1. PRAMS 2000Department of Human Services Office of Family Health Latina prenatal care PRAMS 2000 Suzanne Yusem, Research Analyst June 18, 2003

2. PRAMS 2000Department of Human Services Office of Family Health Overview of PRAMSOverview of PRAMS Prenatal, pregnancy, and postnatal access to care for the Hispanic womenPrenatal, pregnancy, and postnatal access to care for the Hispanic women Contents

3. PRAMS 2000Department of Human Services Office of Family Health Survey women 2-6 months after birthSurvey women 2-6 months after birth About 180 women/monthAbout 180 women/month Started by Oregon in 1998 - 3 cohortsStarted by Oregon in 1998 - 3 cohorts Integrated with CDC: 2002Integrated with CDC: 2002 PRAMS : Pregnancy Risk Assessment Monitoring System

4. PRAMS 2000Department of Human Services Office of Family Health In English and SpanishIn English and Spanish Stratified random sample of births every monthStratified random sample of births every month Oversampling for racial and ethnic minority (Hisp, Afr/Am, Am/In, Asian/PI)Oversampling for racial and ethnic minority (Hisp, Afr/Am, Am/In, Asian/PI) Methods

5. PRAMS 2000Department of Human Services Office of Family Health Methods: Response Rate By mother’s race/ethnicity Hispanics 83%Hispanics 83% Non-Hispanic African American 60%Non-Hispanic African American 60% Non-Hispanic American Indian 73%Non-Hispanic American Indian 73% Non-Hispanic Asian/PI 59%Non-Hispanic Asian/PI 59% Non-Hispanic White 80%Non-Hispanic White 80%

6. PRAMS 2000Department of Human Services Office of Family Health 45,786 births to Oregon residents45,786 births to Oregon residents Total births from Hispanic mothers: 7,397 (16.1%)Total births from Hispanic mothers: 7,397 (16.1%) Proportion of births from Hispanic mothers has doubled in less than 10 yearsProportion of births from Hispanic mothers has doubled in less than 10 years Vital Stats reports that in 2000…

7. PRAMS 2000Department of Human Services Office of Family Health 6,515 Hispanics mothers are represented6,515 Hispanics mothers are represented 80% of Hispanic mothers are foreign-born80% of Hispanic mothers are foreign-born Almost 93% of the foreign-born mothers were born in MexicoAlmost 93% of the foreign-born mothers were born in Mexico PRAMS

8. PRAMS 2000Department of Human Services Office of Family Health Analysis is based on Hispanic moms: 5,045 Mexican moms non-Hispanic moms: 36,755 whose baby is alive and with them

9. PRAMS 2000Department of Human Services Office of Family Health PRAMS: points of analysis Before pregnancyBefore pregnancy During pregnancyDuring pregnancy After baby’s birthAfter baby’s birth

10. PRAMS 2000Department of Human Services Office of Family Health Before pregnancy

11. PRAMS 2000Department of Human Services Office of Family Health Just before you got pregnant, did you have health insurance? PRAMS: Before pregnancy

12. PRAMS 2000Department of Human Services Office of Family Health Just before you got pregnant, did you have health ins. through OHP? PRAMS: Before pregnancy

13. PRAMS 2000Department of Human Services Office of Family Health Where were you/your partner getting BC? Check all that apply Where were you/your partner getting BC? Check all that apply PRAMS: Before pregnancy

14. PRAMS 2000Department of Human Services Office of Family Health Did you know there was free or low cost BC at HD and PP clinics? PRAMS: Before pregnancy

15. PRAMS 2000Department of Human Services Office of Family Health Have you ever read or heard about emergency BC? PRAMS: Before pregnancy

16. PRAMS 2000Department of Human Services Office of Family Health During pregnancy

17. PRAMS 2000Department of Human Services Office of Family Health At the time of your first pregnancy test, were you insured for PNC? PRAMS: During pregnancy

18. PRAMS 2000Department of Human Services Office of Family Health Did OHP pay for any portion of your prenatal care? PRAMS: During pregnancy

19. PRAMS 2000Department of Human Services Office of Family Health About how many weeks pregnant were you when you had your first visit for prenatal care? PRAMS: During pregnancy

20. PRAMS 2000Department of Human Services Office of Family Health Did you get prenatal care as early as you wanted? PRAMS: During pregnancy

21. PRAMS 2000Department of Human Services Office of Family Health Did any of these things keep you from getting PNC as early in your pregnancy as you wanted? Check all that apply. PRAMS: During pregnancy I couldn’t get an appt earlier in my pregnancy 23.6% 13.3%I couldn’t get an appt earlier in my pregnancy 23.6% 13.3% I didn’t have enough $ to pay for my PNC visits 8.4% 8.5%I didn’t have enough $ to pay for my PNC visits 8.4% 8.5% I didn’t have ins. to pay for my PNC visits 5.5% 13.0%I didn’t have ins. to pay for my PNC visits 5.5% 13.0% I didn’t know I was pregnant 9.2% 10.4%I didn’t know I was pregnant 9.2% 10.4% No, I got PNC as early as I wanted 48.9% 62.5%No, I got PNC as early as I wanted 48.9% 62.5% Hisp non-Hisp

22. PRAMS 2000Department of Human Services Office of Family Health Where did you go most of the time for your PNC visits? Check one. PRAMS: During pregnancy

23. PRAMS 2000Department of Human Services Office of Family Health Information received during prenatal care – check each item PRAMS: During pregnancy nutrition nutrition breastfeeding the baby breastfeeding the baby use of BC after delivery use of BC after delivery how smoking during pregnancy could affect the baby how smoking during pregnancy could affect the baby how secondhand smoke could affect your baby after birth how secondhand smoke could affect your baby after birth 70% or more of the Hispanic women recalled being told about…

24. PRAMS 2000Department of Human Services Office of Family Health Information received during prenatal care – continued how drinking alcohol could affect the baby how drinking alcohol could affect the baby how using illegal drugs could affect your baby how using illegal drugs could affect your baby doing genetic tests to screen for birth defects doing genetic tests to screen for birth defects getting tested for HIV and protecting themselves from contracting it getting tested for HIV and protecting themselves from contracting it use of seat belt during pregnancy use of seat belt during pregnancy

25. PRAMS 2000Department of Human Services Office of Family Health Only 30% recalled hearing about the importance of seeing a dentist during pregnancy Only 44% recalled hearing about domestic violence Information received during prenatal care – continued

26. PRAMS 2000Department of Human Services Office of Family Health If you were in WIC during this pregnancy, how many weeks/months pregnant were you when you had your first WIC visit? PRAMS: During pregnancy

27. PRAMS 2000Department of Human Services Office of Family Health Things that happened to you before or during your last pregnancy PRAMS: During pregnancy You got separated/divorced from partner 9.4% 9.3%You got separated/divorced from partner 9.4% 9.3% You moved to a new address 42.2% 42.1%You moved to a new address 42.2% 42.1% You were homeless 7.9% 2.0%You were homeless 7.9% 2.0% Your partner lost a job 19.9% 15.1%Your partner lost a job 19.9% 15.1% You lost your job even though you wanted 21.9% 10.2% to go on workingYou lost your job even though you wanted 21.9% 10.2% to go on working Hisp non-Hisp

28. PRAMS 2000Department of Human Services Office of Family Health Things that happened to you before or during your last pregnancy-- continued PRAMS: During pregnancy Your partner said he did not want you to 6.1% 7.4% get pregnantYour partner said he did not want you to 6.1% 7.4% get pregnant You had a lot of bills you couldn’t pay 31% 27.9%You had a lot of bills you couldn’t pay 31% 27.9% You were involved in a physical fight 4.4% 2.3%You were involved in a physical fight 4.4% 2.3% You or your partner went to jail 4.2% 3.1%You or your partner went to jail 4.2% 3.1% Hisp non-Hisp

29. PRAMS 2000Department of Human Services Office of Family Health Do you think you were treated differently by health care providers during prenatal care, labor or delivery because of your : PRAMS: During pregnancy race4.3%1.0% race4.3%1.0% culture4.8%1.3% culture4.8%1.3% ability to speak/ 11.9% 1.4% understand English ability to speak/ 11.9% 1.4% understand English insurance status 6.4% 6.8% insurance status 6.4% 6.8% Hisp non-Hisp Hisp non-Hisp

30. PRAMS 2000Department of Human Services Office of Family Health What type of insurance paid for your delivery? Check all that apply PRAMS: During labor and delivery

31. PRAMS 2000Department of Human Services Office of Family Health After baby’s birth

32. PRAMS 2000Department of Human Services Office of Family Health Where do you take your baby for routine well baby care? Check all. PRAMS: After baby’s birth

33. PRAMS 2000Department of Human Services Office of Family Health What is your insurance now? PRAMS: After baby’s birth

34. PRAMS 2000Department of Human Services Office of Family Health Are you or your partner using any kind of BC now? PRAMS: After baby’s birth

35. PRAMS 2000Department of Human Services Office of Family Health Where are you or your partner getting your BC method now? Check all PRAMS: After baby’s birth

36. PRAMS 2000Department of Human Services Office of Family Health Summary Hispanic women access health care services (birth control, prenatal care and baby routine care) at county Health Departments and Community Health Centers much more than non-Hispanic womenHispanic women access health care services (birth control, prenatal care and baby routine care) at county Health Departments and Community Health Centers much more than non-Hispanic women Hispanic women are covered for labor and delivery with OHP (via CAWEM) but do not have OHP for prenatal careHispanic women are covered for labor and delivery with OHP (via CAWEM) but do not have OHP for prenatal care

37. PRAMS 2000Department of Human Services Office of Family Health Summary -ctned Hispanic women do not know about emergency contraceptionHispanic women do not know about emergency contraception Hispanic women access WIC services much more than non- Hispanic women, and they do so more often after 19 weeksHispanic women access WIC services much more than non- Hispanic women, and they do so more often after 19 weeks