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Prenatal Care as a Gateway to Other Health Care: A Qualitative Study

  • Katherine Ehrenreich
    Correspondence
    Correspondence to: Katherine Ehrenreich, MSc, Advancing New Standards in Reproductive Health, University of California San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612. Phone: (510) 986-8935.
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
    Search for articles by this author
  • Katrina Kimport
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
    Search for articles by this author
Published:October 03, 2022DOI:https://doi.org/10.1016/j.whi.2022.08.006

      Abstract

      Introduction

      Populations with higher rates of being uninsured in the United States have inconsistent access to health care and struggle to find care that fits their needs. For many without access to regular health care, prenatal care can be an entry point for obtaining care related—and unrelated—to pregnancy. We aimed to understand people's lived experience of whether and how pregnancy status enables access to health care unrelated to pregnancy.

      Methods

      This is a secondary analysis of 18 in-depth interviews collected between June 2015 and May 2017 as part of the Multistate Abortion Prenatal Study. Participants were new obstetrics patients at prenatal clinics in southern Louisiana and Baltimore, Maryland. Interviews were qualitatively analyzed using iterative thematic techniques to identify themes related to experiences navigating health care services on entry to prenatal care.

      Main Findings

      Most participants were insured through Medicaid, and all participants had low incomes. Pregnancy status enabled access to health insurance for many participants. Prenatal care facilitated access to non–pregnancy-related health care that participants had otherwise been unable to obtain before their current pregnancies. However, entry into prenatal care did not mean all participants’ health needs were adequately addressed and some reported ongoing unmet medical needs.

      Conclusions

      Our findings point to pregnancy as a gateway to health care (and insurance) and, further, illustrate how prenatal care can serve as a gateway to other medical care. Participants’ experiences demonstrate how access to health care for women with low incomes can be dependent on pregnancy status, even for non–pregnancy-related health needs.
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      Biography

      Katherine Ehrenreich, MSc, is a Senior Project Manager at the Advancing New Standards in Reproductive Health (ANSIRH) program at the University of California, San Francisco. Her research interests focus on people's experiences accessing abortion services and new models to improve abortion access.

      Biography

      Katrina Kimport, PhD, is an Associate Professor in the Department of Obstetrics, Gynecology & Reproductive Sciences and a research sociologist in the Advancing New Standards in Reproductive Health (ANSIRH) program at the University of California, San Francisco. Her research focuses on gender, health, and reproduction.