Timing of Prenatal Care Initiation and Psychological Wellbeing in Black Women

Wong, Ana C; Rengers, Brooke; Nowak, Alexandra; Schoeppner, Samantha; Price, Mercedes; Zhang, Liying; Dailey, Rhonda; Anderson, Cindy M.; Misra, Dawn P.; Giurgescu, Carmen

doi:10.1097/nmc.0000000000000661

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…23 As previously noted, SDOH exacerbate disparities in perinatal health, with BIPOC birthing individuals facing the most significant threats to their lives, physical health, and emotional well-being. 13 The Early Care model has been well used by patients who are negatively impacted by SDOH, and the median gestation for entry to care for all Early Care patients who had not previously established care with a different perinatal care provider is 6.8 weeks. This is lower than the average entry to care after 10 weeks in the 2017 Hawkins survey.…”

Section: Broader Implicationsmentioning

confidence: 99%

“…Financial concerns, lack of insurance, and various social needs 13 may also delay access to care 1,14,15 . In a study of pregnant low‐income people, 66% of the uninsured participants did not attend any first trimester appointments 15 .…”

Section: Introductionmentioning

confidence: 99%

“…11 In subsequent years, coronavirus disease 2019 (COVID-19) pandemic protocols have further delayed appointment accessibility. 12 Financial concerns, lack of insurance, and various social needs 13 may also delay access to care. 1,14,15 In a study of pregnant low-income people, 66% of the uninsured participants did not attend any first trimester appointments.…”

mentioning

confidence: 99%

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The Early Care Model for Initiation of Perinatal Care: “I Actually Felt Listened To”

Augur¹,

Ellis²,

Moon³

2022

J Midwife Womens Health

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Early access to prenatal care is a crucial component in reducing poor perinatal outcomes. Institutional barriers such as insurance enrollment, clinic wait times, and systemic racism dramatically influence perinatal care engagement. The Early Care model seeks to address these barriers through a collaborative care model with licensed midwives and certified nurse‐midwives. In contrast to traditional models of prenatal care in which the first visit is deferred until gestational age allows for a dating ultrasound, the Early Care model allows for care to be initiated at any gestation. Patients are offered accessible telehealth early pregnancy appointments for thorough assessment of clinical and social needs to better meet each person's unique and diverse experiences. Patients can receive timely referrals for emergent clinical and social needs, as well as education about all care options. This model promotes improved outcomes and decreased disparities, as well as broader awareness of midwifery care. This article provides an overview of the Early Care model experience.

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Section: Broader Implicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Early Care Model for Initiation of Perinatal Care: “I Actually Felt Listened To”

Augur¹,

Ellis²,

Moon³

2022

J Midwife Womens Health

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Racial, ethnic, and socio-economic disparities in neonatal ICU admissions among neonates born with cyanotic CHD in the United States, 2009–2018

Reddy,

Ludomirsky,

Jones

et al. 2024

Cardiol Young

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Introduction: Disparities in CHD outcomes exist across the lifespan. However, less is known about disparities for patients with CHD admitted to neonatal ICU. We sought to identify sociodemographic disparities in neonatal ICU admissions among neonates born with cyanotic CHD. Materials & Methods: Annual natality files from the US National Center for Health Statistics for years 2009–2018 were obtained. For each neonate, we identified sex, birthweight, pre-term birth, presence of cyanotic CHD, and neonatal ICU admission at time of birth, as well as maternal age, race, ethnicity, comorbidities/risk factors, trimester at start of prenatal care, educational attainment, and two measures of socio-economic status (Special Supplemental Nutrition Program for Women, Infants, and Children [WIC] status and insurance type). Multivariable logistic regression models were fit to determine the association of maternal socio-economic status with neonatal ICU admission. A covariate for race/ethnicity was then added to each model to determine if race/ethnicity attenuate the relationship between socio-economic status and neonatal ICU admission. Results: Of 22,373 neonates born with cyanotic CHD, 77.2% had a neonatal ICU admission. Receipt of WIC benefits was associated with higher odds of neonatal ICU admission (adjusted odds ratio [aOR] 1.20, 95% CI 1.1–1.29, p < 0.01). Neonates born to non-Hispanic Black mothers had increased odds of neonatal ICU admission (aOR 1.20, 95% CI 1.07–1.35, p < 0.01), whereas neonates born to Hispanic mothers were at lower odds of neonatal ICU admission (aOR 0.84, 95% CI 0.76–0.93, p < 0.01). Conclusion: Maternal Black race and low socio-economic status are associated with increased risk of neonatal ICU admission for neonates born with cyanotic CHD. Further work is needed to identify the underlying causes of these disparities.

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Timing of Prenatal Care Initiation and Psychological Wellbeing in Black Women

Cited by 2 publications

References 8 publications

The Early Care Model for Initiation of Perinatal Care: “I Actually Felt Listened To”

The Early Care Model for Initiation of Perinatal Care: “I Actually Felt Listened To”

Racial, ethnic, and socio-economic disparities in neonatal ICU admissions among neonates born with cyanotic CHD in the United States, 2009–2018

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