TY - JOUR

T1 - Determinants of prenatal health care utilisation by low-risk women

T2 - A prospective cohort study

AU - Feijen-de Jong, Esther I.

AU - Jansen, Danielle E. M. C.

AU - Baarveld, Frank

AU - Boerleider, Agatha W.

AU - Spelten, Evelien

AU - Schellevis, Francois

AU - Reijneveld, Sijmen A.

N1 - Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

PY - 2015/6

Y1 - 2015/6

N2 - Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women.Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands.Methods: We used longitudinal data from the population-based DELIVER study with 20 midwifery practices across the Netherlands in 2009 and 2010 as the experimental setting. The participants were 3070 pregnant women starting pregnancy care in primary midwifery care.Findings: We collected patient-reported data on potential determinants of prenatal care utilisation derived from the Andersen model. Prenatal health care utilisation was measured by a revised version of the Kotelchuck Index, which measures a combination of care entry and number of visits. Low-risk pregnant women (not referred during pregnancy) were more likely to use prenatal care inadequately if they intended to deliver at a hospital, if they did not use folic acid adequately periconceptionally, or if they were exposed to cigarette smoke during pregnancy. Among those who were referred to secondary care, women reporting a chronic illnesses or disabilities, and women who did not use folic acid periconceptionally were more likely to make inadequate use of prenatal care.Conclusion: Inadequate prenatal health care use in primary midwifery care is more likely in specific groups, and the risk groups differ when women are referred to secondary care. The findings suggest routes that can target interventions to women who are at risk of not adequately using prenatal prevention and care services. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.

AB - Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women.Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands.Methods: We used longitudinal data from the population-based DELIVER study with 20 midwifery practices across the Netherlands in 2009 and 2010 as the experimental setting. The participants were 3070 pregnant women starting pregnancy care in primary midwifery care.Findings: We collected patient-reported data on potential determinants of prenatal care utilisation derived from the Andersen model. Prenatal health care utilisation was measured by a revised version of the Kotelchuck Index, which measures a combination of care entry and number of visits. Low-risk pregnant women (not referred during pregnancy) were more likely to use prenatal care inadequately if they intended to deliver at a hospital, if they did not use folic acid adequately periconceptionally, or if they were exposed to cigarette smoke during pregnancy. Among those who were referred to secondary care, women reporting a chronic illnesses or disabilities, and women who did not use folic acid periconceptionally were more likely to make inadequate use of prenatal care.Conclusion: Inadequate prenatal health care use in primary midwifery care is more likely in specific groups, and the risk groups differ when women are referred to secondary care. The findings suggest routes that can target interventions to women who are at risk of not adequately using prenatal prevention and care services. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.

KW - Pregnancy

KW - Health care utilisation

KW - Public health

KW - Obstetrics

KW - Midwifery

KW - ANTENATAL CARE

KW - UNITED-STATES

KW - OUTCOMES

KW - NETHERLANDS

KW - PREGNANCY

KW - ASSOCIATION

KW - MIDWIFERY

KW - ADEQUACY

U2 - 10.1016/j.wombi.2015.01.005

DO - 10.1016/j.wombi.2015.01.005

M3 - Article

C2 - 25682444

VL - 28

SP - 87

EP - 94

JO - Women and Birth

JF - Women and Birth

SN - 1871-5192

IS - 2

ER -