More Does Not Mean Better: Prenatal Visits and Pregnancy Outcome in the Hispanic Population

Abstract

Early and consistent prenatal care (PNC) is thought to play an important role in the reduction of low birthweight (LBW) in the United States. It has been reported that LBW and delayed PNC are common to the Hispanic woman. In California, this cultural group comprises approximately 26% of the population, and much debate concerning health care reform has been targeted at this problem. A comparative study was conducted in California to examine the number of prenatal visits and the outcomes of Mexico-born Hispanics and U.S.-born Hispanics. Obstetric and medical record review for 783 women was done. The results show that more prenatal visits did not improve the outcome during pregnancy, labor, or the postpartum period. Because a large portion of PNC is now delivered by the advanced practice nurse, implications for practice include exploring alternatives for the delivery of culturally relevant care, addressing the barriers to caring for this population, and finding alternative models of care that have the potential to produce positive outcomes.

Positive Pregnancy Outcomes in Mexican Immigrants: What Can We Learn?

“…Prenatal care is often cited as an important intervention in the reduction of low-birth-weight rates and preterm births; however, some studies have shown little or no effect of prenatal care on low-birth-weight rates (Strobino et al, 1999). In a study of pregnancy outcomes in 783 Hispanic women, researchers found that more prenatal visits did not improve pregnancy outcome (Goss, Lee, Koshar, Heilemann, & Stinson, 1997). Similarly, Collins and Shay (1994) found that the pregnancy risk of inadequate prenatal care for foreign-born Mexican women was not substantiated.…”

Prenatal Care in the Paso del Norte Border Region

“…[2][3][4][5][6][7][8] A similar body of literature reviews the essential elements of the content of that care. [9][10][11][12][13] The factors that promote or impede women's access to prenatal care [14][15][16][17][18] have also been documented. Findings from these studies provided evidence in support of the Healthy People 2010 19 objective that 90% of women should enter prenatal care during the first trimester.…”

Culturally Appropriate Care for Pregnant Latina Women Who Are Victims of Domestic Violence

“…during prenatal visits (Goss et al, 1997). Wiist and McFarlane (1999) found that nurses were key in identifying most cases of abuse and that clinics with bilingual nurses and Spanish-language abuse-assessment materials reported identifying higher levels of abuse than did nonintervention site clinics (7% versus 0%).…”

“…Although Latina women are less likely to enter prenatal care early and continue attending appointments when the care is not culturally sensitive, many studies indicate that the optimal time to screen for abuse is during maternity visits. One study found a serious problem with this approach, however, because more prenatal visits did not necessarily improve the outcomes of pregnancy or reduce perinatal complications ( GOSS, Lee, Koshar, Heilemann, & Stinson, 1997). Hispanic women who were poor and had lower levels of education received less counseling and anticipatory guidance I t took more severe and repeated abuse for Mexican American women to identify it as abuse when compared with white women.…”