| Sumario: | Background: Latina women are less likely to start prenatal care in the first trimester and to attend the recommended amount of prenatal visits compared to their non-Latina white counterparts. Objectives: This study aimed to assess challenges and facilitators to first-trimester prenatal care (FTPNC) and prenatal care utilization (PNCU) in a Midwestern urban area with a growing immigrant Latino community. Methods: This study used a mixed-method approach based on the Theoretical Domains Framework. Nine semi-structured interviews were conducted with healthcare professionals that worked in birth centers, clinics, or hospitals that provided prenatal care (PNC) services for Latina women. Eight focus groups and quantitative surveys were conducted with Latina women and their supporters in Kansas City metropolitan area. Results: FTPNC was challenged by women's immigrant status, lack of healthcare coverage due to immigrant status, and complexity of Medicaid application. PNCU was challenged by the cost of PNC when diagnosed with gestational diabetes, lack of healthcare coverage, PNC literacy, late access to gynecologists/obstetricians, inadequate interpretation services, transportation, and mental health distress. Meanwhile, FTPNC was facilitated by social support and connectedness. PNCU was facilitated by Spanish-proficient providers and interpreters, effective nonverbal communication and education techniques, and pregnancy prevention access and education. Conclusions for Practice: Results from this study highlight important targets to improve PNC for Latina women. Participants called for various types of support to address identified challenges, ranging from information on social media about PNC services to broader efforts such as building trust from the community toward PNC providers and making PNC services affordable for women with gestational diabetes. Significance: Minoritized communities have historically low FTPNC and PNCU. However, access and use of PNC may be affected and improved by specific communities' cultural, social, and patient-provider interactions within specific geographical areas. For a primarily immigrant Latino community living in a midwestern metropolitan area, FTPNC and PNCU were challenged by immigration status, lack of healthcare coverage, difficulty completing public healthcare coverage application, cost of PNC when diagnosed with gestational diabetes, PNC literacy, limited access to women's health providers, inadequate interpretation services, transportation, and mental health distress. However, social support, connectedness, appropriate interpretation services, bilingual providers, empathetic nonverbal communication, spoken communication strategies delivered at the provider's office, access to PNC, and pregnancy prevention education were considered facilitators to FTPNC and PNCU.
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