Copyright 2009 Ranjana Chakrabarti
CONSTRAINED SPACES OF PRENATAL CARE: SOUTH ASIAN IMMIGRANT WOMEN IN NEW YORK CITY
BY
RANJANA CHAKRABARTI
DISSERTATION
Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Geography in the Graduate College of the University of Illinois at Urbana-Champaign, 2009
Urbana, Illinois
Doctoral Committee:
Professor Sara McLafferty, Chair Professor David Wilson Associate Professor Ezekiel Kalipeni Associate Professor Zsuzsa Gille 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
ii 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 impo