non-Latina women with untimely care (OR = 4.03, CI = 2.46, 6.59).


CONCLUSIONS
The design of public health interventions to increase the timeliness of prenatal care initiation will require a greater understanding of pregnant women's own perceptions of their needs for prenatal care, and the differences in perceptions across ethnic groups.
Sarnoff
R
R
University of California at Berkeley School of Public Health, Berkeley, USA. rsarnoff@dhs.ca.gov
Adams
E
E
D000293:Adolescent; D000328:Adult; D002140:California; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000523:psychology*; D011295:Prenatal Care / Q000592:standards*; D015980:Public Health Practice / Q000592:standards*; D012306:Risk; D012959:Socioeconomic Factors; D013997:Time Factors