Grant: Operating Grant: Maternal and Child Health

Prenatal care is an important health service that has the potential to improve the health of pregnant women and result in better pregnancy outcomes. However, not all women receive an optimal level of prenatal care. We plan to conduct a population-based study of all births in the province of Manitoba from 2003 to 2008 to examine patterns of prenatal care use throughout the province (e.g., timing of initiation of care, number of prenatal visits, type of provider), to identify how these patterns differ by socioeconomic status and geographic region, and to determine factors influencing use of prenatal care (e.g., maternal age, education, marital status, depression, receiving social assistance). For each birth, the mother's prenatal care will be categorized as "no care", "inadequate care", "intermediate care", "adequate care", or "intensive care." We will then study the relationship between the various categories of prenatal care and health status measures (e.g., illness of the mother or baby, death of the baby, premature birth, low birth weight), mother's health behaviors (e.g., smoking, breastfeeding), and health care use (e.g., use of well baby care, completeness of infant immunizations). The relationship between the type of health care provider (e.g., midwife, obstetrican, family practice doctor) and outcomes will also be studied. This study will involve analysis of existing data files available in the Population Health Research Data Repository at the Manitoba Centre for Health Policy (MCHP). Strict security measures are in place within MCHP to protect the confidentiality of the data files, and the data files do not contain identifiable personal information. The results will provide important information about disparities in access to and use of prenatal care, and how use of prenatal care is related to pregnancy outcomes. These findings will provide vital information for health care decision makers to assist them with future service planning.