Paper
Thursday, 20 July 2006
Association of Interpersonal Violence and Initiation of Prenatal Care in Mexico
Ana Quelopana, ANP1, Jane Dimmitt Champion, PhD2, and Bertha Salazar Gonzalez, PhD1. (1) Nursing, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico, (2) Department of Family Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| Learning Objective #1: Describe psychological factors, barriers and motivators of prenatal care associated with initiation of prenatal care among Mexican women. |
| Learning Objective #2: Describe the relationship of interpersonal violence and initiation of prenatal care for Mexican women. |
Introduction:
Pregnant woman in Mexico have relatively high mortality rates potentially related to inadequate prenatal care (PNC). Previous studies have reported sociodemographic and socioeconomic barriers for early initiation of PNC in Mexico including low socioeconomic and educational level, transportation problems and parity. There is scientific evidence that acknowledges severe risks of morbidity and mortality associated with pregnancy among abused women. Determination of factors effecting early initiation of PNC is necessary for development of self care interventions promoting early PNC.
Objectives:
Describe psychological factors, barriers and motivators of PNC associated with initiation of PNC among Mexican women.
Describe the relationship of interpersonal violence and initiation of PNC for Mexican women.
Methods:
A descriptive-correlational design was used to obtain a convenience sample (n=150) of pregnant Mexican women at a PNC facility (Universidad Autonoma de Nuevo Leon Hospital) in Monterrey, Mexico. Following informed consent, standardized interviews were administered concerning demographics, psychological factors, interpersonal violence, PNC barriers and motivators and social support.
Results: 49% of participants reported late PNC. Late initiation of PNC was associated (p<.05) with age, living with partner, motivators, psychological barriers, negative attitudes concerning pregnancy, personal and structural barriers, and history of interpersonal violence. Logistic regression indicated interpersonal violence, attitudes toward PNC and pregnancy, age and parity were significant predictors of late initiation of prenatal care. Abused women were more likely than nonabused to initiate late PNC, not live with partners, have previous pregnancy complications, less education, more alcohol use, lower self-concept, depression, stress and family and partner difficulties. More abused women had unplanned pregnancies and were considering abortion. They also reported more difficulty communicating with health providers and unaccompanied PNC visits.
Conclusions: A focus on preventative self care health services in Mexico through identification of motivators and barriers to early initiation of PNC including violence screening may improve perinatal outcomes
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