Women who are late to prenatal care miss opportunities for health interventions and are at increased risk for pregnancy-related complications. Black women have the lowest rates of first trimester care compared with White or Latinx women. We sought to describe barriers to prenatal care experienced by race/ethnicity in a multi-site, prospective cohort.
We performed a secondary analysis of the Community Child Health Research Network Study, a multi-site prospective cohort study of pregnant women from 2008 to 2012. Women were recruited at the time of delivery and followed prospectively for 2 years. Participants who experienced a repeat pregnancy in the 2-year follow-up period had a prospective assessment of prenatal care barriers. A multilevel mixed effects Poisson regression was performed to evaluate the association between race/ethnicity and number of prenatal barriers.
Of the 298 participants in the sample, 43% of Black, 35% of Latinx, and 23% of White participants reported barriers to prenatal care. After adjustment for confounders, Black and Latinx women reported almost twice as many barriers to prenatal care as White women (adjusted rate ratio 1.89 [1.2, 3.0]; 2.00 [1.1, 3.8], respectively).
In our analysis, multiparous Black and Latinx women reported encountering more barriers to prenatal care than White women. Additional reforms and policy change are needed at the clinic, local, and state levels to support women in accessing early quality prenatal care to achieve racial equity in prenatal care.
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We would like to acknowledge the original principal investigators, which included C. S. Minkovitz in Baltimore, M. Shalowitz in Chicago, C. Hobel in Los Angeles, J. Thorp in North Carolina, and S. L. Ramey and L. Klerman in Washington, D.C.
This secondary analysis was of the Child Community Health Network Study, which was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (U HD44207, U HD44219, U HD44226, U HD44245, U HD44253, U HD54791, U HD54019, U HD44226-05S1, U HD44245-06S1, R03 HD59584) and the National Institute for Nursing Research (U NR008929).
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Fryer, K., Munoz, M.C., Rahangdale, L. et al. Multiparous Black and Latinx Women Face More Barriers to Prenatal Care than White Women. J. Racial and Ethnic Health Disparities 8, 80–87 (2021). https://doi.org/10.1007/s40615-020-00759-x
- Prenatal care
- Barriers to care
- Access to care
- Racial equity
- Racial dispartities