Societal Factors in Pregnancy: Why Worry?Limited Access to Care and Home HealthcareTEMPLE, PATRICIA MD, MPH*; LUTENBACHER, MELANIE PhD, MSN, APRN†; VITALE, JOSIE BS‡Author Information *Department of Pediatrics †School of Nursing, Vanderbilt University Medical Center ‡Vanderbilt University Medical Center, Nashville, Tennessee Correspondence: Patricia Temple, MD, MPH, Vanderbilt Children's Hospital, 2200 Children's Way, 8232 Doctors' Office Tower, Nashville, TN. E-mail: [email protected] Clinical Obstetrics and Gynecology: June 2008 - Volume 51 - Issue 2 - p 371-384 doi: 10.1097/GRF.0b013e31816f2952 Buy Metrics Abstract Access to perinatal healthcare services for women living in poverty is complicated by many barriers and directly affects rates of premature births, low birthweight infants, and maternal and infant deaths. Health and social services delivered in the home can help improve pregnancy outcomes. Home visiting programs need sustainable funding and support from physicians and other healthcare providers. Ongoing research is needed to develop, refine, and evaluate systems of care that integrate home visiting components and different service delivery models that address pregnancies complicated by various psychosocial and medical complications. © 2008 Lippincott Williams & Wilkins, Inc.