{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:30:22Z","timestamp":1747186222780,"version":"3.40.5"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>A qualitative picture of the health care experiences prior to pregnancy can inform patient\u2010centered strategies to optimize preconception health. This study describes health care utilization and experiences and how health care costs were covered in the year prior to pregnancy in a population of primarily Hispanic women with low income.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pregnant participants were recruited from 5 Federally Qualified Health Center clinics. Semistructured interviews included questions about health care in the year prior to pregnancy. Transcripts were analyzed using a thematic approach that integrated deductive and inductive analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most participants self\u2010identified as Hispanic. Just under half were US citizens. All but one were Medicaid or Children's Health Insurance Program Perinatal coverage insurance during pregnancy and relied on a variety of strategies to cover prepregnancy health care costs. Almost all received health care during the year prior to pregnancy. Fewer than half reported an annual preventive visit. Health care needs that led to care\u2010seeking included a prior pregnancy, chronic depression, contraception, workplace injury, a persistent rash, screening and treatment for sexually transmitted infection, breast pain, stomach pain (leading to gallbladder removal), and kidney infection. The ways in which study participants covered the costs of health care ranged in terms of sources and complexity. Although some participants described stable health care coverage, most reported changes throughout the year as they pieced together various health care coverage programs and out\u2010of\u2010pocket payments. When participants did seek health care prior to their current pregnancy, most described the experience in positive terms and focused on health care provider communication quality. Respect of patient autonomy was highly valued.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Women with pregnancy\u2010related health care coverage accessed care for a wide range of health care needs prior to pregnancy. Health care providers may consider strategies to respectfully introduce preconception care into any visit by an individual who could become pregnant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.13510","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T17:22:50Z","timestamp":1686158570000},"page":"619-626","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health Care Use, Coverage, and Experiences During the Year Prior to Pregnancy in a Primarily Hispanic Population with Low Income: A Descriptive Qualitative Study"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0675-3030","authenticated-orcid":false,"given":"Eileen K.","family":"Nehme","sequence":"first","affiliation":[{"name":"Health Science Center The University of Texas at Tyler  Tyler Texas USA"},{"name":"School of Nursing The University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divya A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Health Science Center The University of Texas at Tyler  Tyler Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagoberto","family":"Cortez","sequence":"additional","affiliation":[{"name":"Department of Sociology The University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie M.","family":"Morse","sequence":"additional","affiliation":[{"name":"The LBJ School of Public Affairs The University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirkland","family":"Schuessler","sequence":"additional","affiliation":[{"name":"Health Science Center The University of Texas at Tyler  Tyler Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren E.","family":"Gulbas","sequence":"additional","affiliation":[{"name":"Steve Hicks School of Social Work The University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","first-page":"1","article-title":"Births: final data for 2019","volume":"70","author":"Martin JA","year":"2021","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30311-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.7322\/jhgd.v30.11064"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001319"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2010.01.029"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781529716665"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732317726761"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/104973201129119217"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1609406919868354"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732308325857"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468794104044430"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-199205000-00012"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/160940690600500107"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917733847"},{"key":"e_1_2_7_16_1","unstructured":"QSR International Pty Ltd. NVivo (Version 12). Accessed December 9 2022.https:\/\/www.qsrinternational.com\/nvivo\u2010qualitative\u2010data\u2010analysis\u2010software\/home"},{"key":"e_1_2_7_17_1","unstructured":"What is MAP and MAP Basic? Central Health website. Accessed December 9 2022.https:\/\/www.centralhealth.net\/map\/"},{"key":"e_1_2_7_18_1","unstructured":"Eligibility & Payment.Lone Star Circle of Care website. Accessed December 9 2022.https:\/\/lonestarcares.org\/patients\/financial\u2010billing\u2010information\/eligibility\u2010payment\/"},{"key":"e_1_2_7_19_1","unstructured":"Healthy Texas Women.Texas Health and Human Serviceswebsite. Accessed December 9 2022.https:\/\/www.healthytexaswomen.org\/healthcare\u2010programs\/healthy\u2010texas\u2010women"},{"key":"e_1_2_7_20_1","unstructured":"Well\u2010Woman Preventive Visits.American College of Obstericians and Gynecologists Women's Preventive Services Initiative. Accessed May 24 2023.https:\/\/www.womenspreventivehealth.org\/recommendations\/well-woman-preventive-visits\/"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-12-18"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2013.05.003"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.5455\/msm.2012.24.112-120"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/phn.12525"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.4796"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/19371918.2013.776416"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227845"}],"container-title":["Journal of Midwifery &amp; Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jmwh.13510","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T07:01:54Z","timestamp":1707289314000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jmwh.13510"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,7]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/jmwh.13510"],"URL":"https:\/\/doi.org\/10.1111\/jmwh.13510","archive":["Portico"],"relation":{},"ISSN":["1526-9523","1542-2011"],"issn-type":[{"type":"print","value":"1526-9523"},{"type":"electronic","value":"1542-2011"}],"subject":[],"published":{"date-parts":[[2023,6,7]]},"assertion":[{"value":"2023-06-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}