THE INTERACTIVE EFFECTS OF RACE AND ETHNICITY AND MOTHERS RESIDENCE ON THE ADEQUACY OF PRENATAL-CARE

Adequate prenatal care is known to reduce the risks of low birth weigh t and neonatal death, yet nearly one quarter of all women giving birth in the United States receive delayed, inadequate or no prenatal care. This suboptimal use of prenatal care has contributed to rates of low birth weight and neonatal mortality higher than those in most other in dustrialized nations. This paper examines the relationships among race /ethnicity, residence, maternal sociodemographic and medical risk char acteristics, and use of prenatal care in the United States. Using data from the National Maternal and Infant Health Survey, this study found important differences in prenatal cave use by race/ethnicity and resi dence, as well as interactive effects of these variables. Single marit al status, nonmetropolitan residence, poverty, low level of education, and no insurance were move strongly associated with inadequate prenat al care for whites and Hispanics than for blacks. Nonmetropolitan resi dents were more likely to receive inadequate care, regardless of race/ ethnicity or sociodemographic characteristics. Predicted probabilities of prenatal care use by race/ethnicity and residence showed that, reg ardless of risk, nonmetropolitan Hispanic women had the highest probab ility of obtaining inadequate prenatal care. Results highlight the con tinued importance of race/ethnicity and rural residence in determining prenatal care use and the need to design interventions targeted to th ese populations.