Utilization of prenatal care by women of St Thomas, United States Virgin Islands: A descriptive study

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Diane Horner - Committee Chair


Prenatal care is recognized as an intervention that reduces low birth weight (LBW), the greatest contributor to infant mortality. With Orem's Conceptual Model as the theoretical framework, this study described prenatal care utilization by women delivering at St. Thomas' community hospital. Data were collected (a) from hospital record books on a five-year retrospective population of 5,601 women who delivered between January 1990 through December 1994, and (b) from interviews with a one-month sample group of 42 women who delivered during July 1994. Descriptive statistics were compiled for interval data; mutually exclusive categories were formed for nominal data.In the five-year group, 5,359 (95.7%) women received prenatal care at some time during their pregnancy, while 242 (4.3%) women received no prenatal care. Women receiving prenatal care had a lower percentage of LBW newborns (9.6%) than did women receiving no prenatal care (14%). The average woman with no prenatal care was described as 24 to 26 years old with a parity greater than two. The average LBW newborn was described as 32 ½ it weeks gestation, from two to five pounds, and with Apgar scores of 5 or 6. By odds ratio, increased maternal age and decreased gestational age were significant for increased chance of LBW.In the one-month group, most of the women were Black; born on a Caribbean island other than St. Thomas; U.S. citizens; 25 ½ years old; unmarried; with a parity of 2 or less; high school graduates or better, and in unskilled employment. Fathers had the same education but were better employed. While 1 (2.4%) of the 42 women had no prenatal care, 22 (53.7%) began prenatal care the first trimester, and 23 (56.1%) had 10--12 prenatal visits. Three women who began prenatal care in the first trimester had LBW newborns (7.1%). Perceived barriers to prenatal care were placed into categories of patient, system, and financial as self-care deficits. Orem's nursing model was recommended as an alternative to the medical model for developing improved, comprehensive prenatal care with specific interventions to eliminate identified self-care deficits.


Black Studies; Anthropology, Cultural; Health Sciences, Obstetrics and Gynecology; Health Sciences, Nursing; Sociology, Demography

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