ARE THERE DIFFERENCES IN INFORMATION GIVEN TO PRIVATE AND PUBLIC PRENATAL PATIENTS

OBJECTIVES: In 1989 the United States Public Health Service Expert Pan el on the Content of Prenatal Care reported that health education shou ld become a more integral part of prenatal care. Key questions about p roviding this education have not been examined. Our study compared the type of information provided to women who sought prenatal care in a p ublic clinic and to those who were seen in a private practice and the degree to which the patients were satisfied with the information they received. STUDY DESIGN: One hundred fifty-nine pregnant women (80 seen in a public clinic, 79 seen in a private practice) completed two ques tionnaires about 38 topics commonly cited as important during pregnanc y. At the first prenatal visit, the women reported their level of inte rest in each of the topics. At 36 to 40 weeks' gestation the women com pleted a second questionnaire to assess whether information was provid ed for each topic and whether they had learned as much as desired. RES ULTS: Overall, the women in the public sector received more informatio n than did the women who were cared for privately. This was statistica lly significant at the p < 0.05 level for 25 of the 38 topics. Satisfa ction with information learned was highly correlated with information received during prenatal care, but, surprisingly, it was not shown to be associated with the patient's interest level at the first visit. Fe wer than 50% of private patients reported having received information about such important topics as acquired immunodeficiency syndrome, sex ually transmitted diseases, preterm birth prevention, family planning, and family violence. CONCLUSIONS: The one-on-one approach to health e ducation in pregnancy usually used in the private setting may not faci litate addressing many topics believed to be important components of c ontemporary prenatal care. Providers of private prenatal care should i nitiate discussion of prenatal health education topics rather than rel ying on patient interest in requesting information. Just as public pre natal care programs have devoted significant resources to more compreh ensive prenatal education, the providers in the private sector must as sure that pregnant women receive the same comprehensive information. I n so doing, these providers can help promote an optimal outcome for th eir patients, their patients' unborn children, and the family unit.