Prenatal care and pregnancy-related health beliefs among American Indians on Wind River Reservation, Wyoming

The purpose of this study was to elicit information from the American Indians and their health care providers on the Wind River Indian Reservation regarding their perceptions of pregnancy-related health beliefs. A second purpose was to examine the relationship between American Indian and health care provider perceptions about available prenatal care. Techniques based on ethnographic interviews and the Rapid Assessment Procedure (RAP) were used for semi-structured interviews along with participant observations. Analysis of the interviews and the participant observations revealed that the American Indian participants on the Wind River Indian Reservation had positive prenatal care and pregnancy-related beliefs that supported the utilization of prenatal care and a healthy lifestyle. The use of traditional medicine also was believed to support a healthy lifestyle. Prenatal care services identified on the reservation included a prenatal clinic, a county home health visitation program, a new program offering prenatal education and support by community members, and delivery services at two contract civilian hospitals near the reservation. Barriers to prenatal care in this community that were identified in this research included lack of cultural sensitivity by health care providers and one of the contract hospitals, transportation and access difficulties, concerns over continuity of care, issues of confidentiality, and a lack of awareness by the American Indian participants of the full range of services and education provided to the community.