U.S. – Nearly a quarter of pregnant women aren’t getting prenatal care in the early stages of pregnancy, according to a new analysis from the U.S. Centers for Disease Control and Prevention.
The share of pregnant women getting prenatal care had been improving: It rose between 2016 and 2021 to a high of more than 78%, but then declined to 75.5% by 2024, wiping out previous gains.
The trend is worrying because getting care early in pregnancy can improve the likelihood of a healthy pregnancy and baby.
The decrease in early prenatal care held true for nearly all race and ethnic groups, but the drops were sharpest for Native Hawaiian and Other Pacific Islanders, Black women and American Indian and Alaska Native women.
By 2024, less than half of Native Hawaiian and Other Pacific Islander mothers received prenatal care in their first trimester — the first three months of pregnancy.
Anne Markus, a professor at George Washington University’s Milken Institute School of Public Health, said that because the statistically significant decline began around 2021, two events could explain some of the decrease: the COVID pandemic, with its associated stay-at-home orders, and the U.S. Supreme Court’s Dobbs decision in 2022 that dismantled the constitutional right to abortion.
“Both disproportionately affected, and continue to affect, communities of color, and the decline in early entry into prenatal care has been disproportionately bigger for racial and ethnic minorities since 2021,” said Markus, whose work focuses on public policy and access to health care. She was not involved in the analysis.
A lack of early prenatal care has also been disproportionately seen in “very young women who are more likely to have a pregnancy that they do not want,” Markus said. “The Dobbs decision and the fear and uncertainty it generated could be particularly relevant in explaining this disproportionate effect observed in the data.”
The share of women getting late care — beginning in the seventh month of pregnancy or later — or no care at all increased in more than half of states from 2021-2024. Utah saw the biggest rise in late or no care, followed by Massachusetts and Rhode Island. The number of Utah women getting late or no prenatal care jumped 54%, up to nearly 6% of women.
More than 1 in 10 women had late or no prenatal care by 2024 in Florida, Georgia, Hawaii, New Mexico and Texas.
“Geographic and financial barriers to accessing care are often behind late entry to recommended care, including prenatal care,” Markus said.
Late or no prenatal care decreased in six states: Arkansas, New Hampshire, South Carolina, Tennessee, West Virginia and Wisconsin.
The CDC compiled the report based on information from birth certificates, and includes information for all births that occurred in the United States.
Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.
This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network which includes Utah News Dispatch, and is supported by grants and a coalition of donors as a 501c(3) public charity.
Utah News Dispatch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Utah News Dispatch maintains editorial independence. Contact Editor McKenzie Romero for questions: info@utahnewsdispatch.com.
