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Latina prenatal care PRAMS 2000

Latina prenatal care PRAMS 2000. June 18, 2003. Suzanne Yusem, Research Analyst. Contents. Overview of PRAMS Prenatal, pregnancy, and postnatal access to care for the Hispanic women. PRAMS : P regnancy R isk A ssessment M onitoring S ystem. Survey women 2-6 months after birth

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Latina prenatal care PRAMS 2000

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  1. Latina prenatal care PRAMS 2000 June 18, 2003 Suzanne Yusem, Research Analyst

  2. Contents • Overview of PRAMS • Prenatal, pregnancy, and postnatal access to care for the Hispanic women

  3. 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

  4. Methods • In English and Spanish • Stratified random sample of births every month • Oversampling for racial and ethnic minority (Hisp, Afr/Am, Am/In, Asian/PI)

  5. Methods: Response Rate By mother’s race/ethnicity • Hispanics 83% • Non-Hispanic African American 60% • Non-Hispanic American Indian 73% • Non-Hispanic Asian/PI 59% • Non-Hispanic White 80%

  6. 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 mothers has doubled in less than 10 years

  7. 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

  8. Analysis is based on Hispanic moms: 5,045 Mexican moms non-Hispanic moms: 36,755 whose baby is alive and with them

  9. PRAMS: points of analysis • Before pregnancy • During pregnancy • After baby’s birth

  10. Before pregnancy

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

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

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

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

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

  16. During pregnancy

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

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

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

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

  21. 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 couldn’t get an appt earlier in my pregnancy 23.6% 13.3% • I didn’t have enough $ to pay for my PNC visits 8.4% 8.5% • I didn’t have ins. to pay for my PNC visits 5.5% 13.0% • I didn’t know I was pregnant 9.2% 10.4% • No, I got PNC as early as I wanted 48.9% 62.5%

  22. PRAMS: During pregnancy Where did you go most of the time for your PNC visits? Check one.

  23. 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 after delivery • how smoking during pregnancy could affect the baby • how secondhand smoke could affect your baby after birth

  24. 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 defects • getting tested for HIV and protecting themselves from contracting it • use of seat belt during pregnancy

  25. 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

  26. 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?

  27. 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

  28. 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 couldn’t pay 31% 27.9% • You were involved in a physical fight 4.4% 2.3% • You or your partner went to jail 4.2% 3.1%

  29. 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%

  30. PRAMS: During labor and delivery What type of insurance paid for your delivery? Check all that apply

  31. After baby’s birth

  32. PRAMS: After baby’s birth Where do you take your baby for routine well baby care? Check all.

  33. PRAMS: After baby’s birth What is your insurance now?

  34. PRAMS: After baby’s birth Are you or your partner using any kind of BC now?

  35. PRAMS: After baby’s birth Where are you or your partner getting your BC method now? Check all

  36. 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 delivery with OHP (via CAWEM) but do not have OHP for prenatal care

  37. Summary -ctned • Hispanic women do not know about emergency contraception • Hispanic women access WIC services much more than non-Hispanic women, and they do so more often after 19 weeks

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