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- Definition: Percentage of infants whose mothers received prenatal care in the first trimester of pregnancy, by race/ethnicity of mother (e.g., among California infants born to African American mothers in 2010, 78.2% had mothers who received prenatal care during their first trimester).Number of infants whose mothers received prenatal care in the first trimester of pregnancy, by race/ethnicity of mother.
- Data Source: California Department of Public Health, Center for Health Statistics, Vital Statistics Section, Birth Statistical Master Files.
- Footnote: The county-level data reflect the mother's county of residence, not the county in which the birth occurred. LNE (Low Number Event) refers to data that have been suppressed because there were fewer than 20 cases. N/A means that data are not available. For example, data for "Multiracial" women are not available prior to 2000. Use caution in comparing racial/ethnic groups before and after 2000, as the racial definitions changed that year. Data also exclude infants for whom prenatal care information is missing.
- Infant Mortality
- Low Birthweight and Preterm Births
- Prenatal Care
- Teen Births
- Why This Topic Is Important
High quality prenatal care greatly reduces the risk of infant mortality (1). Timely prenatal care, i.e. in the first trimester, is especially important, as it lowers the risk of other adverse birth outcomes, such as low birth weight, developmental delays, and premature birth (one of the leading causes of infant death nationwide) (2). Prenatal doctor visits also are important for the health of the mother. Through prenatal care, health professionals are able to identify and resolve potential medical problems and provide guidance and encouragement on good habits in general and for a healthy pregnancy.
Women whose pregnancies are unintended are more likely to delay prenatal care (3). Rates of unintended pregnancy are highest among young women ages 18-24, those living in poverty, those with less than a high school diploma, and African American/Black and Latina/Hispanic women (4). Reducing disparities in access to prenatal care and improving access to timely care for all women has been a U.S. public health priority for the past two decades. Healthy People 2020, an initiative of the U.S. Department of Health and Human Services that sets national public health goals, set an objective that by the year 2020, 77.9% of pregnant women would receive prenatal care beginning in the first trimester (5).
Find more information and research about prenatal care in kidsdata.org's Research & Links section.
Sources for this narrative:
1. U.S. Department of Health and Human Services, Office of Women’s Health. (2009). Prenatal care fact sheet. Retrieved from: http://www.womenshealth.gov/publications/our-publications/fact-sheet/prenatal-care.cfm
2. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity. (2011). Pediatric and Pregnancy Nutrition Surveillance System: PNSS health indicators. Retrieved from: http://www.cdc.gov/pednss/what_is/pnss_health_indicators.htm
3. Logan, C., Holcombe, E., Manlove, J., & Ryan, S. (2007). The consequences of unintended childbearing: A white paper. Washington: Child Trends, Inc.
4. U.S. Department of Health and Human Services. (2011). Healthy People 2020: Family planning. Retrieved from: http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13
5. U.S. Department of Health and Human Services. (2011). Healthy People 2020: Maternal infant and child health: Pregnancy and health behaviors goal MICH-10.1. Retrieved from: http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=26
- How Children Are Faring
In 2011, 83.5% of California infants were born to mothers who received prenatal care in the first trimester of pregnancy. This figure has held relatively steady in recent years, though it is down from a high of 87.3% in 2003. At the county level, the percentage of infants whose mothers receive timely prenatal care ranges widely, from 57.2% to 94.1% in 2011 among counties with available data. As in previous years, infants of white and Asian/Pacific Islander women had the highest percentages of timely prenatal care in 2010, the latest data available; infants of American Indian/Alaska Native women had the lowest.
- Policy Implications
Increasing the rates of infants whose mothers received timely prenatal care requires access to appropriate and affordable health care (1). It also requires pregnant women to understand the importance of the care and recognize that they are pregnant, as some women delay care when they do not realize or acknowledge that they are pregnant (1). In addition, expectant mothers without health insurance coverage at the start of their pregnancy are less likely to seek timely prenatal care than insured pregnant women (1, 2).
According to research and subject experts, policy options that could influence prenatal care include:
- Supporting health insurance coverage and early enrollment for low-income pregnant women and those who may become pregnant, particularly growing numbers of immigrant women (1)
- Recruiting and training clinicians who are linguistically proficient and culturally attuned to patients who are immigrants, limited-English-speaking, and women of color (3, 4)
- Increasing availability of home visiting programs (5), including leveraging federal funding available under health care reform
- Supporting targeted public education and group prenatal care for at-risk mothers; group care can combine assessment, health education, and social support (6)
For more policy ideas and research on this topic, see kidsdata.org’s Research & Links section, or visit the Kaiser Family Foundation, and the American Congress of Obstetricians and Gynecologists. Also see Policy Implications on kidsdata.org for Teen Births, Low Birthweight and Preterm Births, and Health Care.
Sources for this narrative:
1. Braverman, et al. (2003). Promoting access to prenatal care: Lessons from the California experience. Kaiser Family Foundation. Retrieved from: http://kff.org/womens-health-policy/report/promoting-access-to-prenatal-care-lessons-from/
2. Egerter, et al. (2002). Timing of insurance coverage and use of prenatal care among low-income women. American Journal of Public Health, 92(3), 423-427. Retrieved from: http://ajph.aphapublications.org/cgi/reprint/92/3/423
3. Egerter, et al. (2004). Disparities in maternal and infant health: Are we making progress? Lessons from California. University of California at San Francisco and the Henry J. Kaiser Family Foundation. Retrieved from: http://kff.org/womens-health-policy/issue-brief/disparities-in-maternal-and-infant-health-are/
4. National Committee for Quality Assurance. (2009). 2009 innovative practices in multicultural health care. Retrieved from: http://www.ncqa.org/Portals/0/HEDISQM/CLAS/CLAS_InnovPrac_09.pdf
5. Pew Center on the States. (2010). The case for home visiting. Retrieved from: http://www.pewstates.org/research/reports/the-case-for-home-visiting-85899373065
6. Fleischman, A. R. (2010). What happens when babies are born too early? March of Dimes Foundation, Testimony before the US House of Representatives: Prematurity and Infant Mortality. Retrieved from: http://www.modimes.org/advocacy/prevention_indepth.html
- Websites with Related Information
- Association of Maternal and Child Health Programs
- CityMatch, National Organization of Urban Maternal Child Health Leaders
- Maternal and Infant Health Research, Centers for Disease Control and Prevention
- Preconception and Pregnancy Knowledge Path, Maternal and Child Health Library at Georgetown University
- Prenatal Care & Pregnancy
- U.S. Department of Health and Human Services: Health Resources and Services Administration, Maternal and Child Health
- Key Reports
- Assessing the Role and Effectiveness of Prenatal Care: History, Challenges, and Directions for Future Research, Public Health Reports
- Closing the Black-White Gap in Birth Outcomes: A Life-Course Approach, Ethnicity and Disease
- Disparities in Maternal and Infant Health: Are We Making Progress? Lessons from California, Kaiser Family Foundation & University of California at San Francisco
- Does Managed Care Hurt Health? Evidence from Medicaid Mothers, Review of Economics and Statistics
- Healthy Start National Evaluation 2006: Evidence of Trends, Risk Factors, and Intervention Strategies, U.S. Department of Health and Human Services, Health Resources and Services Administration
- Preventing Low Birthweight: 25 Years, Prenatal Risk, and the Failure to Reinvent Prenatal Care, American Journal of Obstetrics and Gynecology
- Racial/Ethnic Disparities in Obstetrical Outcomes and Care: Prevelance and Determinants, American Journal of Obstetrics and Gynecology
- Recommendations to Improve Preconception Health and Health Care --- United States, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report
- County/Regional Reports
- San Diego County Report Card on Children & Families
- Solano County Children's Report Card, Children's Network
- Tulare County Children’s Report Card 2010, Children's Services Network