Medicaid, motherhood, and the challenges of having a healthy pregnancy amidst changing social networks.

BACKGROUND: African American women with low income face various challenges to having a healthy pregnancy. Unplanned pregnancies often amplify those challenges and negatively impact women's ability to get the care that she needs. Research has shown that social networks can improve pregnancy outcomes by helping women cope with and address the problems that they face. However, there is little research on how unintended pregnancy impacts the medical and social support that African American women receive. AIM: This research explored how unintended pregnancies impact women's social networks and the type of support that they need throughout the pregnancy. DESIGN AND SAMPLE: This ethnographic study included 20 African American women who used pregnancy services at a health department in the United States. Fourteen women were enrolled in the study during their first or second trimester and were interviewed upon enrollment, in their third trimester, and within one month of giving birth. An additional six women were enrolled and interviewed within one month of giving birth.
RESULTS: African American women's needs and social support networks change throughout their pregnancy. When medical providers primarily offer pregnancy information and referrals to social service agencies during the first trimester, problems that women have later in the pregnancy are not properly addressed.
CONCLUSION: Social support needs to be accessed at multiple times during the pregnancy. Pregnancy resources should be provided throughout the pregnancy, recognizing that social support and personal struggles evolve during the pregnancy.