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Prenatal Care in Oregon and Washington: Policy and Utilization for Vulnerable Women

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https://ir.library.oregonstate.edu/concern/articles/fb494f15s

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  • BACKGROUND: In the prenatal period, women can have sustained contact with nurses and other clinicians, forming relationships that are likely to be health enhancing both for the woman and her unborn child. Yet first trimester care use in Oregon dropped noticeably over the past decade. In comparison with Washington State, Oregon has not shown substantial recovery. OBJECTIVE: To explore potential reasons for the declining prenatal trend in Oregon METHODS: We collated county level birth data from all Oregon and Washington counties from 2000-2010. A descriptive, observational, time-series regression analysis for both states assessed the influence of maternal determinants known to impact first trimester care utilization. RESULTS: In Oregon, two factors were significantly associated with declining first trimester care: Medicaid funding (P<.01) and maternal Hispanic ethnicity (P=.016). In Washington, there was no significant association between any assessed determinant and first trimester care. DISCUSSION: In Oregon, over the period of our study, women dependent on Medicaid and women of Hispanic origin were less likely to utilize first trimester care. A similar trend for these variables was not observed in Washington. At the time of our study, both states had different policy approaches which may explain some of the observable patterns. Amid current health care reforms and rising immigration, our findings suggest the need for strong advocacy for those less able to access or utilize care.
  • This is a non-final version of an article. The article is copyrighted by Wolters Kluwer Health, Inc., and published by Lippincott Williams & Wilkins. It can be found as published in final form at: http://journals.lww.com/nursingresearchonline/pages/default.aspx
  • Keywords: Ethnicity, Medicaid, First trimester, Prenatal care, Health disparity
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  • Docherty, A., & Johnston, A. L. (2015). Prenatal Care in Oregon and Washington: Policy and Utilization for Vulnerable Women. Nursing Research, 64(2), 117-127. doi:10.1097/NNR.0000000000000073
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  • 64
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  • 2
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