Adequate Prenatal Care

Adequate Prenatal Care in New York

New York

Early and regular prenatal care aims to help a woman have a healthy pregnancy and birth. Prenatal checkups can help expectant mothers avoid or treat pregnancy complications such as infections, gestational diabetes and preeclampsia. It also gives expectant mothers a chance to talk with health professionals about their questions and concerns. Infants who do not receive prenatal care are 3 times more likely to have low birthweight and 5 times more likely to die than those born to mothers who do get care. The risks imposed by missing prenatal care are not limited to infants — women who do not receive prenatal care are also 3-4 times more likely to die from pregnancy-related complications than those who do receive care.

The majority (77.7%) of births in the United States are to women receiving early prenatal care, but 1 in 16 infants in the U.S. is born to a woman receiving late or no prenatal care. Many factors contribute to whether and when a pregnant woman begins prenatal care. Late initiation of prenatal care may be due to lack of knowledge, lack of insurance coverage, negative perceptions of health care providers and ambivalence about pregnancy. American Indian/Alaska Native, Black and Hispanic women are at higher risk of late initiation of prenatal care than white women.

Early initiation of prenatal care can be encouraged by improving access to care — e.g., increasing insurance coverage and extending hours of operation at care facilities — and expanding patient education and outreach. Women should be educated in the importance of early prenatal care. Women also benefit from understanding the signs of pregnancy, and where to access affordable diagnostic testing to confirm pregnancy early in gestation. Reducing unwanted pregnancies is also an important way to improve maternal and child health, as these pregnancies are associated with prenatal behaviors that increase risk of poor pregnancy outcomes.

Healthy People 2030 has an objective to increase the proportion of pregnant women who receive early and adequate prenatal care. 

Bryant, Allison S., Ayaba Worjoloh, Aaron B. Caughey, and A. Euguene Washington. “Racial/Ethnic Disparities in Obstetrical Outcomes and Care: Prevalence and Determinants.” American Journal of Obstetrics & Gynecology 202, no. 4 (January 12, 2010): 335–43. https://dx.doi.org/10.1016%2Fj.ajog.2009.10.864.

Chang, Jeani, Laurie D. Elam-Evans, Cynthia J. Berg, Joy Herndon, Lisa Flowers, Kristi Seed, and Carla Syverson. “Pregnancy-Related Mortality Surveillance --- United States, 1991--1999.” MMWR. Surveillance Summaries 52, no. SS02 (February 21, 2003): 1–8.

Cheng, Diana, Eleanor B. Schwarz, Erika Douglas, and Isabelle Horon. “Unintended Pregnancy and Associated Maternal Preconception, Prenatal and Postpartum Behaviors.” Contraception 79, no. 3 (March 2009): 194–98. https://doi.org/10.1016/j.contraception.2008.09.009.

Daniels, Pamela, Godfrey Fuji Noe, and Robert Mayberry. “Barriers to Prenatal Care among Black Women of Low Socioeconomic Status.” American Journal of Health Behavior 30, no. 2 (April 2006): 188–98. https://doi.org/10.5555/ajhb.2006.30.2.188.

Novoa, Cristina. “Ensuring Healthy Births Through Prenatal Support: Innovations From Three Models.” Center for American Progress, January 31, 2020. https://www.americanprogress.org/issues/early-childhood/reports/2020/01/31/479930/ensuring-healthy-births-prenatal-support/.

Orr, Suezanne T., Sherman A. James, and Jerome P. Reiter. “Unintended Pregnancy and Prenatal Behaviors Among Urban, Black Women in Baltimore, Maryland: The Baltimore Preterm Birth Study.” Annals of Epidemiology 18, no. 7 (July 2008): 545–51. https://doi.org/10.1016/j.annepidem.2008.03.005.

Rosenberg, Deborah, Arden Handler, Kristin Rankin, Meagan Zimbeack, and E. Kathleen Adams. “Prenatal Care Initiation among Very Low-Income Women in the Aftermath of Welfare Reform: Does Pre-Pregnancy Medicaid Coverage Make a Difference?” Maternal and Child Health Journal 11, no. 1 (January 2007): 11–17. https://doi.org/10.1007/s10995-006-0077-z.

Shah, Jaimin S., F. Lee Revere, and Eugene C. Toy. “Improving Rates of Early Entry Prenatal Care in an Underserved Population.” Maternal and Child Health Journal 22, no. 12 (December 2018): 1738–42. https://doi.org/10.1007/s10995-018-2569-z.