Receiving prenatal care early increases the chances of having a healthy pregnancy and baby. However, a recent federal report indicates that this has been decreasing. According to data published by the Centers for Disease Control and Prevention on Thursday, the percentage of births in the U.S. to women who initiated prenatal care in the first trimester fell from 78.3% in 2021 to 75.5% in 2024.
At the same time, the number of women beginning prenatal care later in their pregnancies or receiving no care has increased. The percentage of those starting care in the second trimester increased from 15.4% to 17.3%, and those beginning care in the third trimester or receiving no care rose from 6.3% to 7.3%.
“Participating in prenatal care at an early stage is linked to better health results,” said Dr. Clayton Alfonso, an obstetrician-gynecologist at Duke University located in North Carolina. When patients postpone medical attention during pregnancy, “that opportunity to enhance care for both the mother and fetus has been lost.”
While the trend highlighted in the report was observed across almost all racial and ethnic categories, the reduction in early prenatal care was more pronounced among mothers from minority backgrounds. For instance, first-trimester care for Black mothers decreased from 69.7% in 2021 to 65.1% in 2024.
Late or absent prenatal care increases the risk of maternal mortality, particularly elevated among Black mothers. Michelle Osterman, the primary author of the report, noted that the findings indicate a notable change.
From 2016 to 2021, U.S. women's initiation of prenatal care had been improving. Doctors asserted that the sooner prenatal visits commence, the earlier any complications can be identified. These visits provide opportunities for doctors to offer health advice and can include procedures such as blood pressure assessments, screenings, blood tests, physical examinations, and ultrasound imaging.
The report does not clarify the reasons behind the later commencement of prenatal care. However, the rise of maternity care shortages in various regions is an increasing worry, according to Dr. Grace Ferguson, an OB-GYN in Pittsburgh. Numerous hospitals have closed their labor and delivery departments, “and the prenatal care providers associated with those facilities have likely relocated,” said Ferguson, who was not part of the report.
A March of Dimes report from 2024 revealed that over 35% of counties in the U.S. are categorized as areas lacking maternity care, signifying an absence of childbirth centers or obstetric healthcare professionals. Women residing in these regions tend to receive less prenatal care, as shown in the report.
Ferguson, who incorporates abortion services into her OB-GYN practice, mentioned that restrictions post-Roe v. Wade might influence some obstetricians' decisions to avoid states with stricter laws. Alfonso, who did not participate in the CDC report, expressed concern that access challenges for patients may be contributing to the delays in prenatal care, especially in rural communities.
Patients might need to travel longer distances for appointments and may have difficulties finding a provider who accepts their insurance, particularly if they rely on Medicaid. Doctors are apprehensive that the situation may deteriorate. “If this pattern persists,” Alfonso noted, “I am anxious about what implications this may have for the health and survival of our mothers.”
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