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Child Health USA 2013 An illustrated collection of current and historical data, published annually.

Barriers to Prenatal Care

Narrative

Early and adequate prenatal care is important for ensuring a healthy pregnancy. It is recommended that women schedule their first prenatal visit as soon as they think they might be pregnant.1 Unfortunately, not all mothers are able to access early prenatal care. (Read more in Prenatal Care Utilization.)

In 2009-2010, 17.2 percent of recent mothers in a 30-state area reported that they were not able to access prenatal care as early as they had wanted. Mothers aged 19 years or younger were the most likely to report delayed prenatal care (29.8 percent) as compared to all other age groups. With respect to race and ethnicity, the proportion of mothers reporting delayed access to care was highest among non-Hispanic American Indian/Alaska Native mothers, non-Hispanic mothers of multiple race, and non-Hispanic Black mothers (24.2 percent, 23.2, and 22.2 percent, respectively), as compared to non-Hispanic Asian mothers, and was lowest among non-Hispanic White mothers (15.1 and 14.7 percent, respectively; data not shown in graph images or in data tables on this site). These patterns are consistent with first trimester entry rates into prenatal care. (Read more in Prenatal Care Utilization.)

Common barriers to getting prenatal care as early as desired (or at all) can include limited resources, transportation issues, and not knowing that one is pregnant. In 2009-2010, more than one-third (37.1 percent) of mothers who reported delayed care attributed this to not knowing that they were pregnant. Additionally, a lack of resources was a common barrier, as 38.7 percent of mothers reported that care had been delayed because they lacked the money or insurance to pay for their visits, while 36.4 percent of mothers cited not having a Medicaid card. More than half (59.0 percent) of women who reported experiencing a delay in care listed 1 or 2 of the barriers described in the graph under the Graphs tab on this page, “Barriers to Receiving Prenatal Care at All or as Early as Desired Among Women Who Reported Delayed Care, 2009–2010,” while 34.9 percent reported experiencing 3 or more of the barriers listed in that graph.

1 The Mayo Clinic . Pregnancy Week by Week. August 2012. Accessed: 07/11/13.

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Graphs

This image is described in the Data section.

barriers by age graph

This image is described in the Data section.

barriers graph

Data

Mothers Who Experienced Barriers to Receiving Prenatal Care as Early as Desired, by Maternal Age, 2009–2010*

Percent of Recent Mothers:

  • 19 Years or Younger 29.8
  • 20-24 Years 23.8
  • 25-29 Years 15.7
  • 30-34 Years 11.2
  • 35 Years or Older 10.9
  • Total 17.2

*Includes data from a total of 30 states and New York City; 25 states contributed both years. Mothers completed surveys between 2 and 9 months postpartum.

Source: Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System, 2009-2010. Analysis conducted by the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.

Barriers to Receiving Prenatal Care at All or as Early as Desired Among Women Who Reported Delayed Care, 2009–2010*

Percent of Recent Mothers:

  • Lacked money or insurance for visits 38.7
  • Couldn’t get appointment when desired 37.8
  • Didn’t know she was pregnant 37.1
  • Didn’t have a Medicaid card 36.4
  • Doctor or health plan did not start as early as desired 24.1
  • Mother was too busy 19.7
  • Lacked transportation to clinic or doctor's office 13.9
  • Didn’t want anyone to know about pregnancy 13.9
  • Could not take time off work or school 9.8
  • Needed childcare for other children 7.9

*Includes data from a total of 30 states and New York City; 25 states contributed both years. Mothers completed surveys between 2 and 9 months postpartum.

Source: Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System, 2009-2010. Analysis conducted by the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.