Early Prenatal Care in Urban Black and White Women

Authors

  • Diana Petitti M.D., M.P.H.,

    Corresponding author
    1. Diana Petitti is Associate Professor, Department of Family and Community Medicine, School of Medicine, University of California at San Francisco. Donald Binsacca and Barbara Allen are co-principal investigators with The Adult Health Section, Alameda County Health Care Services Agency, Oakland, California. Charlotte Coleman is the Project Director.
      Direct correspondence to Dr. Petitti, AC-9, Box 0900, UCSF, San Francisco, CA 94143.
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  • Charlotte Coleman,

    1. Diana Petitti is Associate Professor, Department of Family and Community Medicine, School of Medicine, University of California at San Francisco. Donald Binsacca and Barbara Allen are co-principal investigators with The Adult Health Section, Alameda County Health Care Services Agency, Oakland, California. Charlotte Coleman is the Project Director.
    Search for more papers by this author
  • Donald Binsacca M.S.,

    1. Diana Petitti is Associate Professor, Department of Family and Community Medicine, School of Medicine, University of California at San Francisco. Donald Binsacca and Barbara Allen are co-principal investigators with The Adult Health Section, Alameda County Health Care Services Agency, Oakland, California. Charlotte Coleman is the Project Director.
    Search for more papers by this author
  • Barbara Allen M.D., M.P.H.

    1. Diana Petitti is Associate Professor, Department of Family and Community Medicine, School of Medicine, University of California at San Francisco. Donald Binsacca and Barbara Allen are co-principal investigators with The Adult Health Section, Alameda County Health Care Services Agency, Oakland, California. Charlotte Coleman is the Project Director.
    Search for more papers by this author

  • This research was supported by a grant R01-HD-19830 from the National Institute of Child Health and Human Development.

Direct correspondence to Dr. Petitti, AC-9, Box 0900, UCSF, San Francisco, CA 94143.

Abstract

ABSTRACT: If the ultimate success of efforts to improve pregnancy outcome depends on assurance that prenatal care begins in the first trimester, it is important to identify potentially modifiable factors associated with the start of care as well as the groups in which it is most likely to be late. This topic was explored in a population-based study of low birthweight in 766 black women and 462 white women who gave birth in Alameda County, California, in 1987. Variables related to insurance coverage and financial status showed the greatest difference between early and late attenders at prenatal care in both groups. At virtually every level of almost every variable studied, black women were less likely than white women to begin prenatal care in the first trimester. The data suggested that some of the difference in the timing of prenatal care may be due to lack of awareness of, or failure to pay attention to, the signs of early pregnancy. We conclude that, although addressing problems of insurance coverage and financial status is critical to the solution of the problem of late initiation of prenatal care, as financing difficulties are solved, attention should be paid to women's internal factors such as depression and denial as modifiers of the earliness of seeking prenatal care.

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