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Advisor: Mona Sarfaty, MD, Family and Community Medicine, Thomas Jefferson University


In Philadelphia, where infant mortality ranks among the highest in the United States, prenatal care and postnatal care access are major issues for many women and expecting mothers. Although it is well known that prenatal care improves pregnancy outcomes, women report encountering barriers with local health care entities in their efforts to seek and receive prenatal and postnatal care, which may undermine the potential benefits. The purpose of this study was to: 1) gain an understanding of knowledge and attitudes of women of childbearing age regarding pregnancy and their own health, 2) identify strengths and facilitators of prenatal care and maternal healthcare in Philadelphia, and 3) identify barriers and weaknesses to prenatal care and maternal healthcare in Philadelphia. By understanding these factors, recommendations can be made that are informed by the views of the women who seek to access local health care. Twenty-five women participated in five focus group discussions that centered on their experiences during pregnancy and the postnatal period. The sessions were taped and transcribed. In the qualitative analysis process, at least two readers reached consensus on the meaning of each statement. Qualitative analysis revealed the following strengths and facilitators present in the community: breastfeeding classes, support from providers, support from family and friends, education, therapy, and social services. Analysis also identified the following weaknesses and barriers: lack of support from providers, lack of support from family and friends, difficulty or inability to access social services, and lack of education. Based on these results, the views of local clients of the prenatal care system should be considered in efforts to expand services to address the needs of this vulnerable population during pivotal childbearing and childrearing years.