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Table 1 Barriers and facilitators related to Use of Prenatal Care (PNC) and suggestions to improve use of PNC by inner-city women: perceptions of health care providers

From: Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers

Topic area Themes and subthemes
Barriers Caregiver qualities
• Too busy/lack of time
• Negative personality characteristics (e.g., rude, judgmental)
Health care system barriers
• Lack of public awareness of PNC services
• Shortage of health care providers who provide PNC
Personal barriers
• Logistical difficulties related to transportation and child care
• Financial problems
• PNC not viewed as a priority, no interest, not seen as important
• Previous negative experience with/distrust of health care system
• Personal pressures (e.g., addictions, intimate partner violence)
• Lack of social support
Program and service characteristics: Inaccessible and/or inconvenient
• Geographic distance
• Lengthy office wait
• Short visits; rushed appointments
• Inflexible or inconvenient hours
Facilitators Caregiver qualities
• Investing in relationship with client
• Making women feel respected and valued
• Effective communication skills
Caregiver approaches to provision of PNC
• Providing individualized, culturally sensitive care
• Sharing health information with women, answering questions
• Taking time with clients
• Helping women understand importance of PNC
Multidisciplinary approach to PNC
• Referring women to additional services or programs
• Using a team approach to meet women’s needs
Program and service characteristics
• Geographic proximity
• Flexible hours/scheduling
• Self-referral options for clients
• Appointment reminders and follow-up contact
• Expanding community-based clinics
• Assistance with transportation and child care
• Tangible rewards
Suggestions Make PNC more accessible and convenient
• Establish more community-based PNC clinics
• Ensure closer proximity of PNC
• Provide flexible hours/scheduling
• Create drop-in access to PNC
• Assist with transportation and child care
Motivate women to attend PNC
• Increase public awareness of PNC
• Provide client-focused care
• Explain rationale for PNC during visits
• Offer tangible rewards
Make PNC more responsive to complex needs
• Maintain or enhance Health Baby and Families First programs
• Offer PNC services specific for teens
• Provide substance abuse support for pregnant women
• Expand and promote midwifery services
• Establish “one-stop shops” within a multidisciplinary environment