{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T22:03:43Z","timestamp":1767823423735,"version":"3.49.0"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Research in Nursing &amp;amp; Health"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Timely and adequate prenatal care (PNC) is essential for optimizing maternal and infant health outcomes. However, persistent disparities in PNC utilization exist in the United States, particularly among ethnic\/racial minority populations. While discrimination has been recognized as a barrier, its multifaceted influence across social and structural contexts remains underexplored. This systematic review, guided by the Social\u2010Ecological Model, synthesizes evidence on how various forms of discrimination affect PNC utilization. We conducted comprehensive searches in PubMed, Web of Science, and CINAHL for peer\u2010reviewed studies published in the United States between 2010 and 2024. After screening 342 records, 11 studies met the inclusion criteria. Five studies employed qualitative methods, five used quantitative methods, and one utilized a mixed\u2010methods approach. Findings revealed that structural discrimination, such as language barriers and institutional policies, was associated with delayed or insufficient PNC utilization. Interpersonal dynamics, including negative patient\u2010provider interactions and implicit bias, discouraged engagement with care. Additionally, intrapersonal factors, like internalized discrimination, shaped perceptions of care quality and trust in healthcare systems. The review highlights how discrimination operates across multiple levels to influence PNC behaviors and outcomes. Addressing discrimination requires culturally responsive care models, provider training in cultural humility, and institutional reforms aimed at equity. Future research should explore protective factors, such as social support and resilience, that may buffer the negative effects of discrimination. Understanding these dynamics is crucial for developing interventions that promote equitable and effective PNC utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nur.70033","type":"journal-article","created":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T15:20:08Z","timestamp":1763306408000},"page":"60-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Examining the Role of Discrimination in Prenatal Care Utilization: A Systematic Review Using the Social\u2010Ecological Model"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2183-8913","authenticated-orcid":false,"given":"Abdul\u2010Manaf","family":"Mutaru","sequence":"first","affiliation":[{"name":"School of Nursing and Health Studies University of Miami Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexa","family":"Parra","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Studies University of Miami Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia Nicole","family":"Lebron","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Studies University of Miami Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wonsuk","family":"Yoo","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Studies University of Miami Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4040-366X","authenticated-orcid":false,"suffix":"Jr.","given":"Hudson P.","family":"Santos","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Studies University of Miami Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Guidelines for Perinatal Care","author":"American Academy of Pediatrics; The American College of Obstetricians and Gynecologists","year":"2017"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.12490"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-018-2490-5"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2632"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/00333549141291s206"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4159\/9780674028845"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nwh.2021.10.001"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-021-03281-6"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2015.183"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmcd.12076"},{"key":"e_1_2_10_12_1","volume-title":"Social Determinants of Health","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.4325"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0193945914533747"},{"issue":"3","key":"e_1_2_10_15_1","first-page":"112","article-title":"Women's Experiences With Prenatal Care: A Mixed\u2010Methods Study Exploring the Influence of the Social Determinants of Health","volume":"9","author":"D'Angelo K. 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