Julia C. Phillippi, CNM, MSN, is a lecturer at Vanderbilt University School of Nursing in Nashville, TN, and a PhD student at the University of Tennessee, Knoxville, TN. She practices on a locum tenens basis with the Women's Wellness & Maternity Center and Lisa Ross Birth & Women's Center in East Tennessee.
Women's Perceptions of Access to Prenatal Care in the United States: A Literature Review
Article first published online: 24 DEC 2010
2009 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 54, Issue 3, pages 219–225, May-June 2009
How to Cite
Phillippi, J. C. (2009), Women's Perceptions of Access to Prenatal Care in the United States: A Literature Review. Journal of Midwifery & Womens Health, 54: 219–225. doi: 10.1016/j.jmwh.2009.01.002
- Issue published online: 24 DEC 2010
- Article first published online: 24 DEC 2010
- health services accessibility;
- maternal health services;
- prenatal care
Women report many barriers to accessing prenatal care. This article reviews the literature from 1990 to the present on women's perceptions of access to prenatal care within the United States. Barriers can be classified into societal, maternal, and structural dimensions. Women may not be motivated to seek care, especially for unintended pregnancies. Societal and maternal reasons cited for poor motivation include a fear of medical procedures or disclosing the pregnancy to others, depression, and a belief that prenatal care is unnecessary. Structural barriers include long wait times, the location and hours of the clinic, language and attitude of the clinic staff and provider, the cost of services, and a lack of child-friendly facilities. Knowledge of women's views of access can help in development of policies to decrease barriers. Structural barriers could be reduced through changes in clinic policy and prenatal care format, and the creation of child-friendly waiting and examination rooms. Maternal and societal barriers can be addressed through community education. A focus in future research on facilitators of access can assist in creating open pathways to perinatal care for all women.