Late or No Prenatal Care

Publication Date:

May 03, 2019

Key facts about late or no prenatal care

  • In 2017, late or no prenatal care was most likely to be reported by American Indian and Alaska Native, and non-Hispanic black women (12 and 10 percent of births, respectively). By contrast, only 6 and 5 percent of Asian or Pacific Islander and non-Hispanic white women, respectively, received late or no prenatal care.
  • Eight percent of Hispanic women reported late or no prenatal care, but there was substantial variation by subgroup, with women from Central and South American countries reporting the highest rates, at 9 percent, and Cuban women reporting the lowest rate, at 4 percent.
  • In 2017, 27 percent of births to females younger than 15 were to mothers who received late or no prenatal care, compared to 5 percent for mothers in their thirties.

Trends in late or no prenatal care

With the exception of a period during the 1980s, there has been a positive downward trend since the 1970s in the proportion of mothers receiving late or no prenatal care. This percentage dropped by more than a third from 1989 to 2003, from 6 to 4 percent. From 2003 to 2006, there was little apparent change; then there was  an increase in 2007. However, historical comparisons are complicated by the states’ transition to a revised birth certificate, a process that began in 2003 and was completed in 2015 (see Definition section). Consequently, nationwide year-to-year comparisons are problematic, and not possible at all between 2006 and 2007 (Appendix 1).

Differences by race and Hispanic origin*

In 2017, American Indian and Alaska Native women were most likely to report late or no prenatal care (12 percent of births), followed by non-Hispanic black (10 percent) and Hispanic women (8 percent). By contrast, only 6 percent of 2017 births among Asian or Pacific Islander women, and 5 percent of births among non-Hispanic white women, were births where the mother received late or no prenatal care.

There is large variation in prenatal care receipt among Hispanic subgroups. For example, in 2017, the rate of women receiving late or no prenatal care was 4 percent for mothers of Cuban origin, 6 percent for mothers of Puerto Rican origin, 8 percent for mothers of Mexican origin, and 9 percent for mothers of Central and South American origins (Appendix 1).

* Hispanic mothers may be of any race. Estimates for white and black mothers in this report do not include Hispanic mothers. 

Differences by age

Young women in their teens report the highest rates of late or no prenatal care. In 2017, 27 percent of births to females under age 15, and 11 percent of births to teens ages 15 to 19, were to those receiving late or no prenatal care. This proportion drops with increasing age, reaching a low of 5 percent for women in their 30s; then it increases slightly to 6 percent among women in their 40s (Appendix 1).

Other estimates

State and local estimates

Estimates of the percentage of births to mothers who received late or no prenatal care for 2003-2016 are available for all states and the 50 largest U.S. cities at the KIDS COUNT Data Center: http://datacenter.kidscount.org/data#USA/2/27/28.

International estimates

The most recent estimates of the percentage of women who received prenatal care at least once during pregnancy are available from UNICEF at http://data.unicef.org/maternal-health/antenatal-care.html.

Data and appendices

Data source

  • Data for 2003-2006 and 2014; by age for 1990-1999 and 2007-2013; and Asian subgroups for 2009-2013: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (1990-2015). VitalStats [Data tool]. Retrieved from https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm.
  • All other data for 2007-2017: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (2018). CDC WONDER [Data tool]. Retrieved from http://wonder.cdc.gov/natality-current.html.
  • Data for 2002: Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Menacker, F., & Munson, M. L. (2003). Births: Final data for 2002 [Tables 24, 25, and 33]. National Vital Statistics Reports, 52(10). Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_10.pdf.
  • Data for 2001: Martin, J. A., Hamilton, B. E., Ventura, S.J., Menacker, F., Park, M. M., & Sutton, P. D. (2002) Births: Final data for 2001 [Tables 24, 25, and 33]. National Vital Statistics Reports, 51(2). Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr51/nvsr51_02.pdf.
  • Data for 2000: Martin, J. A., Hamilton, B. E., Ventura, S. J., Menacker, F., & Park, M. M. (2002). Births: Final data for 2000. National Vital Statistics Reports, 50(5). Retrieved from
    http://www.cdc.gov/nchs/data/nvsr/nvsr50/nvsr50_05.pdf.
  • Data for 1970-1999: Eberhart, M. S., Ingram, D. D., Makuc, D. M., et al. (2001). Urban and rural health chartbook: Health, United States, 2001 [Table 6]. Hyattsville, MD: National Center for Health Statistics. Retrieved from http://www.cdc.gov/nchs/hus/previous.htm.

Raw data source

Birth Data, National Vital Statistics System.
http://www.cdc.gov/nchs/nvss.htm

Appendices

Appendix 1. Births to Mothers Receiving Late or No Prenatal Care, as a Percentage of All Births, by Race, Hispanic Origin, and Age of Mother: Selected Years, 1970-2017

Background

Definition

Late or no prenatal care is calculated as the percentage of births that occur to mothers who, on their child’s birth certificate, reported receiving prenatal care only in the third trimester of their pregnancy or no prenatal care. Beginning in 2003, states and other jurisdictions began adopting a new revision of the standard birth certificate, and the last states transitioned in 2014. National data for years prior to 2003 are not strictly comparable with data for subsequent years, because the 1989 revision asks for the month that prenatal care began, while the 2003 revision asks for the date of the first prenatal visit.

Because of this inconsistency, data from states using different versions of the birth certificate are not comparable. Data through 2006 reflect only those jurisdictions which had not yet adopted the 2003 certificate revision (see Appendix 2). Data for 2007 forward include only those jurisdictions that have adopted the 2003 certificate revision (see Appendix 2). Although New York State began using the 2003 revision in 2004, New York City continued to use the 1989 revision until 2008, and is excluded for 2007. For details on this change, see http://www.cdc.gov/nchs/nvss/vital_certificate_revisions.htm.

Citation

Child Trends. (2019). Late or no prenatal care. Retrieved from https://www.childtrends.org/indicators/late-or-no-prenatal-care.