USE OF PRENATAL SERVICES BY HISPANIC WOMEN IN SAN DIEGO COUNTY: A Comparison of Urban and Rural Settings

Authors

  • John K. Conrad MD,

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    • John Conrad received a bachelor of arts degree in English from the University of California at Santa Barbara and a doctor of medicine degree from the University of California, San Diego (1994). This article was prepared in partial fulfillment of his medical school Independent Study Project. Dr. Conrad is a second-year resident in surgery at Baylor Medical Center, Houston, Texas.

  • Kathryn A. Hollenbach PhD,

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    • Kathryn Hollenbach received a bachelor of science degree from Boston College, a master's degree in public health from San Diego State University, and a PhD in epidemiology from the University of Washington (1990). She is an assistant professor in the Department of Family and Preventive Medicine at the University of California, San Diego(UCSD) School of Medicine, where she serves as the interim coordinator of the UCSD/San Diego State University joint doctoral program. Dr. Hollenbach was the chair of the Independent Study Project.

  • Judith T. Fullerton PhD, CNM, FACNM,

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    • Judith Fullerton received a bachelor of science degree in nursing from Wayne State University, a master of science degree and certificate in nurse-midwifery from Columbia University (1970), and a PhD in health education/health administration from Temple University (1981). Dr. Fullerton was formerly a professor at the University of California, San Diego, Department of Family and Preventive Medicine, and principal investigator of the study “Access to Prenatal Care for Hispanic Women of San Diego County,” from which data for the present report were drawn, and a member of the Independent Study committee. Dr. Fullerton, a fellow of the American College of Nurse-Midwives, is a professor with the Department of Family Nursing Care, University of Texas Health Science Center, San Antonio, Texas.

  • Heather Spencer Feigelson PhD

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    • Heather Feigelson received a master's degree in public health from San Diego State University and a PhD in epidemiology from the University of California, Los Angeles in 1996. Dr. Feigelson served as a statistical analyst for the Independent Study Project. She is a postdoctoral fellow at the University of Southern California, Department of Preventive Medicine.


Address correspondence to Judith T. Fullerton, PhD, CNM, FACNM, 4114 Medical Drive, #16104, San Antonio, TX 78229.

ABSTRACT

The purpose of this study was to investigate patterns of prenatal care use among urban and rural Hispanic women in San Diego County, California. A cohort study of Hispanic women delivering at one of five San Diego County hospitals between July 1991 and January 1992 was conducted (N = 587). Data were collected by in-person interview and medical record abstraction. Logistic regression was used to identify variables associated with late entry into prenatal care, while simultaneously adjusting for important confounding variables. Three factors were found to be significantly associated with late entry into prenatal care. Women who resided in urban areas were two times more likely to enter prenatal care late as compared to women who lived in rural areas (odds ratio = 2.11; 95% confidence intervals (CI) = 1.12, 4.0). Women who reported not having initially “wanted” the pregnancy were 2.2 times more likely to enter prenatal care late (95% CI = 1.05, 4.59). The risk of entering prenatal care late increased by 20% for each additional barrier to care that was reported (95% CI = 1.09, 1.34). Results indicate that timely entry into prenatal care may be improved among San Diego Hispanic women by targeting specific barriers to prenatal care identified in this study and by providing greater family planning assistance to this population to decrease unwanted pregnancies.

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