UNINTENDED CHILDBEARING, MATERNAL BELIEFS, AND DELAY OF PRENATAL-CARE

Background: Delay of prenatal care is an important risk for poor birth outcome, yet its association with maternal knowledge and beliefs rema ins insufficiently studied. This research examined the relationship of unintended childbearing and beliefs about the importance of prenatal care with initiation after the first trimester, adjusting for key soci odemographic determinants. Methods: One hundred fifty-four Texas hospi tals accounting for 80 percent of state births were asked to collect s urveys from all women delivering infants during a one-week interval in 1986. Seventy-four percent of hospitals and 70 percent of women parti cipated (n = 2032). No differences occurred between the sample and the population on rates of delayed care and low birthweight or maternal d emographics. Results: Since delayed prenatal care is more frequent amo ng low-income women, analyses were limited to those below the 200 perc ent poverty level. After adjustment for maternal age, marital status, education, parity, race, and health insurance status employing logisti c regression, unintended births were 1.6 times more likely to involve delayed care. Mothers who believed prenatal care was unimportant were 2.1 times more likely to delay care. the coefficients exceeded or abou t equaled those for the covariates. Conclusions: Preconception educati on about the value of prenatal care and family planning programs to pr event unintended pregnancies should be conducted together with efforts to overcome financial and structural barriers if progress toward nati onal prenatal care objectives is to be achieved.