Women’s Perceived Control of Their Birth Outcomes in the Central Pennsylvania Women’s Health Study: Implications for the Use of Preconception Care
Received 18 June 2007; received in revised form 7 August 2007 published online 22 October 2007.
Purpose
This study examines nonpregnant women’s beliefs about whether or not they can influence their future birth outcomes with respect to the baby’s health and factors associated with internal locus of control for birth outcomes. Perceived internal control of birth outcomes could be a predisposing factor for use of preconception care, which is recommended for all women of childbearing age by the Centers for Disease Control and Prevention. The overall hypothesis is that internal control of birth outcomes is a function of prior pregnancy experiences, current health status and stress levels, access to health care, and sociodemographics.
Methods
Data are from the Central Pennsylvania Women’s Health Study random digit dial telephone survey of 2,002 women ages 18–45; the analytic sample is 614 nonpregnant women with current reproductive capacity who reported that they are considering a future pregnancy. Internal control of birth outcomes is measured using 1) a 4-item Internal Control of Birth Outcomes Scale, 2) a single-item measure of Preconceptional Control, and 3) a score reflecting high internal control on both of these measures.
Findings
In multiple logistic regression analyses, internal control of birth outcomes is positively associated with older age (35–45 vs. 18–34 years), higher education (some college or more), marital status (currently married or living with a partner), and higher self-rated physical health status on the SF-12v2 (but not mental health status or psychosocial stress). Previous adverse pregnancy outcomes and current access to health care have no association with internal control for birth outcomes.
Conclusion
Variables associated with internal control of birth outcomes among women contemplating a future pregnancy are primarily sociodemographic and physical health related. Educational and social marketing efforts to increase women’s use of preconception care may be particularly important for women who are likely to have lower internal control, including younger, less educated, unmarried, and less healthy women.
aPennsylvania State University Collage of Medicine, Hershey, Pennsylvania
bPennsylvania State University, University Park, Pennsylvania
Correspondence to: Carol S. Weisman, PhD, Penn State College of Medicine, 600 Centerview Drive, Hershey, PA. Fax: 717-531-0839.
Funded, in part, under grant number 4100020719 with the Pennsylvania Department of Health. The Department specifically disclaims responsibility for any analyses, interpretations or conclusions.
1 Carol S. Weisman, PhD, is Professor of Public Health Sciences and Obstetrics & Gynecology, and Director of the Central Pennsylvania Center of Excellence for Research on Pregnancy Outcomes at the Penn State College of Medicine. Her research focuses on women’s health care and policy.
2 Marianne M. Hillemeier, PhD, MPH, is Assistant Professor of Health Policy and Administration and Demography at the Pennsylvania State University. Her research interests focus on maternal and child health and health disparities.
3 Gary A. Chase, PhD, is Professor of Public Health Sciences and Chief of the Division of Biostatistics at the Penn State College of Medicine. he has served as principle statistician on a number of projects related to public health and infant outcomes.
4 Dawn P. Misra, PhD, is Associate Professor of Health Behavior and Health Education at the University of Michigan School of Public Health. She is a perinatal epidemiologist with a principal interest in maternal and child health.
5 Cynthia H. Chuang, MD, is Assistant Professor of Medicine and Public Health Sciences at the Penn State College of Medicine. Her research focuses on reproductive health care for women with chronic medical conditions.
6 Roxanne Parrott, PhD, is Professor of Communication Arts & Sciences and Director of the Center for Health & Risk Communications at Pennsylvania State University. She is a health communication researcher with interest in women’s health.
7 Anne-Marie Dyer, MS, is a biostatistician in the Department of Public Health Sciences at the Penn State College of Medicine. Her interests include the analysis of categorical data in cross-sectional and longitudinal studies.
ABSTRACT