Low birthweight (LBW) is a major determinant of infant mortality in the United States. One of the major factors associated with reduction in LBW is early and regular prenatal care. While numerous demographic risk factors and structural barriers to receiving prenatal care have been identified over the past several decades, mush less research has focused on individual differences associated with insufficient prenatal care. Even where financial barriers to care have been reduced and services have been altered to meet client needs, some pregnant women still do not receive sufficient prenatal care. The purpose of this study is to use a sample of women who are high risk for inadequate prenatal care and delivery of LBW infants to examine individual factors related to the level of prenatal care the women received. Within this high risk population three groups of women will be recruited those who received adequate, intermediate or inadequate prenatal care. Additionally, the three groups of women will be followed for one year to determine whether or not level of prenatal care is associated with subsequent pattern of health care utilization. Specifically the study will examine: 1. maternal socio-demographic and psychologic characteristics at the time of delivery and for one year after delivery; 2. stated reasons for seeking or not seeking adequate prenatal care; and 3. pattern of health care utilization for mother and infant for one year post delivery. The sample will consist of 180 newly delivered women at the Hospital of the University of Pennsylvania. Subjects are clinic patients, non-white, with a high school education or less. Data analysis will include discriminant function analysis, MANCOVA, ANOVA, and chi-square statistics. Data from the tape recorded personal interview will be analyzed through a content analysis. The findings of the proposed study are most important since a large percentage of women who do not get adequate prenatal care deliver LBW high risk infants who are at greater risk of mortality and morbidity in the first year of life. The findings will be useful in developing community outreach programs, public service announcements and in the design of prenatal services.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
Project #
Application #
Study Section
Nursing Research Study Section (NURS)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Pennsylvania
Schools of Nursing
United States
Zip Code
York, R; Tulman, L; Brown, K (2000) Postnatal care in low-income urban African American women: relationship to level of prenatal care sought. J Perinatol 20:34-40
York, R; Grant, C; Tulman, L et al. (1999) The impact of personal problems on accessing prenatal care in low-income urban African American women. J Perinatol 19:53-60
York, R; Grant, C; Gibeau, A et al. (1996) A review of problems of universal access to prenatal care. Nurs Clin North Am 31:279-92