Early Prenatal Care is the percentage of pregnant women who receive care within the first trimester of pregnancy and was revised in the 2010 Edition. Early prenatal care is derived directly from the birth certificate. In 2003, CDC’s National Center for Health Statistics (NCHS) introduced a revised live birth certificate, however implementation of the new certificate has not occurred across all 50 states. Because states are using different versions of the birth certificate, a state-to-state direct comparison of prenatal care measures cannot be made, and a national average cannot be calculated. Therefore, the prenatal care measure only compares one state to another state using the same birth certificate and their scores are calculated based upon their peer group. Early prenatal care is not adjusted for frequency of care, continuation of care, age or race. Ranks are based on the most recently available data from the National Center for Health Statistics, three years prior to the publication date. Prior to the 2010 Edition, a broader definition of prenatal care was used that included frequency and timeliness of prenatal care throughout the pregnancy. The 1990 through 2004 Editions of the report defined Prenatal Care using the Kessner Index and 2005 through 2009 Editions used the Kotelchuck (APCNU) index.

Prenatal care is a critical component of health care for pregnant women and a key step towards having a healthy pregnancy and baby. Early prenatal care is especially important because many important developments take place during the first trimester, screenings can identify babies or mothers at risk for complications and health care providers can educate and prepare mothers for pregnancy.  Women who receive prenatal care have consistently shown better outcomes than those who did not receive prenatal care[1]. Mothers who do not receive any prenatal care are three times more likely to deliver a low birth weight baby than mothers who received prenatal care, and infant mortality is five times higher[2].  Early prenatal care also allows health care providers to identify and address health conditions and behaviors that may reduce the likelihood of a healthy birth, such as smoking and drug and alcohol abuse.