The Amish Prenatal, however, consider pregnancy and childbirth to be normal biological functions of the female body; because of their cultural beliefs, they will not seek prenatal care until the end of the pregnancy if no problems occur. Primiparous women, who give birth for the first time, generally seek prenatal care around four months of age, while multiparous women, those who have given birth multiple times, generally seek prenatal care during the third trimester. However, Amish women typically do not outright reject the use of modern medical technology and practices if they can help during pregnancy; they must determine which practices coincide with their cultural and spiritual belief system. Many Amish women will seek the advice and care of modern medical professionals, as well as family and friends, such as taking prenatal vitamins and herbal remedies (Campanella et all, 1993). Amish women tend to adhere to a “regular” diet of fresh fruits, vegetables and proteins. However, many women believe in the need to increase their consumption of dairy products, especially milk during pregnancy (Kulig et all, 2004). There are several barriers that dissuade many Amish women from receiving modern prenatal care due to their cultural and spiritual beliefs. . Cost can be a major factor when it comes to modern prenatal treatments, as many Amish families cannot afford it. Transportation is also an important factor when it comes to prenatal care. The vast majority of Amish transportation is the horse-drawn carriage. Perhaps the greatest barrier present is the cultural system of the Amish themselves. The Amish are humble and modest and, as such, loathe to reveal their nakedness, to the point that many women would not allow their physical appearance... middle of paper... their diet during pregnancy to cure all types of disorders. It is important to exclude any side effects, drug interactions or harms that may be associated during pregnancy.Five nursing diagnoses1. Ineffective pregnancy process R/T Inconsistent and lack of prenatal health visits AEB Insufficient transportation and most Amish women do not seek medical care until the second or third trimester.2. Risk of constipation R/T effects of prenatal iron supplements3. Risk of ineffective management of one's health R/T Health beliefs and cultural influences.4. Ineffective Health Maintenance R/T Insufficient Resources and Funding AEB Most Amish do not have health insurance and cannot afford health care.5. Decisional Conflict R/T Cultural, Religious, and Family Beliefs AEB The Amish generally do not believe in preventative medicine (prenatal testing and vaccinations).