Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA.
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
Matern Child Health J. 2018 Jul;22(7):1067-1076. doi: 10.1007/s10995-018-2490-5.
Objectives Pacific Islanders are disproportionately burdened by poorer perinatal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care. The aim of this study is to examine Marshallese mothers' beliefs, perceptions, and experiences of prenatal care and to identify potential barriers. Methods Three focus groups were conducted with Marshallese mothers, who were 18 years or older, and living in Arkansas. Focus groups focused on mothers' beliefs, perceptions, and experiences of prenatal care. A thematic qualitative analysis was conducted to identify salient themes within the data. Results The results demonstrated that negotiating health insurance, transportation, and language barriers were all major structural barriers that constrain prenatal care. The social-cultural barriers that emerged included a lack of understanding of the importance of seeking early and consistent prenatal care, as well as how to navigate the healthcare process. The more complicated challenges that emerged were the feelings of shame and embarrassment due to the perception of their age or being unmarried during pregnancy not being acceptable in American culture. Furthermore, the participants described perceived discrimination from prenatal care providers. Lastly, the participants described fear as a barrier to seeking out prenatal care. Conclusions for Practice This study identified both structural and socio-cultural barriers that can be incorporated into suggestions for policy makers to aid in alleviating maternal health disparities among Pacific Islander women. Further research is needed to address the Marshallese mothers' perceived discrimination from maternal health care providers.
目的 太平洋岛民的围产期健康结局较差，早产儿、低出生体重儿、婴儿死亡率较高，产前护理不足或没有，他们受到的影响不成比例。本研究旨在探讨马绍尔群岛裔母亲对产前护理的信念、看法和经验，并确定潜在的障碍。
方法 在阿肯色州，对 18 岁或以上的马绍尔群岛裔母亲进行了三次焦点小组讨论。焦点小组重点讨论了母亲对产前护理的信念、看法和经验。对数据进行了主题式定性分析，以确定数据中的显著主题。
结果 研究结果表明，协商健康保险、交通和语言障碍都是限制产前护理的主要结构性障碍。出现的社会文化障碍包括对寻求早期和持续产前护理的重要性缺乏理解，以及如何处理医疗保健过程；还有一些更复杂的挑战，比如因怀孕时年龄或未婚而感到羞耻和尴尬，因为在美国文化中，这些是不被接受的；此外，参与者还描述了他们对产前护理提供者的歧视感；最后，参与者还描述了因害怕而寻求产前护理的障碍。
结论 本研究确定了结构和社会文化障碍，可以纳入政策制定者的建议，以帮助减轻太平洋岛民妇女的母婴健康差距。需要进一步研究以解决马绍尔群岛裔母亲对产妇保健提供者的歧视感知问题。
