Barriers to accessing prenatal care in low income rural women

Abstract

Barriers exist to accessing prenatal care for low income women throughout the United States, such as scheduling appointments, finding childcare, and paying for prenatal care. Women who reside in rural areas experience barriers to accessing prenatal care unique to their geographical locations. Barriers to accessing prenatal care have been associated with less than optimal health outcomes for both women and infants. The purpose of this study was to explore the barriers to accessing prenatal care that are specific to low income rural women. A qualitative approach was used by conducting telephone interviews using open ended questions with low income women from one rural county in Montana. A sample of 6 women was recruited from the Women, Infants, and Children (WIC) nutritional supplement program in a rural county. Patterns were identified from the interview responses and categorized into themes that allowed for identifying common barriers. The results from this study revealed that low income rural women reported an overall lack of providers who offered prenatal care in their area. Difficulty with scheduling transportation to and from appointments was reported in half of the women, as well as distance to the nearest hospital for 2 of the women. These same 2 women also reported that if a complication arose during pregnancy or if a woman were to have a high risk pregnancy, distance to the nearest hospital or provider would be a barrier. There was difficulty recruiting a larger sample population, therefore the sample size of 6 women was a major limiting factor of this study. Implications for practice included a need for recruitment of providers in rural areas, and the potential use of nurse practitioners for providing high-quality, low cost prenatal care for low income rural women. The implementation of group prenatal care in rural locations and investing in rural communities were also implications for future practice. Lastly, the results from this study may help with future practice and research to help focus on the needs of this unique population for gaining improved access to prenatal care.