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Constrained spaces of prenatal care: South Asian immigrant women in New York City

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Title: Constrained spaces of prenatal care: South Asian immigrant women in New York City
Author(s): Chakrabarti, Ranjana
Director of Research: McLafferty, Sara L.
Doctoral Committee Chair(s): McLafferty, Sara L.
Doctoral Committee Member(s): Wilson, David; Kalipeni, Ezekiel; Gille, Zsuzsa
Department / Program: Geography
Discipline: Geography
Degree Granting Institution: University of Illinois at Urbana-Champaign
Degree: Ph.D.
Genre: Dissertation
Subject(s): Place Health Everyday places Therapeutic landscapes Multiple scales New York City US South Asian Bengali immigrant women
Abstract: Abstract The aim of this research is to examine use of prenatal care by South Asian immigrant women in New York City, focusing not only on barriers to care but also women’s reliance on multi-scalar, place-based social networks and resources. Recently, public health analysts have raised concern about low utilization of prenatal care by South Asian women who are much less likely than US-born women to receive early and adequate prenatal care. I use a mix of quantitative and qualitative methods to examine spatial variation in use of prenatal care for South Asian women in New York City and to understand experiences of pregnancy care for a specific sub-group of South Asian immigrant women. In the quantitative section, GIS and statistical methods are employed to identify risk factors and areas where use of prenatal care is especially low. The qualitative section comprises in-depth interviews with women from Bangladesh and Bengali women from India to understand their formal as well as informal pregnancy care experiences. I seek to examine the social, cultural and geographical barriers these women face in gaining access to prenatal care and explore how women create and draw upon resources at different geographical scales to maintain health and well-being during pregnancy. Results from the quantitative section show that Bangladeshi and Pakistani women are at higher risk of receiving less than adequate prenatal care especially in specific areas such as in South Central Brooklyn. Education and employment emerges as significant risk factor for Pakistani and Bangladeshi women’s low use of prenatal care. Results from the qualitative section highlight South Asian women’s situatedness in local and transnational networks and the role of such networks in enabling women to use both formal and informal pregnancy care. Situated within the theoretical framework of a ‘new’ medical geography this research makes several contributions to the emerging body of work untying the linkages between health and place. Home emerged as important as a space for care as well as strenuous labor for pregnant South Asian women. Everyday places such as neighborhood parks, temples emerged as important spaces with physical as well as social therapeutic qualities. ‘Social therapeutic networks’, operating at multiple geographical scales were important in shaping women’s place-based experiences of pregnancy care. As these networks unfolded, places were recreated and/or transformed making them therapeutic and healthy places. Therapeutic qualities of informal conversations and of sights and sounds surfaced in women’s narratives, further enriching the notion of therapeutic landscapes. Identifications of everyday locales as therapeutic as well as use of social therapeutic networks differed based on differences in class, religion and country of origin. The research has several policy implications. Issues raised by the women, such as long waiting times and too many tests, need to be addressed. By highlighting within group diversity amongst South Asian women, this research emphasizes the need to fine-tune prenatal care policies to cater to the needs of diverse sub-groups of women masked under a broad label. By highlighting the importance of place in South Asian women’s use of pregnancy care, this research emphasizes the need to focus not only on barriers to care but also on women’s reliance on multi-scalar, place-based social networks and resources.
Issue Date: 2010-01-06
URI: http://hdl.handle.net/2142/14713
Rights Information: Copyright 2009 Ranjana Chakrabarti
Date Available in IDEALS: 2010-01-06
2012-01-07
Date Deposited: December 2
 

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