Prenatal services for adolescents: Institutional factors and personal experiences

This study was designed to investigate the range of prenatal services available to inner city pregnant adolescents, and to compare birth outcomes and perceptions of health care across groups of adolescents who received prenatal care at different types of service settings. Data were collected from 112 students at an alternative public high school for pregnant adolescents. Information on students' background demographic characteristics, psychosocial functioning, and social supports were obtained, along with the name of each participant's primary source of prenatal care, information about her experiences within that setting, and her general satisfaction with health care. After delivery, postnatal interviews were conducted and medical records were examined in order to assess infant birth weight, gestational age, and overall consistency of prenatal care use. Additional independent data were gathered from each of the nominated prenatal service settings, and six of the settings were selected to be visited by a researcher for a more in-depth description. Finally, study participants were grouped according to type of prenatal setting attended. Cross-group comparisons were conducted to examine differences in psychosocial functioning, attitudes toward health care, consistency of prenatal service use, and birth outcomes.The clinics the study participants nominated were divided into three groups: hospital-based clinics (clinics located within hospitals), comprehensive community-based clinics (clinics located outside of hospitals and having a relatively wide range of resources), and standard community-based clinics (clinics located outside of hospitals and having limited economic and human resources). The three groups of clinics were found to differ in the range of prenatal services they offered and in their appointment-making policies. Results from the observational component of the study indicated that the standard community-based clinics were less inviting physically and offered poorer quality services compared to the other two types.Participants who used the three types of clinics were not found to differ in their psychosocial functioning, satisfaction with health care or perceived barriers to service use. Participants who used standard community-based clinics were more likely to have been referred by their mothers than were participants in the other two groups, and they were less likely to have been offered services related to substance use at the initial prenatal visit. No group differences were detected in adequacy of prenatal service use, or in birth outcomes.U of I OnlyETDs are only available to UIUC Users without author permissio