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Cultural Differences In Prenatal Care

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Cultural Differences in Prenatal Care

A Comparison of White versus African American Prenatal Care

Ideally, a pregnancy is planned, and the appropriate pre-conception steps are taken to ensure a healthy pregnancy. But we all know that that is not always the case. So, we begin by asking ourselves, what is prenatal care? Standard prenatal care in an assumed, normal pregnancy basicly means seeing a health care provider once a month for the first 28 weeks; then every two to three weeks until 36 weeks; and then weekly until delivery, according to the guidelines of the American College of Obstetricians and Gynecologists. (Women's Health, 2005).

Soon after a positive pregnancy test, pregnant women should receive a physical, report their medical history and get routine prenatal tests, including blood tests, urinalysis, and more. The obstetrician or health care provider will then recommend avoiding alcohol, smoking and recreational drugs, he or she will also discuss the appropriate and healthy weight gain during pregnancy, eating well-balanced meals, exercise, and taking prenatal vitamins.

During pregnancy, women need a higher caloric intake, basically they should eat an extra 300 calories per day, but that doesn't mean doubling your food intake; the expectant mother should make sure she gets proper nutrition, including fruits and vegetables, whole grains, dairy products and protein. Much research has found that with White versus African American women, many African American women do not pursue proper prenatal care, but they should, as it is the first step to a healthy mom and baby. (Ebony, 2006)

"Of the annual 8 million infant deaths worldwide, 5 million occur in the neonatal period and most of these occur in the developing countries. Close to two-thirds of these neonatal deaths occur in the early neonatal period. Perinatal mortality, comprising of still births and early neonatal deaths is one of the sensitive indices of the quality of prenatal, obstetric and early neonatal care available to women and newborns." (Ogunlesi, 2006).

The major causes of early neonatal death are perinatal asphyxia, prematurity and severe infections like bacterial septicemia and tetanus, and these are directly or indirectly related to the quality of prenatal and delivery services available to pregnant women. (Ogunlesi, 2006)

The trouble with the deteriorating utilization of obstetric and neonatal services in consonance with the depressed national economy had previously been raised in Nigeria. This study was, therefore, carried out to assess the pattern of utilization of the prenatal and delivery services available in Ilesa - a semi urban Nigerian community in the 21st century. (Ogunlesi, 2006)

The conventional prenatal and maternity services are provided in Ilesa by the Wesley Guild Hospital and the Multipurpose Health Center, both of which are part of a tertiary health institution. There are twenty-eight local-government owned primary health centers and maternity centers that provide the primary health care, while the State Hospital, Ilesa provides the secondary health care. There are also many privately owned clinics and hospitals. They also have traditional Birth Homes, churches and unregistered health posts that also provide unorthodox services. (Ogunlesi, 2006)

By receiving early prenatal care, mothers can help to reduce the occurrence of perinatal illness, disability, and death; this allows for proper health care advice and identification and management of any chronic or pregnancy-related risks. In a study reported by Women's Health Magazine in 2005, the percentage of mothers receiving prenatal care in their first trimester of pregnancy increased slightly from 2002 to 2003, from 83.7 percent to 84.1 percent. Overall this figure has risen 11 percent since 1990, when only 75.8 percent of women received first trimester care. (Women's Health, 2005).

Even though there was a positive trend observed among most racial/ethnic groups, there are still inconsistencies among these groups in the probability of entering in to early prenatal care. In 2003, 89.0 percent of White women entered care in the first trimester, while, African American women were at 76.0 percent. Since 1990 the total number of women receiving late or no care has dropped from 6.1 to 3.5 percent although the rate of late or no care remains high among African American women at 6.0 percent. (Watcher, 2003).

African American women of all economic levels lose more babies and have more low-birth-weight babies than White women, experts say. African American women tend to also have more pregnancy complications and issues than other races. According to one study, African American women are actually three times more likely than White women to die during pregnancy and twice as many African American babies die in infancy. Researchers are now studying why pregnancy and infant health differ by race, despite widespread efforts to address this persistent problem. But most studies indicate that early prenatal care is a consistent key to a positive pregnancy. (Watcher, 2003).

"The single most important thing you can do to increase the chance that you will have a healthy baby is to get early and regular prenatal care" says prominent obstetrician/gynecologist Dr. Hilda Hutcherson in her book, Having Your Baby, A Guide for African American Women, written with Margaret Williams. (Ebony, 2006).

The proportion of women receiving adequate prenatal care rose for both groups from the early 1980's to the late 1990s: from 27% to 44% for African Americans and from 34% to 50% for whites. These increases represent a 64% improvement for African American women and a 50% improvement for white women, said Greg R. Alexander, Sc.D., of the University of Alabama, Birmingham, and his colleagues. (Alexander et al, 2002)

The researchers reviewed data from the National Center for Health Statistics natality files for 1981-1998. More than 60 million birth certificates were available for analysis over the study period (AJPH, 2002). In both groups, prenatal care was started earlier. The percentages of women beginning care in the first trimester increased from 61% to 73% for African American women and from 80% to 85% for white women. However, the racial disparity increased among young girls. The ratio of white to African American girls receiving adequate care rose from 1.07 in 1985-1987 to 1.13 in 1995-1997. "Greater emphasis on follow-up of African American teens once enrolled in care may be a promising avenue for stemming this trend," the researchers said. (Alexander et al, 2002).

In another study done on prenatal care from 1981-1998 and reported by the American Journal on Public Health, the obectives were to (1) examine trends



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