Prenatal care use among women of low income: a matter of "taking care of self".

The grounded theory study discussed in this article provides a theoretical explanation of prenatal care use among women of low income. The author recruited 26 women from two communities in Ontario, Canada, to participate in an individual or focus group interview and analyzed data using descriptive coding, interpretive coding, and constant comparison. Perceptions of the health care system were identified as important influences on usage behavior. This broad theme included two subthemes: (a) program and service attributes and (b) service provider characteristics. Within each subtheme, both barriers to and facilitative factors for prenatal care became apparent. The author examined relationships among categories to identify a unifying construct. Taking care of self emerged as the central phenomenon that explained usage behavior. Women weigh the pros and cons when deciding whether to access prenatal care, and then take charge, ultimately making a decision in terms of its meaning for self.