Late or No Prenatal Care

Publication Date:

Sep 18, 2018

Key facts about late or no prenatal care

• In 2016, American Indian and Alaska Native women and non-Hispanic black women were the most likely to report receiving late or no prenatal care (12 and 10 percent of births, respectively), whereas only 6 and 4 percent, respectively, of Asian or Pacific Islander and non-Hispanic white women received late or no prenatal care.
• Eight (8) percent of Hispanic women received late or no prenatal care, but there was substantial variation by subgroup: Central and South American women reported the highest rates, at 9 percent, and Cuban women reported the lowest rate, at 4 percent.
• In 2016, 26 percent of births to females younger than age 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, the proportion of mothers receiving late or no prenatal care has trended downward since the 1970s. The percentage of births where the mother received late or no prenatal care dropped by more than one-third from 1989 to 2003—from 6 to 4 percent. There was little apparent change from 2003 to 2006, but the rate increased in 2007. However, comparisons are complicated by 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 for 2006 and 2007 (Appendix 1).

Differences by race and Hispanic origin

In 2016, American Indian and Alaska Native women reported the highest rates of late or no prenatal care (12 percent of births), followed by non-Hispanic black (10 percent) and Hispanic women (8 percent). In contrast, the mother received late or no prenatal care in only 6 percent of 2016 births among Asian or Pacific Islander women and 4 percent of births among non-Hispanic white women.

There is large variation in prenatal care receipt by subgroups within the Hispanic category. Among Hispanic mothers in 2016, the percentage of women receiving late or no prenatal care ranged from 4 percent among mothers of Cuban origin, to 6 percent for mothers of Puerto Rican origin, to 8 percent for mothers of Mexican origin, and to 9 percent for mothers of Central or South American origin (Appendix 1).

Differences by age

Young women in their teens report the highest rates of late or no prenatal care. In 2016, mothers received late or no prenatal care in 26 percent of births to females under age 15 and 11 percent of births to teens ages 15 to 19. This proportion drops as the age of the mother increases, reaching a low of 5 percent for women in their thirties, and then increases slightly to 6 percent among women in their forties (Appendix 1).

Other estimates

State and local estimates

Estimates of the percentage of births to mothers who received late or no prenatal 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 by 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 2007–2016: 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., et al. (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., et al. (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., Pamuk, E. R., Freid, V. 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, 1970–2016

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 who reported receiving 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 in which 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 table below). Data for 2007 and later years include only those jurisdictions that have adopted the 2003 certificate revision (see table below). Although New York state began using the 2003 revision in 2004, New York City continued to use the 1989 revision until 2008; the city is excluded for 2007. For details on this change, see http://www.cdc.gov/nchs/nvss/vital_certificate_revisions.htm.

Citation

Child Trends. (2018). Late or no prenatal care. Bethesda, MD: Author. Retrieved from https://www.childtrends.org/indicators/late-or-no-prenatal-care.

Endnotes

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