title: Prenatal care in the Paso del Norte border region.
abstract: OBJECTIVE
  The impact of a Medicaid-managed care system on access to prenatal care was investigated.
  
  
  METHODS
  Postpartum interviews and medical chart abstractions were conducted among 493 Hispanic women who reside on the El Paso Texas/Juarez Mexico border (the Paso del Norte region). Descriptive analysis identified barriers and facilitators to prenatal care. Logistic regression identified the impact of social and demographic characteristics on selected maternal and infant outcomes.
  
  
  RESULTS
  The factors reported by these women as barriers to timely entry and sustaining enrollment in prenatal care were related to the availability of social support networks and affiliation with the Mexican/Hispanic culture (acculturation). Having Medicaid-managed care or other insurance was associated with receiving more adequate levels of prenatal care. Women who crossed the border to seek perinatal services were more likely to have infants who received higher levels of neonatal care (odds ratio 0.500; 95% CI [0.264, 0.946]).
  
  
  CONCLUSIONS
  The promotion of preconceptional, prenatal, and family planning services is strongly recommended as a strategic, regional, public health intervention.
authors.affiliation: School of Nursing, University of Texas at El Paso, TX, USA.
authors.forename: Judith T
authors.initials: JT
authors.lastname: Fullerton
authors.forename: Carlene
authors.initials: C
authors.lastname: Nelson
authors.forename: Rachel
authors.initials: R
authors.lastname: Shannon
authors.forename: Julia
authors.initials: J
authors.lastname: Bader
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003469:Culture; D004641:Emigration and Immigration; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006630:Hispanic or Latino; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008484:Medicaid; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics*; D012944:Social Support; D013781:Texas