US Prenatal Care Rates Increase Overall but Lag for Certain Groups

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Between 1989 and 1997 the proportion of US women receiving prenatal care (PNC) increased. According to a recent report issued by the Centers for Disease Control and Prevention (CDC), the percentage of women with either delayed PNC or no PNC declined from 25% to 18% during the 9-year period. (Delayed PNC is defined as obtaining PNC after the 12th week of gestation). An estimated 206,000 women receiving PNC during the period would not have received it if the 1989 rate had remained unchanged.

Despite the overall increase in the percentage of women receiving PNC, some groups of women remained less likely to use or have access to such care. Women least likely to receive PNC during this period included non-Hispanic blacks, Hispanics, women younger than age 20, women with less than a high-school education, and multiparous women. Although these women were less likely than other women to receive PNC, during the study period the proportion of women obtaining care increased within these groups.

An accompanying editorial note states, "In 1997, the percentages of non-Hispanic black women and Hispanic women with delayed or no PNC remained approximately two times that of white women, approximately the same as in 1989. Such continuing disparities in obtaining early PNC mirror the disparities in many reproductive health outcomes among non-Hispanic black and Hispanic women compared with non-Hispanic white women."

The most common reasons women gave for not seeking or receiving PNC included 1) failure to recognize pregnancy, 2) lack of money or insurance to pay for PNC, and 3) inability to get an appointment.

The CDC used data from birth certificates from all 50 states and the District of Columbia and data from the 1997 Pregnancy Risk Assessment Monitoring System (PRAMS) to generate these figures.

Entry into prenatal care--United States, 1989-1997. 2000. Morbidity and Mortality Weekly Report 49(18):393-398. http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4918a1.htm

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.