Presentations

Abstract

Introduction: Quality prenatal care has been shown to have a positive impact on both the mother and child. Mothers who receive consistent prenatal care are less likely to die due to pregnancy-related complications and their children are less likely to experience adverse health outcomes and death. Many factors can impede access to prenatal care. These factors include insurance status, distrust of medical providers, racism, socioeconomic status, availability of prenatal appointments, social support, transportation, and mental health status. The United States has an infant mortality rate of 5.4:1000, yet Norfolk City has an infant mortality rate 9.6:1000. When broken down by race, Black individuals in Norfolk have an infant mortality rate of 15.7:1000. Norfolk City is also above the national average for both low birthweight and very low birthweight newborns. These statistics indicate a need for increased access to prenatal care within the Norfolk/Hampton Roads area. The Mother and Baby Mermaids (MBM) CEL at EVMS created a survey to access public knowledge of prenatal care resources. The goal of the quality improvement study was to find gaps in access to care and quality of prenatal/postpartum care among low-income women in Hampton Roads.

Methods: Inclusion criteria were respondents 1) 18 years old or older and 2) interested in prenatal care. The 28-question survey included questions on demographics, pregnancy status, concerns during current/previous/future pregnancies, and awareness of currently available resources in Hampton Roads. Some questions also provided a "write-in" option that allowed us to analyze qualitative data in addition to our quantitative data. Survey data collection occurred primarily at EVMS OB/GYN Clinic at Hofheimer Hall. Patients were asked as they entered the waiting room if they would be willing to fill out the survey, which was available in both English and Spanish, via a QR code linked to Redcap. The data was analyzed using Excel to elucidate demographic data and trends in responses.

Results: Out of 100 respondents, 71 were currently pregnant, 25 had specific concerns about breastfeeding, 5 had concerns about postpartum birth control, and 14 had nutrition concerns. Data analysis revealed first-time pregnant people were less likely to have heard of or used at least one local prenatal/pregnancy resource than women with 1+ children (56% vs 72%). Additionally, individuals with Medicaid/Medicare were more likely to have heard of or used at least one resource than those with other insurance (81% vs 53%). 30 people were interested in educational sessions about pregnancy-related topics, 85 responded their questions were fully answered by their healthcare providers, and 86 respondents plan on regularly seeing a provider for prenatal visits.

Conclusion: Analysis of our data shows that first-time pregnant individuals as well as pregnant individuals without Medicaid/Medicare are less likely to be aware of local prenatal/pregnancy resources. Additionally, Concerns about breastfeeding, prenatal nutrition, and post-partum birth control are still present in this community. Our next steps include developing community education classes focusing on breastfeeding and nutrition as well as identifying ways to educate first-time pregnant individuals about community resources.