Examining the Role of Discrimination in Prenatal Care Utilization: A Systematic Review Using the Social-Ecological Model.
Abdul-Manaf Mutaru, Alexa Parra, Cynthia Nicole Lebron and 2 others
PMID 41241865WHAT IT FOUND
Across 11 U.S. studies, discrimination was linked to delayed, avoided, or less satisfactory prenatal care.
Language barriers and provider bias were common themes. These are observational links, not proof that changing care works.
Key findings
01Most included studies reported that women who felt discriminated against were less likely to use prenatal care.
02Negative patient-provider interactions interpreted as racial discrimination were linked to poorer prenatal care utilization.
03Language barriers were reported as a form of discrimination and were linked to fewer prenatal visits.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 11 studies were included, and most focused on non-Hispanic Black and Hispanic women in the United States. The search may not have been exhaustive. Because designs and outcome definitions varied, the authors could not combine results statistically. The Social-Ecological Model grouping relied on the authors' framing and may differ under another appraisal. No policy documents were analysed. The review included U.S. studies only, so it may not apply to other health systems. The included studies used observational designs, so the review does not test interventions. One study included non-Hispanic White participants but did not report minority groups separately.
The easy way to misread this
Do not read this as proof that discrimination caused missed prenatal visits or that cultural competence training improves outcomes. The review combined observational studies with different measures, and when other factors were accounted for some links became weak or uncertain.