Maternal Characteristics and U.S. Prenatal Care: Associations with Neonatal Health and Postpartum Maternal Wellbeing

Prenatal care provides an opportunity for the promotion of healthy parent and neonatal outcomes, but there are gaps in understanding the consequences and antecedents of prenatal care experiences during pregnancy. The objective of the current study was to provide insight into the mediational processes of sociodemographic and pregnancy characteristics on neonatal health and postpartum maternal wellbeing outcomes through prenatal care experiences. Data were analyzed from the publicly available Listening to Mothers III dataset comprised of 2,400 online-survey participants (ages 18-45) who gave birth to singleton infants in hospitals between July 2011 and June 2012 in the U.S. Primary analyses were conducted using two separate path analysis models examining maternal characteristics (i.e., sociodemographic and pregnancy factors) and the mediation of prenatal care experiences (i.e., responsive provider behavior, week of first prenatal visit, and attendance in group prenatal care) on infant health (i.e., preterm, low birthweight, NICU stays) and postpartum maternal wellbeing (i.e., social support, depression, confidence). The perceived need for treatment of depression and smoking during pregnancy resulted in 0.15 and 0.20 larger proportions of infants admitted into the NICU, respectively. Women who reported responsive provider behavior indicated higher social support (b = 0.29, p <.001), less depressive symptomology (b = -0.20, p <.001), and felt more confident (b = 0.07, p =.005). While maternal characteristics were related to neonatal health, the interpersonal experiences during prenatal care related to postpartum maternal wellbeing, indicating a need for providers to bolster their responsiveness to women during prenatal visits.