Accessing prenatal and perinatal health care services: Experiences of first generation Latina immigrants in a rural west Tennessee county

Between 1990 and 2000, there was a substantial immigration of people of Latino heritage to the United States. Tennessee, with an increase in Latino residents of 278.2%, had the fourth largest percentage Latino population increase in the nation. Research findings show that people of Latino heritage experience difficulties accessing healthcare services. Furthermore, people of all ethnicities and races living in rural areas experience greater difficulty in accessing healthcare services than do people living in non-rural areas. The purpose of this research was to explore how first generation Latina immigrants in a rural West Tennessee county accessed prenatal and perinatal healthcare services and to discover the associated facilitators and barriers to healthcare services that they experienced in the process. This descriptive study incorporated a researcher-developed structured demographic questionnaire as well as a semi-structured interview guide to obtain participants' experiences of accessing prenatal and perinatal healthcare. In order to capture these experiences, as perceived by the participants, qualitative research methods were employed. Face-to-face interviews were conducted with 11 first generation Latina immigrants living in Crockett County who were either pregnant or who had given birth while living in Crockett County within the past year. To control for the effects of acculturation, participation was limited to those who have been living in the United States for less than five years. The process of taxonomic analysis was used to guide data analysis. Through this process, at least one or more of four factors were identified to encompass the collection of categories and themes for all taxonomies. The factors were Personal Factors, Interpersonal Factors, Institutional Factors, and Societal Factors. Each factor related to the source of an issue regarding the underlying causes of facilitators and barriers. These issues were Cultural Competency, Language, Transportation, Finance, Process, and Resource issues. Two additional groupings for health access barriers, Consequences of Language Barriers and Consequences of Transportation Barriers, were also recognized. Implications for nursing practice, nursing administration, and nursing education were identified and discussed. Finally, suggestions for further study were explored.