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. Early prenatal care increases the likelihood of a healthy pregnancy and birth.

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 to increase the percentage of pregnant women who receive prenatal care beginning in the first trimester from 70.8% to 77.9% by the year 2020 (5).

In 2013, 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 49% to 93% in 2013 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 2013; infants of American Indian/Alaska Native women (69%) had the lowest.

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, 2). 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 (3). 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 (2, 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, 2, 6)