ERIC Number: EJ862454
Record Type: Journal
Publication Date: 2009
Abstractor: As Provided
Does Rural Residence Affect Access to Prenatal Care in Oregon?
Epstein, Beth; Grant, Therese; Schiff, Melissa; Kasehagen, Laurin
Journal of Rural Health, v25 n2 p150-157 Spr 2009
Context: Identifying how maternal residential location affects late initiation of prenatal care is important for policy planning and allocation of resources for intervention. Purpose: To determine how rural residence and other social and demographic characteristics affect late initiation of prenatal care, and how residence status is associated with self-reported barriers to accessing early prenatal care. Methods: This observational study used data from the 2003 Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) (N = 1,508), with late initiation of prenatal care (after the first trimester) as the primary outcome. We used Rural-Urban Commuting Area (RUCA) codes to categorize maternal residence as urban, large rural, or small/isolated rural. Multivariate logistic regression was used to evaluate whether category of residence was associated with late initiation of prenatal care after adjusting for other maternal factors. Association between categories of barriers to prenatal care and maternal category of residence were determined using the Cochran-Mantel-Haenszel test of association. Findings: We found no significant association between residence category and late initiation of prenatal care, or residence category and barriers to prenatal care initiation. Urban women tended to be over age 34 or nonwhite. Women from large rural areas were more likely to be younger than 18 years, unmarried, and have an unintended pregnancy. Women from small rural areas were more likely to use tobacco during pregnancy. Conclusions: Maternal residence category is not associated with late initiation of prenatal care or with barriers to initiation of prenatal care. Differences in maternal risk profiles by location suggest possible new foci for programs, such as tobacco education in small rural areas.
Descriptors: Prenatal Care, Place of Residence, Smoking, Females, Pregnancy, Rural Areas, Resource Allocation, Prenatal Influences, Health Behavior, Influences, Mothers, Social Influences, Barriers, Access to Health Care, Urban Areas, Rural Urban Differences, Age Differences, Racial Differences, Marital Status, At Risk Persons
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Authoring Institution: N/A
Identifiers - Location: Oregon
Grant or Contract Numbers: N/A