Latina prenatal care PRAMS 2000

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Latina prenatal care PRAMS 2000
June 18, 2003
Suzanne Yusem, Research Analyst
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Contents
Overview of PRAMS Prenatal, pregnancy, and post
natal access to care for the Hispanic women

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PRAMS Pregnancy Risk Assessment Monitoring
System
Survey women 2-6 months after birth
About 180 women/month Started by Oregon in 1998
- 3 cohorts
Integrated with CDC 2002
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Methods
In English and Spanish Stratified random sample o
f births every month Oversampling for racial and
ethnic minority (Hisp, Afr/Am, Am/In, Asian/PI)

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Methods Response Rate
By mothers race/ethnicity
Hispanics 83 Non-Hispanic African American
60 Non-Hispanic American Indian 73 Non-His
panic Asian/PI 59 Non-Hispanic White 80

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Vital Stats reports that in 2000
45,786 births to Oregon residents
Total births from Hispanic mothers 7,397
(16.1) Proportion of births from Hispanic mother
s has doubled in less than 10 years
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PRAMS
6,515 Hispanics mothers are represented
80 of Hispanic mothers are foreign-born
Almost 93 of the foreign-born mothers were born
in Mexico
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Analysis is based on Hispanic moms 5,045 Mexica
n moms non-Hispanic moms 36,755
whose baby is alive and with them
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PRAMS points of analysis
Before pregnancy During pregnancy After baby
s birth

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Before pregnancy
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PRAMS Before pregnancy
Just before you got pregnant, did you have health
insurance?

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PRAMS Before pregnancy
Just before you got pregnant, did you have health
ins. through OHP?

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PRAMS Before pregnancy
Where were you/your partner getting BC?
Check all that apply

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PRAMS Before pregnancy
Did you know there was free or low cost BC at HD
and PP clinics?

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PRAMS Before pregnancy
Have you ever read or heard about emergency BC?


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During pregnancy
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PRAMS During pregnancy
At the time of your first pregnancy test, were
you insured for PNC?

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PRAMS During pregnancy
Did OHP pay for any portion of your prenatal
care?

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PRAMS During pregnancy
About how many weeks pregnant were you when you
had your first visit for prenatal care?

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PRAMS During pregnancy
Did you get prenatal care as early as you
wanted?

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PRAMS During pregnancy
Did any of these things keep you from getting PNC
as early in your pregnancy as you wanted? Check
all that apply.

Hisp non-Hisp

I couldnt get an appt earlier in my pregnancy
23.6 13.3 I didnt have enough to pay fo
r my PNC visits 8.4 8.5
I didnt have ins. to pay for my PNC visits
5.5 13.0 I didnt know I was pregnan
t 9.2
10.4 No, I got PNC as early as I wanted
48.9 62.5
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PRAMS During pregnancy
Where did you go most of the time for your PNC
visits? Check one.

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PRAMS During pregnancy
Information received during prenatal care check
each item

70 or more of the Hispanic women recalled being
told about
nutrition breastfeeding the baby use of BC af
ter delivery how smoking during pregnan
cy could affect the baby how secondhand smoke co
uld affect your baby after birth
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Information received during prenatal care
continued

how drinking alcohol could affect the baby
how using illegal drugs could affect your baby
doing genetic tests to screen for birth d
efects getting tested for HIV and protecting the
mselves from
contracting it use of seat belt during pregnan
cy
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Information received during prenatal care
continued

Only 30 recalled hearing about the importance of
seeing a dentist during pregnancy

Only 44 recalled hearing about domestic
violence

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PRAMS During pregnancy
If you were in WIC during this pregnancy, how
many weeks/months pregnant were you when you had
your first WIC visit?

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PRAMS During pregnancy
Things that happened to you before or during your
last pregnancy

Hisp non-Hisp
You got separated/divorced from partner
9.4 9.3 You moved to a new address
42.2 42.1
You were homeless
7.9 2.0
Your partner lost a job
19.9 15.1
You lost your job even though you wanted
21.9 10.2 to go on working
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PRAMS During pregnancy
Things that happened to you before or during your
last pregnancy--continued

Hisp non-Hisp
Your partner said he did not want you to
6.1 7.4 get pregnant
You had a lot of bills you couldnt pay
31 27.9 You were involved in a p
hysical fight 4.4 2.3
You or your partner went to jail
4.2 3.1
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PRAMS During pregnancy
Do you think you were treated differently by
health care providers during prenatal care, labor
or delivery because of your
Hisp non-Hisp
race 4.3 1.0 culture 4.8 1.3
ability to speak/ 11.9
1.4 understand English
insurance status 6.4
6.8
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PRAMS During labor and delivery
What type of insurance paid for your delivery?
Check all that apply

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After babys birth
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PRAMS After babys birth
Where do you take your baby for routine well baby
care? Check all.
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PRAMS After babys birth
What is your insurance now?
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PRAMS After babys birth
Are you or your partner using any kind of BC now?
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PRAMS After babys birth
Where are you or your partner getting your BC
method now? Check all
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Summary
Hispanic women access health care services
(birth control, prenatal care and baby routine
care) at county Health Departments and Community
Health Centers much more than non-Hispanic women
Hispanic women are covered for labor and deliv
ery with OHP (via CAWEM) but do not have OHP for
prenatal care
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Summary -ctned
Hispanic women do not know about emergency
contraception Hispanic women access WIC service
s much more than non-Hispanic women, and they do
so more often after 19 weeks