Utilizing Focus Groups to Determine Barriers to Prenatal Care Adequacy among African American Adolescents

Introduction Prenatal care adequacy and its relationship to negative birth outcomes continue to be the focus of many health care initiatives. Inadequate prenatal care, failure to initiate care in the first 3 months of pregnancy attributes to negative birth outcomes (Miller & Ruijter, 1999, Keppel, Pearcy & Wagener, 2002). Negative birth outcomes range from congenital defects to maternal complications. The outcomes that will be the focus of this study are very low birth weight, low birth weight and infant mortality. Communicating the importance of obtaining prenatal care in the first trimester is key to decreasing obstacles in access to care when services are available. Racial disparities exist within the American population across racial lines in many areas of public health. However, the greatest cause for concern lies in the African American population. When comparing African American negative birth outcomes to that of any other population, as well as the average for any given analysis, African Americans have the greatest disproportions (Department of Health & Human Services, 2001). Although disparities exist in areas ranging from cardiac disease to diabetes, the focus of this study will be prenatal care adequacy and negative birth outcomes. Recent studies display that adverse or neutral perceptions about prenatal health care are held by many African Americans of childbearing age. It is reported that African Americans of childbearing age do not feel that it is important to obtain prenatal care in the first trimester (Gibbs, Leff, Meikle, Orleans & Shain, 1995). Furthermore, an even greater cause for concern lies with African American adolescents. Although adolescent pregnancy has decreased over the last decade for all Americans, the African American birth rate remains two times greater than that of Caucasians (Abma, Curtin, Henshaw, Mosher & Ventura, 2001). Being that this group is more at risk than those of the general population (Cosey & Bechtel, 2001), interventions must be developed to eradicate this disparity.