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LATE ENTRY INTO PRENATAL CARE IN A RURAL SETTING

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  • Daniel Chandler PhD

    Corresponding author
      436 Old Wagon Road, Trinidad, CA 95570.
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    • Daniel Chandler received a PhD in sociology from the University of California, Berkeley. He has worked as a mental health consultant to the California Legislature and as Chief of Planning and Evaluation for the Sacramento County public mental health program. Since 1987, he has been an independent health policy analyst and consultant.


  • The study was performed under contract with the Humboldt County Public Health Department using funds provided by the California State Department of Health Services, Maternal Child Health Branch, allocation #199912. The author gratefully acknowledges the assistance and support of Rebecca Stauffer, MD, Ninon McCullough, RN, PHN, of the Public Health Department and the assistance of research assistants Jeanne Kirk and Sally Stablein. Sociology graduate students Christina Begley, Tracie Carrasco, Farnad Darnell, Laura Estetter, Carlin Finke, Diane Goldsmith, John Haskell, Karla Lusby, Marika Myrick, Dan Sarabia, Marcia Sterling, and Paula Yoon did much developmental work in formulating the design and collecting data. Shawna Thorsen, RN; Annie Howell, RN; Michelle Van Ooy, MD; Ruth Howell, RN; Betty Braver, CNM; Cynthia Ihle, RN; Kate Maguire; Holly Baker; Emily Arents, CNM; Carol Meyer, CNM; and Mary Ann Shah, CNM, suggested strategies for public health intervention.

436 Old Wagon Road, Trinidad, CA 95570.

ABSTRACT

Social support, behavioral risk, and structural or demographic variables as well as acceptance of pregnancy were tested as determinants of late entry into prenatal care in a sample of 176 women in a rural county in California. The respondents were all those over age 18 served by four obstetric practices during a 4-month period ending in February 2000. One nurse-midwifery practice was included. Late entry into prenatal care during the first trimester occurred in 27.3% of the cases overall. Statistically significant independent variables in bivariate analyses were modeled in multivariate logistic regression. Stress, lack of family and friend support, Medicaid enrollment, age under 20 or over 34, low acceptance of pregnancy, and lack of a high school diploma were all predictors of late entry. Lack of family and friend support modified the effects of stress and Medicaid as payer. Although the determinants of late entry were remarkably complex in this sample, they have potential for public health intervention.

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