The Prenatal Runaround - Exel: Drexel University's Research Magazine
 
 

_PUBLIC HEALTH

The Prenatal Runaround
A hypothetical case study illustrates the challenges faced by low-income pregnant women in reaching places for prenatal care.

_Joan Bloch

Joan Bloch is an associate professor in the College of Nursing and Health Professions with a secondary appointment in the School of Public Health.

As a researcher and practicing nurse, Drexel’s Joan Bloch has access to a lot of data. And in that data is a shocking statistic — there is a stunning two-fold racial disparity in infant mortality in the city of Philadelphia. But, why?

“As a nurse, I try to make sense of what the data may mean based on my experiences caring for real pregnant women in Philadelphia,” says Bloch, who is an associate professor in the College of Nursing and Health Professions with a secondary appointment in the School of Public Health. Her research explores the challenges faced by low-income pregnant women who must rely on public transportation.

“I wanted to delve more deeply into what does travel really entail for women who have babies in communities that have a really high rate of preterm births,” says Bloch.

Bloch and her collaborators combined large-scale geographical map data with a hypothetical “case-vignette” of a low-income pregnant woman in a Philadelphia neighborhood with high preterm birth rates.

“The simulated case subject was vetted through an expert panel of prenatal care providers who said ‘she’ was a typical example of what they see in their patient population,” she says.

The mapping and case-vignette work produced some shocking numbers: This hypothetical mother-to-be would need to make 25 visits to different facilities to get prenatal care, traveling nearly 180 miles over more than 19 hours.

The blame shouldn’t necessarily be placed on the flaws of the city’s public transportation system, says Bloch. It’s the number of different facilities a pregnant woman must visit that compounds the problem.

“We have to create more efficiencies — every neighborhood needs a one-stop shop for moms as they take care of themselves, their babies and their children,” says Bloch. “We have to make it less difficult.”