Heaman - healthcare system barriers

So then moving on to barriers that are related to the healthcare system; not knowing where to go to get prenatal care was a barrier; not valuing the importance of prenatal care, they didn’t think they needed it, they thought they could get advice from their family and friends or they would go to the obstetrical triage unit at the hospital when they had a problem instead of booking in to go for regular prenatal care; so all of these were factors.  In terms of prenatal care visits themselves, sometimes there were barriers and problems with scheduling appointments; inflexible hours at the clinics, they’re mainly open Monday to Friday, not available on weekends and evenings.  And for the working poor, sometimes it’s hard to get away from work to get in for your appointment.  When they did go for appointments, they ended up waiting in the waiting room too long and then having a short visit, for some women, depending on where they were receiving their care; so all of these were things that would kind of make them think twice about going for their visits. Other factors related to service characteristics would be rude or judgmental or rushed care providers were identified. And one additional factor was a lack of prenatal care providers.  Sometimes it’s hard to find a provider.  Many women don’t have a regular family physician so they didn’t always know where to go for care.  Some women do like getting care from the midwives which have been regulated in Manitoba since 2000 but there is a shortage of midwives so it’s hard to get in to the midwives so that’s one additional factor.