The Purpose of this study is to explore African American women's perceived risks for Preterm Labor and Barriers to Healthcare as it relates to their decision to seek prenatal care.  Barriers are factors that prevent or otherwise inhibit participants from seeking prenatal care.  The perceived barrier construct of the Health Belief Model has consistently been identified as the variable which is most influential in determining health behaviors. 

Pretem birth continues to constitute a major clinical an public health challenge of the highest order, especially for the African American population.  Notably, in the United States overall, preterm birth rates increased from 8.9% in 1980 to 12.3% in 2003.  In African Americans specifically, the preterm birth rate was 17.8% in 2003 (March of Dimes, 2007).  System barriers, such as the lack of available providers, negative institutional practices, and poor patient-provider communication contribute to the deferment of prenatal care; and patients take on the assumption that their unborn babies willbe just "fine" without it.  Lack of education provided to pregnant women regarding signs and symptoms of preterm labor, as well as lack of empowerment to report these symptoms to their health care provider further contribute to the rise in preterm labor and birth rates. 

The partnership between providers (doctors and nurses) and patients cannot be overemphasized.  Although participation in prenatal care is only one factor in preventing negative outcomes, such as perterm birth, unless a woman enters the healthcare system, healthcare problems that may lead to preterm birth and/or other negative outcomes, may go unnoticed. 

The methodology for this study involves enlisting 20-25 pregnant African American women, aged 16-26, from varying socioeconomic and educational backgrounds, who currently receive prenatal care at a private, urban, OB/GYN office in the Southwest Atlanta, Georgia community.  Once the articipants are enlisted they will be grouped into 2 focus groups, "early initiators" of prenatal care (began prenatal care in 1st trimester) and "late initiators" (began prenatal care in 2nd or 3rd trimester).  There will be 2 opportunities for each group to meet, although the participants are only required to attend one session.  Meetings will last 1-1.5 hours each.  They will be made aware that their participation in this study is confidential, and they each will be asssigned a code number to maintain anonymity.  Each session will be audiotaped with the permission of the participants, keeping in mind that the audiotapes will be destroyed at the conclusion of the study.

Through these focus group discussions, the participants will have the opportunity to express their beliefs toward prenatal care and pregnancy, behavior in receiving health care services, social support, barriers toward receiving prenatal care, and experiences toward prenatal care.  They will also complete the Health Practices in Pregnancy Questionnaire (HPQ-II), which is a 34-item, self-report tool used to measure healh practices important to pregnancy outcomes.  Based on the findings of this study, recommendations will be made to assist the participants through the 5 Stages of Change process (a component of the Transtheoretical Model), in order to change some of their identified negative health practices/behaviors, in an effort to promote positive neonatal health outcomes in their unborn babies.