Park Jeong-Hwan, Vincent Deborah, Hastings-Tolsma Marie
University of South Carolina, College of Nursing, Columbia, South Carolina, USA.
Midwifery. 2007 Mar;23(1):28-37. doi: 10.1016/j.midw.2005.08.002. Epub 2006 Jul 13.
To describe the disparity in prenatal care among women of colour in timing of initiation of prenatal care and total number of prenatal visits.
A retrospective, descriptive design.
A large, urban university midwifery faculty practice.
439 healthy women at term (37-42 weeks gestation) with a vertex singleton pregnancy, and an essentially uncomplicated prenatal course. One clinic, the university facility, provided full-scope services. The other four community clinics, all outside the university in the larger metropolitan area, were designed to provide care to low-, under-, and uninsured pregnant women.
Timing of initiation of prenatal care and total number of prenatal visits were examined in relation to demographic variables, including race, education, age, marital status, method of payment and clinic sites.
Significant differences in initiation of prenatal care and total number of prenatal visits were documented. The non-Hispanic white women at the university hospital clinic, with high school or college degrees and insurance or Medicaid, were more likely to visit prenatal clinics. Examination of association between timing of initiation of prenatal care and demographic variables showed significant differences in race and education.
This study reflects the difficulty in access to care faced by women of colour. When comparing 1997 national survey findings with those of a 2001 study, about 40% of the 50 States and the District of Columbia showed an increase in the frequency of women receiving late care or no care; additionally, a disparity in access to prenatal care between non-Hispanic white and non-white women was noted in most of these areas.
The number of births to women of colour delivered by midwives has rapidly increased in recent years. Also, the numbers of babies born to women of colour is anticipated to surpass 50% in the next few decades. Considering the increased proportion of births to women of colour, special attention to promote early prenatal care for these populations is needed. Recruitment and retention efforts for non-white midwives, regular education for cultural competence of midwives, and provision of culturally and linguistically appropriate care for women of colour should be considered.
描述有色人种女性在产前护理开始时间和产前检查总次数方面的差异。
回顾性描述性设计。
一所大型城市大学的助产士专业实践机构。
439名足月（妊娠37 - 42周）、单胎头位妊娠且产前过程基本无并发症的健康女性。一家诊所，即大学机构，提供全面服务。其他四家社区诊所均位于大学所在大城市区域之外，旨在为低收入、未充分保险和无保险的孕妇提供护理。
研究产前护理开始时间和产前检查总次数与人口统计学变量的关系，包括种族、教育程度、年龄、婚姻状况、支付方式和诊所地点。
记录到产前护理开始时间和产前检查总次数存在显著差异。在大学医院诊所，拥有高中或大学学历且有保险或医疗补助的非西班牙裔白人女性更有可能去产前诊所就诊。对产前护理开始时间与人口统计学变量之间关联的研究表明，种族和教育程度存在显著差异。
本研究反映了有色人种女性在获得护理方面面临的困难。将1997年全国调查结果与2001年一项研究的结果进行比较时，50个州和哥伦比亚特区中约40%的地区显示接受晚期护理或未接受护理的女性比例有所增加；此外，在这些地区的大多数地方，非西班牙裔白人女性和非白人女性在获得产前护理方面存在差异。
近年来，由助产士接生的有色人种女性的分娩数量迅速增加。此外，预计在未来几十年内，有色人种女性所生孩子的数量将超过50%。鉴于有色人种女性分娩比例的增加，需要特别关注促进这些人群的早期产前护理。应考虑招募和留住非白人助产士，对助产士进行文化能力方面的定期培训，并为有色人种女性提供文化和语言适宜的护理。
