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Prenatal care for the underserved is a national concern, with pregnancy rates as high as 22% in homeless women and 75% of these women reporting barriers to care during pregnancy. Inadequate prenatal care confers increased risk for gestational complications and unfavorable postnatal outcomes, including prematurity and low birth weight. Yet while many studies delineate the prevalence and health consequences of inconsistent prenatal care in the homeless population, few address healthcare barriers. To both fill this gap in the literature and design effective interventions increasing consistency of care, we explored prenatal care experiences of pregnant homeless women at Philadelphia’s primary intake shelter for women and children. Study participants were recruited from the Eliza Shirley House Shelter for Women for individual interviews, which were subsequently reviewed for thematic elements by all researchers on the study.

Five women have been interviewed so far, with data still being collected. Self-identified barriers to consistent prenatal care included limited financial and transportation resources. While women who had received prenatal care reported rewarding relationships with their prenatal care providers, many expressed unmet needs for education on healthy exercise and dietary habits for expecting and breastfeeding mothers. Women also demonstrated interest in support groups, parenting classes, and stress-management sessions as venues to share their stories with, and learn from, others. These insights inspired several initiatives at our medical student-run free clinic, as described in the Future Directions section.