Abuse and psychosocial stress as factors in high utilization of medical services during pregnancy

Tina Bloom, Mary Ann Curry, Laurel Durham

Research output: Contribution to journalArticlepeer-review

Abstract

High utilization of medical services during pregnancy has not been described as most studies have focused on women who receive inadequate or no prenatal care. This paper describes the characteristics and medical utilization data of 500 pregnant women enrolled in a prospective study. High utilizers (HU), who had a mean of 7.8 utilizations (SD = 3.2), were significantly more likely to be nonwhite, low income, and younger than low utilizers (LU) who had a mean of 0.99 utilizations (SD = 1.1). HU reported a 32% rate of recent abuse compared to 9% for LU. HU also reported significantly more stress, lower self-esteem, and more ambivalence about the pregnancy. Consistent with their higher utilization, they were more likely to be diagnosed with preterm labor, hyperemesis, and gestational diabetes. HU had a higher proportion of complaints of nausea, vomiting, diarrhea, and pain and more mental health diagnoses than LU. Overall, HU were a vulnerable group characterized by recent abuse, economic disadvantage, psychosocial stress, and mental health issues. Their high utilization of medical services may have been due in large part to unmet psychosocial needs.

Original languageEnglish (US)
Pages (from-to)849-866
Number of pages18
JournalIssues in mental health nursing
Volume28
Issue number8
DOIs
StatePublished - Aug 2007
Externally publishedYes

ASJC Scopus subject areas

  • Phychiatric Mental Health

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