Prenatal Care of Women in and out of the U.S.


Name: Joseph Schmelz

Rank: Lt Col, USAF

Organization: Henry M. Jackson Foundation

Performance Site: Kirk Army Health Clinic, Aberdeen Proving Ground, Aberdeen, MD; 52nd Medical Group, Bitburg and Spangdahlem, Germany U.S. Naval Hospital, Rota, Spain

Year Published: 1996

Abstract Status: Final


Poor neonatal outcomes create significant economic and readiness burdens for military health care systems. Early and comprehensive prenatal health care has been supported in studies in the civilian population as the most effective intervention in the prevention of infant mortality, low birth weight, and problematic development. However, limited research on prenatal care has been conducted on CONUS or OCONUS military women. Therefore, the purposes of this study were to: 1) determine the needs, availability, accessibility, use, and satisfaction with prenatal care services received by active duty and beneficiary military women inside the United States (CONUS) and outside the United States (OCONUS), 2) determine the birth outcomes of CONUS and OCONUS military women, 3) determine if military women's reported needs, availability, accessibility, use and satisfaction with prenatal care services and birth outcomes were significantly different for CONUS versus OCONUS military women. This study employed methodological triangulation using a comparative descriptive design to examine and describe group differences in variables. The sample consisted of 238 (107 CONUS versus 131 OCONUS) active duty and beneficiary Army, Navy, and Air Force women who received prenatal care and gave birth while assigned to one of six military sites in Europe or the East Coast of the United States. For each group descriptive statistics were used to summarize and analyze demographic data as well as the various aspects of prenatal care. Comparisons between the two groups of mothers for each of the prenatal care variables were analyzed using the Chi-Square test for nominal level variables and the t-test for continuous level variables. Content analysis was used to analyze qualitative data obtained through individual interviews of a subset of military women. No significant differences were found in birth outcomes. staff and facilities. Significant differences were found in the availability of several types of prenatal information/counseling, and food supplemental programs; in several barriers to prenatal care; in availability of clinic supplies/equipment; and in mothers' knowledge of availability and how to access to health care at the site.


Final report is available on NTRL: