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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/Black mothers in 2012, 78.7% 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 Dept. of Public Health, Center for Health Statistics, Birth Statistical Master Files (Mar. 2014).
- 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 infants whose mothers received prenatal care in a given racial/ethnic group. Data exclude infants for whom prenatal care information is missing. 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.
- Measures of Prenatal Care on Kidsdata.org
Prenatal care refers to health care during pregnancy. Timely prenatal care is measured by the number or percentage of infants born to mothers who received prenatal care in the first trimester (1-3 months). This information also is presented by the race/ethnicity of the mother, as a percentage and number. Early prenatal care increases the likelihood of a healthy pregnancy and birth.
- Prenatal Care
- Infant Mortality
- Low Birthweight and Preterm Births
- 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://womenshealth.gov/publications/our-publications/fact-sheet/prenatal-care.pdf
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 2012, 84% 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% in 2003. At the county level, the percentage of infants whose mothers receive timely prenatal care ranges widely, from 52% to 94% in 2012 among counties with available data. As in previous years, infants of white (88%) and Asian/Pacific Islander women (87%) had the highest percentages of timely prenatal care in 2012; infants of American Indian/Alaska Native women (69%) had the lowest.
- Policy Implications
Ensuring that all pregnant women receive timely prenatal care requires that women understand the benefits of prenatal care, have access to affordable care, and feel comfortable during the process (1, 3). The Affordable Care Act offers new provisions supporting pregnant mothers, such as requiring that all state-based plans include maternity care in their coverage, and funding new home-visiting programs and other support services (2). However, improving access to prenatal care for all women in California remains a major public health goal.
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 (1)
- Supporting targeted public education and group prenatal care; group care can combine risk assessment, health education, and social support (3, 4)
- Increasing availability of home visiting programs, including leveraging federal funding available under health care reform (5)
- Recruiting and training clinicians who provide individualized, linguistically proficient, and culturally sensitive care to patients who are immigrants, limited-English-speaking, and women of color (1, 3, 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. Kaiser Family Foundation. (2003). Promoting access to prenatal care: Lessons from the California experience. Retrieved from: http://www.cdph.ca.gov/data/surveys/MIHA/MIHAPublications/MO-MIHA-PromotingAccessToPrenatalCare.pdf
2. National Partnership for Women and Families. (2012). Why the Affordable Care Act matters for women: Better care for pregnant women and mothers. Retrieved from: http://go.nationalpartnership.org/site/DocServer/PREGNANT_WOMEN.pdf?docID=10006
3. Novick, G. (2010). Women’s experience of prenatal care: An integrative review. Journal of Midwifery and Women’s Health, 54(3), 226-237. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754192/
4. Ickovics, K., et al. (2011). Effects of group prenatal care on psychosocial risk in pregnancy: Results from a randomized controlled trial. Psychological Health, 26(2), 235-250. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311036/
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. 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
- Websites with Related Information
- Association of Maternal and Child Health Programs
- California Maternal Quality Care Collaborative
- California Perinatal Quality Care Collaborative
- 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, California Department of Public Health
- 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, 2001, Public Health Reports, Alexander & Kotelchuck
- Closing the Black-White Gap in Birth Outcomes: A Life-Course Approach, 2010, Ethnicity and Disease, Lu et al.
- Disparities in Maternal and Infant Health: Are We Making Progress? Lessons from California, 2004, Kaiser Family Foundation & University of California at San Francisco, Egerter et al.
- Does Managed Care Hurt Health? Evidence from Medicaid Mothers, 8/2007, Review of Economics and Statistics, Aizer, Currie & Moretti
- 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, Maternal and Child Health Bureau
- Preventing Low Birthweight: 25 Years, Prenatal Risk, and the Failure to Reinvent Prenatal Care, 5/2012, American Journal of Obstetrics and Gynecology, Krans, et al.
- Racial/Ethnic Disparities in Obstetrical Outcomes and Care: Prevelance and Determinants, 4/2010, American Journal of Obstetrics and Gynecology, Bryant, et al.
- Recommendations to Improve Preconception Health and Health Care --- United States, 4/2006, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Johnson et al.
- County/Regional Reports
- Children's Report Card: Sacramento County Children's Coalition, 2013
- Orange County Community Indicators Report, 2014
- San Diego County Report Card on Children & Families, 2013, The Children's Initiative and Johnson Group Consulting, Inc.
- Solano County Children's Report Card, 2013, Children's Network
- Tulare County Children’s Report Card 2010, 2011, Children's Services Network
- Tuolumne County Profile 2012
- More Data Sources For Prenatal Care
- The Youngest Americans: A Statistical Portrait of Infants and Toddlers in the United States, 2013, Child Trends, Murphey, D., Cooper, M., & Forry, N.