Data on approximately 45,000 North Carolina women who gave birth in 1989 and 1990 and received prenatal care in public health facilities were studied to assess the effects in a low-income population of prior family planning services on low birth weight and adequacy of prenatal care. Women who had used family planning services in the two years before conception were significantly more likely than those who had not used such services to have a birth-to-conception interval of greater than six months. They were also more likely to receive early and adequate prenatal care and to be involved in a food supplement program and maternity care coordination. In addition, the family planning participants were less likely than the nonparticipants to be younger than 18 and were somewhat less likely to deliver a low-birth-weight infant. Though the results of this retrospective study must be interpreted with caution because of such factors as self-selection into family planning programs, they suggest that family planning services may improve birth weight and use of prenatal health services among low-income women.
PIP: To determine the effects of prior use of family planning services on birth weight and adequacy of prenatal care, researchers compared data on 14,338 low-income women who gave birth in North Carolina during 1989-1990 and had earlier attended family planning services at public health clinics with data on 30,761 low-income women who also gave birth in 1989-1990 but did not use family planning services. Both groups of women basically matched in terms of education, Medicaid coverage, marital status, smoking history, medical risk factors, and previous incompleted pregnancy, or infant or child mortality. Most women who used family planning services were black (64% vs. 48.1%). 18-year old and younger women who used family planning services had fewer births than those who did not use family planning services (7.2% vs. 14.7% for whites and 9.6% vs. 19.7% for blacks; p .001). Further, women who used family planning services were more likely to participate in the food supplementation program referred to as WIC (89.9% vs. 86.6% for blacks and 87.9% vs. 81.7% for whites; p .001) and in the maternity care coordination program for Medicaid recipients (59.4% vs. 52.9% for blacks and 50.2% vs. 44.1% for whites; p .001). Moreover, they tended to receive earlier and more adequate prenatal care (51.6% receiving no are in 1st trimester vs. 58.3% receiving care in 1st trimester for blacks, and 40% vs. 47.1% for whites, and 51.6% vs. 58.3% for blacks and 40% vs. 47.1% for whites; p .001 respectively). They were also less likely to deliver a low birth weight (LBW) infant than those who did not use these services, but the difference was only significant for blacks (13.1% for no visits vs. 12.2% for any visit [p .05] and 11.6% for at least 3 visits [p .1]); for whites, 7.9% for no visits vs. 7.4% for any visit and at least 3 visits. Despite the possibility of self selection bias, these findings indicate that family planning services reduce the incidence of LBW and improve use of prenatal health services.