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

Prenatal Care Utilization

Narrative

Early and adequate prenatal care helps to promote healthy pregnancies through screening and management of a woman’s risk factors and health conditions, as well as education and counseling on healthy behaviors during and after pregnancy.1 In 2011, among the 36 states and District of Columbia that had implemented the 2003 revision to the standard birth certificate as of January 1st and collected prenatal care information in the same format, 73.7 percent of women giving birth received early prenatal care in the first trimester, while 6.0 percent of women began prenatal care in the third trimester or did not receive any prenatal care.

Rates of first trimester prenatal care increased with greater educational attainment, from only 58.0 percent of mothers with less than a high school diploma to 86.3 percent of mothers with a bachelor’s degree or higher. First trimester prenatal care initiation was highest among non-Hispanic White and non-Hispanic Asian women (78.8 and 77.8 percent, respectively), followed by Hispanic (68.3 percent) and non-Hispanic Black women (63.4 percent), while non-Hispanic American Indian/Alaska Native and non-Hispanic Native Hawaiian/Other Pacific Islander women had the lowest rates of early prenatal care (59.0 and 55.7 percent, respectively; data not shown in graph images or in data tables on this site in graph images or in data tables on this site).

In 2011, 84.8 percent of women in 37 jurisdictions received adequate prenatal care, defined as receiving 80 percent or more of expected visits given the timing of prenatal care entry and gestational age at delivery. Non-Hispanic American Indian/Alaska Native and non-Hispanic Native Hawaiian and Other Pacific Islander mothers were least likely to receive adequate care (76.7 and 77.9 percent, respectively), followed by non-Hispanic Black mothers (80.8 percent). Of women with a college degree, 88.1 percent had received adequate care upon initiation compared to 79.2 percent of women without a high school diploma (data not shown in graph images or in data tables on this site in graph images or in data tables on this site).

1 Office on Women’s Health. Pregnancy: Prenatal care and tests. Accessed: on 7/31/13

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Graphs

This image is described in the Data section.

timing of prenatal care graph

This image is described in the Data section.

adequacy of prenatal care graph

Data

Timing of Prenatal Care Initiation,* by Maternal Education, 2011
Maternal Education Percent of Mothers, 1st Trimester Percent of Mothers, 2nd Trimester Percent of Mothers, 3rd Trimester or No Care
*Data are from 36 states and the District of Columbia that implemented the 2003 revision of the birth certificate as of January 1, 2011, representing 83% of all U.S. births. Percentages may not total to 100 due to rounding.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. 2011 Natality Public Use File. Analysis conducted by the Maternal and Child Health Bureau.
Less Than High School Diploma 58.0 30.7 11.3
High School Diploma or GED 68.6 24.3 7.1
Some College or Technical School 76.1 19.1 4.8
Bachelor's Degree or Higher 86.3 11.1 2.6
Total 73.7 20.3 6.0
Adequacy of Prenatal Care Utilization Upon Initiation,* by Maternal Race/Ethnicity, 2011
Race/Ethnicity Adequate Intermediate Inadequate
*Based on a ratio of observed to expected prenatal care visits given the timing of prenatal care entry and gestational age at delivery (Kotelchuck Index). Adequate prenatal care is defined as receiving 80 percent or more of expected visits. Intermediate is receipt of 50 to 79.9 percent of expected visits. Inadequate is receipt of less than 50 percent of expected visits. Data are from 36 states and the District of Columbia that implemented the 2003 revision of the birth certificate as of January 1, 2011, representing 83% of all U.S. births. Percentages may not total to 100 due to rounding.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. 2011 Natality Public Use File. Analysis conducted by the Maternal and Child Health Bureau.
Non-Hispanic White 86.6 11.0 2.4
Non-Hispanic Black 80.8 13.3 5.9
Hispanic 83.3 12.7 4.0
Non-Hispanic American Indian/Alaska Native 76.7 16.3 7.0
Non-Hispanic Asian 86.4 11.5 2.1
Non-Hispanic Native Hawaiian/Other Pacific Islander 77.9 15.1 7.0
Non-Hispanic American Multiple Race 83.1 13.0 3.9
Total 84.8 11.8 3.3