Everyone deserves to have a healthy pregnancy free of anxiety and worry. However, many pregnant women worry about where their next meal will come from, how they will pay the rent, and if they will truly be able to provide for their unborn child. I have worked in the public health field for over 15 years with individuals and families who are at risk in our communities. They are our refugee and immigrant families, our teen parents, our working poor who tirelessly attempt to hold numerous jobs and balance life with children, more often than not, as single parents.
What I have found over the years is that the concerns of expectant women have remained constant. The individuals I have worked with want to have a safe pregnancy and a healthy baby; however, not everyone has the same opportunity. Often, they have not received education on the importance of prenatal care, or systematic barriers prevent them from getting the care and support they need.
Pregnancy and birth are the first of several definitive life events that shape health outcomes within the course of an individual’s lifetime. Health care does not impact one’s health as much as the social determinants of health, such as access to quality housing, healthy food, and financial resources. We can screen for these factors to identify women who may need greater support to promote whole-person care and to create the best foundation for their child's future.
Here are five areas where pregnant women living in poverty often need support to have a safe pregnancy and a healthy baby.
Imagine not being able to obtain health services when needed for you or your child. This lack of access to health care can have a detrimental impact on a person’s overall physical and mental well-being. Differences in access among populations is the main reason for disparities in health care. People need to have access to affordable, quality health care from providers and facilities that are close to where they live and accessible by transportation.
Prenatal care is especially critical to reducing the risk of pregnancy-related complications for mother and infant. In addition to access, a woman's perception of whether the care is useful and supportive affects the quality of prenatal services. Care must be culturally comprehensive and in a language the pregnant woman speaks.
Transportation is a significant barrier to whether a pregnant woman can make it to her prenatal appointments. Long distances to reach a provider, the high cost of transportation, and no transportation options are all challenges for pregnant woman when attempting to follow through with scheduled prenatal appointments. Women who miss appointments can easily be labeled as “non-compliant” with care, when the reality is that transportation access is a real barrier, especially for women living in poverty.
One of the biggest expenses a family can face is affordable, quality child care. The barrier to quality care can impact a woman’s ability to work, go to school, and access prenatal care. Unfortunately, if affordable, convenient child care is difficult to arrange, a pregnant mother may have to bring older children to a prenatal care appointment. For some, the burden of taking children may outweigh the perceived benefits of the prenatal visit.
Not being able to afford basic needs impacts a family’s ability to thrive. In particular, it can impact pregnant women several ways:
Social support during pregnancy is critical to helping alleviate stress and provide for maximum emotional wellness during this life changing time. While friends and family are important in providing this essential support, the community also has many resources to work with moms struggling to overcome possible obstacles. In the work I do, we partner as a public health community agency with OB/GYN providers to support that mom through a healthy pregnancy and beyond. Some of the most common concerns we work to address with pregnant women are relationship/family issues; refugee/immigration status and navigating a new country; lack of help with children; financial concerns and needing baby supplies; inability to make food resources last the entire month; and housing and transportation concerns.
Having an awareness of these barriers can help us as health and human service providers be more impactful in the work that we do with families. It starts by better assessing the needs of one’s family and working piece by piece to help reduce the barriers that are causing the stressors in the pregnancy. Partnering with pregnant woman and taking the time to provide a surveillance and screening tool to gain a better understanding of the challenges someone may be dealing with allow for better assessment and more useful referrals to community resources.