Abstract
The impact of in utero and early childhood experiences on health, well-being, literacy and competence has been well described by economists, governments, researchers and healthcare providers, and engagement of all women in appropriate prenatal care is a vehicle to improve the chances of optimal child development. Prenatal strategies that meet the needs of low-resource (young, single, of lower educational achievement and/or lower income) pregnant women have the potential to alter the trajectory for vulnerable mothers and children. This review examines factors that distinguish women with limited resources who are retained in prenatal care from those who are not retained. Services that acknowledge and address mental health and social well-being may result in greater retention in prenatal care and improved outcomes. Measuring the outcomes of an intervention among only those who are retained in the program leads to an overestimate of the benefit and potential complacency with regard to addressing the needs of our most complex and vulnerable women. It is imperative that we continue to develop strategies for those women who are at highest risk of not being retained in prenatal care to fulfill the aims of the United Nations Convention on the Rights of the Child.
Acknowledgements
Suzanne Tough would like to acknowledge the Alberta Heritage Foundation for Medical Research, which provides her salary support. We would like to thank the Calgary Children’s Initiative as well as the Physician Partnership Steering Committee and the Child and Women’s Health Portfolio of the Calgary Health Region for funding and endorsing the Community Perinatal Care Study. We also gratefully acknowledge the support and assistance of the Community Perinatal Care Study Team, the Conception to Five Working Group and the Advisory Council of the Calgary Children’s Initiative. The Community Perinatal Care study was made possible with the support of the Maternity Care Clinic, the Grace Maternal Child Clinic and the Low Risk Maternity Clinic (all of the Calgary Health Region). We would also like to acknowledge Monica Jack of the Calgary Health Region for her editorial assistance in the preparation of this manuscript.
Financial disclosure
The authors have no relevant financial interests related to this manuscript, including employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.