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Underserved Pregnant and Postpartum Women's Access and Use of Their Health Records

Guo, Yuqing, PhD, RN; Hildebrand, Janet, MSN, FNP-BC, RN; Rousseau, Julie, PhD, CNM, RN; Brown, Brandon, PhD, MPH; Pimentel, Pamela, RN; Olshansky, Ellen, PhD, RN, FAAN

MCN, The American Journal of Maternal/Child Nursing: May/June 2018 - Volume 43 - Issue 3 - p 164–170
doi: 10.1097/NMC.0000000000000432

Purpose: The purpose of this study was to examine knowledge of and experiences with use of their electronic health record (EHR) among mostly Hispanic women during pregnancy and postpartum.

Methods: Women who were in the MOMS Orange County prenatal or postpartum home visitation program completed surveys and participated in focus groups. Descriptive and content analyses were used.

Results: Twenty-six women participated. Nearly all women (24, 92.3%) knew what health records were and most (80.8%) felt that keeping their records would increase or greatly increase their confidence in caring for themselves and their families. Approximately one third reported already keeping a copy of their health records. Common barriers to accessing and understanding health records included healthcare providers' noncompliance with the Health Information Technology for Economic and Clinical Health Act, limited EHR adoption, unfriendly patient portals, complicated medical terminology, rushed appointments with healthcare providers, lack of Spanish interpreters, and lack of Spanish-speaking healthcare providers.

Clinical Implications: Programs are needed to educate and support women and providers in using health records to promote health literacy, pregnancy management, and patient–provider relationships in underserved populations.

Electronic health portals are becoming more common as part of pediatric and maternity care. In this study, access and use of health records among underserved pregnant and postpartum women is examined and suggestions for clinical practice recommendations based on findings are presented.

Yuqing Guo is an Assistant Professor, University of California, Irvine Sue & Bill Gross School of Nursing, Irvine, CA. The author can be reached via e-mail at

Janet Hildebrand is a PhD candidate, University of California, Irvine Sue & Bill Gross School of Nursing, Irvine, CA.

Julie Rousseau is an Associate Clinical Professor, University of California, Irvine Sue & Bill Gross School of Nursing, Irvine, CA.

Brandon Brown is an Assistant Professor, University of California, Riverside School of Medicine, Riverside, CA.

Pamela Pimentel is Chief Executive Officer, MOMS Orange County, Santa Ana, CA.

Ellen Olshansky is Professor and Chair, University of Southern California, Suzanne Dworak-Peck School of Social Work, Department of Nursing, Los Angeles, CA.

The authors declare no conflicts of interest.

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