Women's reasons for not seeking prenatal care: racial and ethnic factors.

Our objective was to determine if there were differences in the reasons for not seeking early prenatal care among low-income black, Hispanic, and white women who had four or fewer prenatal care visits or care only in the third trimester, and who gave birth at Denver General Hospital in Colorado. Data were gathered from 606 women (48% Hispanic, 26% black, 26% white) after delivery, using a 188-item questionnaire and abstracted medical charts. The most important reasons for not seeking early prenatal care were attitudinal (47%), financial (26%), and structural and system problems (8.5%). Financial reasons were more important to white than to black or Hispanic women, and attitudinal reasons were more important to black and Hispanic than to white women. The analysis showed that education and marital status were sometimes confounding variables. Clear differences in reasons for not seeking prenatal care were reported by women of dissimilar racial and ethnic groups in this public hospital. Cultural variations in women's views should be taken into account in developing programs intended to improve prenatal care and pregnancy outcome in Denver.