Journal of Obstetric, Gynecologic & Neonatal Nursing
Clinical ResearchBarriers to Prenatal Care for Homeless Pregnant Women
Section snippets
Literature Review
Homelessness has a profound effect on an individual’s ability to maintain health. Homeless individuals often are victims of environmental exposure, infestations, peripheral vascular disease, respiratory infections and tuberculosis, and mental illness (Hwang, 2001; Kushel, Vittinghoff, & Haas, 2001).
Because of unsafe environments and high-risk lifestyles, women who are homeless are at increased risk for sexually transmitted diseases, including HIV and hepatitis (Nyamathi, Flaskerud, Leake,
Methodology
This study used a descriptive survey design to identify perceived barriers to care among women who are currently pregnant and homeless, or who have delivered a child while homeless within the previous 6 months. Homelessness was defined as not having a stable place to live and included women living in established shelters, in improvised shelters, in the home of a stranger, on the streets or out of a car, and women who have lived in three or more places within the past year. Prenatal care was
Sample and Procedure
Following approval by the institutional review board, a convenience sample of homeless pregnant women was recruited through agencies serving homeless women. Completion of the questionnaire constituted consent to participate in the research. An initial telephone survey of all agencies in Northeast Florida providing shelter and/or services to the homeless revealed an estimated 183 homeless pregnant women in any given month. These agencies included homeless shelters, domestic violence shelters,
Instruments
Participants completed a demographic data form that included age, race, marital status, educational level, current working status, stability and safety of their current living arrangements, current and previous pregnancies, substance use and abuse, and information about prenatal care and plans for place of birth.
Perceived barriers to prenatal care were measured using Melnyk’s Barriers Scale (Melnyk, 2008)
Sample Demographics
The 47 participants ranged in age from 12 to 38 years (M = 24.96; SD = 6.14). Seven (14.9%) were younger than age 20. The majority (55.3%) were African American and single (66%; see Table 1). Thirty-nine (83.9%) had been pregnant at least once before (range = 1 to 10, M = 2.81, SD = 2.33), and 18 (38.3%) had children currently with them (range = 1 to 6). Twenty-seven (57.4%) had less than a high school education. Nine participants (19.1%) were working either full or part time, 11 (23.4%) were
Acknowledgments
Funding was provided by a research grant from the Northeast Florida Healthy Start Coalition. Dr. Ruth Robillard is acknowledged for her assistance in this research study.
References (48)
- et al.
Barriers to timely prenatal care among women with insurance: The importance of prepregnancy factors
Obstetrics & Gynecology
(2000) - et al.
Delayed entry into prenatal care: Effects of physical violence
Obstetrics & Gynecology
(1997) - et al.
Prenatal care for low‐income women enrolled in a managed‐care organization
Obstetrics & Gynecology
(1999) - et al.
Use of contraceptive methods among homeless women for protection against unwanted pregnancies and sexually transmitted diseases: Prior use and willingness to use in the future
Contraception
(2001) - et al.
Pregnancy among three national samples of runaway and homeless youth
Journal of Adolescent Health
(1998) Poverty and procreation among women. An anthropologic study with implications for health care providers
Journal of Nurse-Midwifery
(1998)- et al.
Recent evidence on the effectiveness of prenatal care
Ambulatory Pediatrics
(2001) - et al.
Interpersonal violence and the pregnant homeless woman
Journal of Obstetric, Gynecologic, and Neonatal Nursing
(1998) - et al.
The impact of prenatal care on neonatal deaths in the presence and absence of antenatal high‐risk conditions
American Journal of Obstetrics and Gynecology
(2002) - et al.
The impact of childhood foster care and other out of home placement in homeless women and their children
Child Abuse and Neglect
(1999)