Norplant selection and satisfaction among low-income women

OBJECTIVES

This study examined correlates of Norplant selection and satisfaction among low-income women.

METHODS

Interviews were completed in family planning clinics in 4 Florida counties with 1152 Norplant users and 1268 nonusers, with follow-up interviews with a subsample up to 1 year later. Logistic regression models estimated the associations of socio-demographic and medical characteristics with Norplant selection and method satisfaction.

RESULTS

Odds ratios for Norplant selection were significantly greater among women who planned to have children in 5 or more years, those who were "offered" Norplant, those who lived in Palm Beach County, those who were using drugs, and those who were Medicaid clients. Women younger than 17 and those who learned about Norplant from a friend were twice as likely as others to select Norplant. Ninety-two percent of Norplant users were satisfied with the method; women with side effects and those who felt pressure to select a method were significantly less likely than others to be satisfied.

CONCLUSIONS

Norplant provides an acceptable and satisfying method of birth control for many low-income women. Proper counseling about all methods of birth control and about Norplant's side effects remains critical to the appropriate delivery of this method.

Prenatal care use in nonmetropolitan and metropolitan America: racial/ethnic differences

Pregnant women in nonmetropolitan communities are believed to use prenatal care services at lower rates than are metropolitan residents due to higher levels of poverty, lower levels of insurance coverage, and declining numbers of local hospitals and physicians. Yet scarce data exist on actual patterns of prenatal care use in nonmetropolitan areas. This study provides national estimates of prenatal care use among African American, White, and Hispanic women who delivered in 1988 in non-metropolitan and metropolitan areas of the United States. This study finds that nonmetropolitan residents are no more likely than metropolitan residents to go without care, to enter care late, or to make fewer visits. Nonmetropolitan residents are more likely to receive "inadequate" prenatal care as measured by the Kotelchuck Adequacy of Prenatal Care Utilization Index, with Hispanic residents having the highest rates of inadequate care. These findings are consistent with recent state-level reports, and they suggest the need to target prenatal care policies for populations in greatest need.