Abstract
In each of the last 6 years, the number of infants born to women who failed to receive adequate prenatal care has increased. Instead of moving toward the Surgeon General's goal that by 1990, 90% of women would begin care in the first trimester, the trend is in the opposite direction. The percentage of women who received late or no prenatal care increased 26% for Blacks and 17% for Whites between 1980 and 1987 (National Commission to Prevent Infant Mortality, 1990). Because early and continuous prenatal care is strongly associated with better perinatal outcomes, including fewer low birth weight (LBW) infants (Institute of Medicine [IOM] Committee to Study the Prevention of Low Birthweight, 1985), it is crucial to understand the factors that prevent women from obtaining adequate prenatal care. This article describes the sociodemographic characteristics, personal barriers, and system barriers that have been found to prevent access to prenatal care. Understanding how these factors interact is essential to developing successful nursing interventions in order to increase the number of women who enter and remain in prenatal care.

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