Child Care as a Barrier to Perinatal Health Care in Illinois

PurposeWithin a multi-state Collaborative Improvement and Innovation Network addressing the social determinants of health during 2017-2020, the Illinois Department of Public Health led an exploratory project to understand how the availability of child care affects maternal health care utilization. The project assessed whether lack of child care was a barrier to perinatal health care utilization and gathered information on health facility practices, resources, and policies related to child careDescriptionTWe surveyed (1) birthing hospitals (n = 98), (2) federally qualified health centers (FQHCs) (n = 40), and (3) a convenience sample of postpartum persons (n = 60).AssessmentEach group reported that child care concerns negatively affect health care utilization (66% of birthing hospitals, 50% of FQHCs, and 32% of postpartum persons). Among postpartum persons, the most common reported reason for missing a visit due to child care issues was "not feeling comfortable leaving my child(ren) in the care of others" (22%). The most common child care resource reported by facilities was "staff watching children" (53% of birthing hospitals, 75% of FQHCs); however, most did not have formal child care policies or dedicated space for children. Fewer than half of FQHCs (43%) discussed child care at the first prenatal visit.ConclusionThe project prompted the Illinois Title V program to add a child care-related strategy to their 2021-2025 Action Plan, providing opportunity for further examination of practices and policies that could be implemented to reduce child care barriers to perinatal care. Systematically addressing child care in health care settings may improve health care utilization among birthing/postpartum persons. What is already known on this subject? Child care is a social determinant of health affecting parents' ability to seek medical services. Research has shown that child care is an important factor affecting health care utilization during the perinatal period (prenatal, labor and delivery, and postpartum).What this study adds? The results of this project indicate that lack of child care is a barrier to health care utilization for some Illinois residents who are pregnant or up to one year postpartum. However, child care resources reported by health care facilities were limited and most facilities reported not having formal child care policies in place.