Published Dec 31, 2004
This is something I think is interesting. I dont know about other areas, but here there are plenty of places for low income women to get prenatal care with no insurance. planned parenthood, and a clinic near the hospital where they not only take medicaid but help you apply for it while you are there so you dont even have to go to social services yourself.
I don't understand why people would choose not to go to a doctor while pregnant? Ignorance-they don't understand the importance? they don't think they can pay for it/don't know about medicaid? have a drug/alcohol/whatever problem they dont want a dr to know about?
do you see women coming in to deliver having had no prenatal care? or very late prenatal care?
I think you basically ran down the "why" list yourself.
It's too bad there isn't a portable ob/gyn bus that can get to those less fortunate and misinformed.
duh! that thought never occured to me-no transportation
Some are in denial "I'm not pregnant, only putting on weight", "it was my first time".
Sad to say, some are just plain irresponsible. We handed out milk vouchers, multi-vitamins, etc. to get them to come in for their check ups. Some you never saw again due to transient life styles. Others' wouldn't commit to further appointments, "I dont know if that day is good" and would change their appointments and never show...
Some its peer pressure "come on go to the mall with me, you'll have that kid forever"...
Take ur pick, the world isn't perfect.
We have a lot of illegals in CA. The state guarantees them medical care when pregnant, but they are still scared to go to the doctor. They also often have drug problems and don't want anyone to take their kids away.
If a woman really didn't want to be pregnant she has no reason to help keep the baby healthy. Plus if it interferes with her lifestyle or she fears judgements from healthcare providers she'd be less likely to go. Let's face it- someof these woman haven't had the best experiences with asking for help.
I think with immigrants there is more often then not a language and/or cultural barrier that isn't very well addressed. Living in a border town, I found it very hard to understand why women were reluctant to get prenatal care. There were MANY signs everywhere, in English and Spanish advertising free PNC. Some were ashamed to take it, some just were ignorant, some lacked transportation and had other children to deal with, and some did not have their husband's permission to go. Many were afraid of being deported, and some just did not think PNC was necessary. I've been told many times that "women have been having babies without PNC for centuries, why should I get it?"
Living away from the border, I do not see much help being offered. I haven't seen a single sign for free PNC since I've been here.
The reasons are numerous, and you've complied a pretty good list.
I think with immigrants there is more often then not a language and/or cultural barrier that isn't very well addressed.
i dont live in a border town, or even a border state, for that matter, but there is a large hispanic population in my town. in the clinic that helps ppl get medicaid, they have a spanish interpreter on staff.
i always thought that was great. i dont think they have one at the hospital though. when i was in my OB rotation,there were a few spanish speaking only moms.
Many of our "Moms", and I use that term loosely, do not get prenatal care because doctors tend to frown upon drug use during pregnancy.
lovingtheunloved, ASN, RN
Or, there's the very responsible young woman who works full time, is enrolled in college, is married, her husband works hard to support her, they have an unexpected pregnancy, do not have insurance, apply for assistance and are denied because they make too much. Never mind that the wife makes $6 and hour and the husband makes okay money but is paying off massive SCHOOL loans. She didn't get knocked up when she was 15 and neither one has a substance abuse problem, they're just trying to be upstanding members of society. Her father refinanced his house and gave her the money to pay for prenatal care. How many women are in the same situation and don't have a daddy to rescue them? She made good choices for herself so screw her. Apparently, the only people worthy of assistance are the ones who suck it out of my paycheck and have no intention of bettering themselves.
I think it all boils down to a lack of education. I see the moms-to-be at home as an emt when I am called to the scene. Most of them are african or hispanic immigrants (please, I am not trying to be stereotypical or predjudical). Most of the women I see don't even speak english. There is definitely a lack of health insurance, and I think they don't realize there are places out there that can provide assistance. Maybe even cultural aspects come into play. If ancestors from the past are able to have multiple babies without any help, then why can't they?
The unfortunate part is that it only gets worse once the baby is born. The knowledge just isn't there. I get numerous calls for the baby with a temperature...he is running a fever...okay what was the thermometer reading? What is that? I don't have one...well............it can go on and on.
Kinda off topic, but I just finished watching the movie "John Q" with Denzel Washington...his son needed a heart transplant and they didn't have enough insurance to cover him. Good movie. It really makes you think.
Marie_LPN, RN, LPN, RN
Quite a few at our facility have given the excuse that they can't afford it, yet they live right in town. We have FOUR places that are free clinics, that even have people that will come and pick people up, yet some say they can't afford it.
And it's EXTREMELY hard for me to not be judgemental about it (ok, i am, though) when someone says "i can't afford care", yet are wearing $200 sneakers, $550 leather coat, very thick gold chains, chatting on the latest style of cell phone, and complaining that they want to go out and smoke. I can't help it, that annoys me. Although it WOULD make sense, i mean if i'd bought all of that, i probably couldn't afford care afterwards either.
(This is why i don't work in Maternity or Peds. I saw way too many people with out-of-whack priorities when i was doing clinicals)
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