* 25.0% of the Mexican-American women, 22.1% of the African-American women, and 10.4% of the non-Hispanic white women reported receiving inadequate prenatal care;
* The Mexican-American women were more likely than the African-American women and the non-Hispanic white women to report perceived financial and service barriers to prenatal care;
* When race/ethnicity was included as a covariate, the African-American women and Mexican-American women were more likely than the non-Hispanic white women to receive inadequate and intermediate prenatal care;
* After controlling for sociodemographic, economic, and health variables, the African-American women were more likely than the non-Hispanic white women and Mexican-American women to receive intermediate or intensive prenatal care;
* Inadequate prenatal care was more common among teenagers, women with little education, women who were unmarried, high-parity women, women with low incomes, and women who relied on government insurance, such as Medicaid, to pay for delivery; and
* Receipt of public assistance and participation in WIC were both associated with an increased likelihood of receiving adequate prenatal care.
The authors conclude that although women's receipt of public assistance and participation in WIC generally reduces the likelihood that they will receive inadequate prenatal care, "it continues to appear that the United States is characterized by a health care system in which equal access is, at best, not guaranteed and, at worst, stratified along race/ethnic and socioeconomic dimensions."
Frisbie WP, Echevarria S, Hummer RA. 2001. Prenatal care utilization among non-Hispanic whites, African Americans, and Mexican Americans. Maternal and Child Health Journal 5(1):21-33.
Pregnant women might die more often from homicide than from any other cause, report researchers in the Journal of the American Medical Association. An editorial in the journal urges routine screening of all female patients for domestic violence. Investigators in Baltimore found 247 pregnancy-associated deaths in Maryland from 1993 to 1998, after combing through death certificate data, live birth and fetal death records and medical examiner records. The research revealed a "disturbing finding" -- more than one out of five deaths was caused by homicide. Heart disorders were the second leading cause, account- ing for 19 percent of deaths. To stop these largely preventable pregnancy-associated homicides, "health care professionals must be willing to undertake routine domestic violence screening and imple- ment sensitive interventions when appropriate," the editorial says. In the United States, homicide is a leading killer of young women, pregnant or not. In 1998, homicide was the second leading cause of death among women ages 15 to 24, according to the National Vital Statistics Report.
