Using incentives to increase participation in prenatal care.

Objective: To test the effectiveness of offering two kinds of incentives to encourage low-income women's participation in prenatal and postpartum care.

Methods: Two hundred five Medicaid-eligible women enrolled in a prenatal clinic were randomly assigned to receive a $5.00 gift certificate (N = 51) or a gift certificate and a chance to win a $100 raffle (N = 53) for each prenatal appointment they kept. Controls (N = 101) and the two experimental groups were interviewed postpartum about their satisfaction with prenatal care. Women in the three groups were compared for the number of prenatal and the postpartum appointments, satisfaction with care, length of gestation, and birth weight.

Results: Thirty-nine percent missed one to seven prenatal appointments, and 45% missed the postpartum appointment. There were no significant differences among the three groups in any of the outcome variables. Women missed appointments because of the lack of transportation, poor weather, and illness.

Conclusions: Providing incentives does not overcome barriers to receiving prenatal care.