Forum on Child and Family StatisticsAdequacy of Prenatal Care
Early and regular prenatal care, a measure of healthcare quality for pregnant women, improves the chances of a healthy birth and may prevent complications during pregnancy and birth that negatively impact maternal and infant health.46 Inadequate prenatal care is associated with increased risk of preterm birth, stillbirth, and infant mortality.47
Adequate prenatal care is defined as prenatal care that begins early, before the 4th month of pregnancy, and occurs on a regular basis, with the mother attending 80% or more of the expected number of prenatal care visits based on recommendations from the American College of Obstetricians and Gynecologists.48, 49
Figure 25. Percentage of pregnant women who received adequate prenatal care by race and Hispanic origin, 2018–2022
NOTE: NH = non-Hispanic origin; AIAN = American Indian or Alaska Native; NHOPI = Native Hawaiian or Other Pacific Islander. This measure is based on the Adequacy of Prenatal Care Utilization Index (APNCU), which uses data from the birth certificate on the month of pregnancy when prenatal care began, the number of prenatal care visits, and the infant's gestational age to classify levels of prenatal care. The APNCU classifies care as intensive use (or adequate plus) and adequate care, which are combined here to define adequate prenatal care that began by the 4th month of pregnancy and where the woman attended 80% or more of the expected number of visits. Race and Hispanic origin refer to the mother's race and Hispanic origin. The 1997 U.S. Office of Management and Budget standards for data on race and ethnicity were used to classify people into one of the following five racial groups: White, Black or African American, Asian, American Indian or Alaska Native, or Native Hawaiian or Other Pacific Islander. All categories are single race. Data on race and Hispanic origin are collected and reported separately. People of Hispanic origin may be of any race.
SOURCE: National Center for Health Statistics, National Vital Statistics System – Natality.
- From 2018 to 2022, the total percentage of all pregnant women who received adequate prenatal care did not change significantly, ranging from 75% to 77%.
- The percentage of pregnant women who received adequate prenatal care did not change significantly for any race or Hispanic origin group except Native Hawaiian or Other Pacific Islander, non-Hispanic, where the percentage of pregnant women who received adequate prenatal care decreased from 49% in 2018 to 46% in 2022.
- Throughout the period, White, non-Hispanic women were the most likely to receive adequate prenatal care, whereas Native Hawaiian or Other Pacific Islander, non-Hispanic women were the least likely to receive adequate prenatal care.
- In 2022, Native Hawaiian or Other Pacific Islander, non-Hispanic women were the least likely to receive adequate prenatal care (46%), followed by American Indian or Alaska Native, non-Hispanic (61%), Black, non-Hispanic (67%), Hispanic (69%), Asian, non-Hispanic (78%), and White, non-Hispanic (81%) women.
Figure 26. Percentage of pregnant women who received adequate prenatal care, by age, 2018–2022
NOTE: This measure is based on the Adequacy of Prenatal Care Utilization Index, which uses data from the birth certificate on the month of pregnancy when prenatal care began, the number of prenatal care visits, and the infant's gestational age to classify levels of prenatal care. The APNCU classifies care as intensive use (or adequate plus) and adequate care that are combined here to define adequate prenatal care, which began by the 4th month of pregnancy and where the woman attended 80% or more of the expected number of visits.
SOURCE: National Center for Health Statistics, National Vital Statistics System – Natality.
- From 2018 to 2022, the percentage of pregnant women who received adequate prenatal care did not change significantly for any age group.
- Generally, the receipt of adequate prenatal care increased with age from 2018 to 2022.
- In 2022, adolescents ages 15–19 were the least likely to receive adequate prenatal care (61%), followed by women ages 20–24 (69%) and 25–29 (75%). Women ages 30–34 and 35 and over (78% for both) were the most likely to receive adequate prenatal care.
Figure 27. Percentage of pregnant women who received adequate prenatal care by metropolitan status, 2018–2022
NOTE: This measure is based on the Adequacy of Prenatal Care Utilization Index, which uses data from the birth certificate on the month of pregnancy when prenatal care began, the number of prenatal care visits, and the infant's gestational age to classify levels of prenatal care. The APNCU classifies care as intensive use (or adequate plus) and adequate care, which are combined here to define adequate prenatal care that began by the 4th month of pregnancy and where the woman attended 80% or more of the expected number of visits. The Office of Management and Budget identifies counties in metropolitan statistical areas (metropolitan). In this report, counties not in a metropolitan statistical area are considered nonmetropolitan.
SOURCE: National Center for Health Statistics, National Vital Statistics System – Natality.
- In 2022, 75% of pregnant women living in metropolitan counties received adequate prenatal care, and 76% of pregnant women in nonmetropolitan counties received adequate prenatal care.
- From 2018 to 2022, the percentage of pregnant women who received adequate prenatal care did not change significantly for those living in metropolitan or nonmetropolitan counties.
- Throughout the period, pregnant women living in nonmetropolitan counties were more likely to receive adequate prenatal care (ranging from 76% to 77%) than pregnant women living in metropolitan counties (ranging from 75% to 77%).
46 National Institute of Child Health and Human Development (2017). What is prenatal care and why is it important? Webpage: Author. https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/prenatal-care#:~:text=Pre%2DPregnancy%20and%20prenatal%20care,the%20risk%20of%20pregnancy%20complications.
47 Partridge, S., Balayla, J., Holcroft, C. A., & Abenhaim, H. A. (2012). Inadequate prenatal care utilization and risks of infant mortality and poor birth outcome: a retrospective analysis of 28,729,765 US deliveries over 8 years. American journal of perinatology, 29(10), 787–794. Available from: https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0032-1316439
48 Kotelchuck M. (1994). An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index. Am J Public Health 84(9):1414–20.
49 ACOG/APP. Guidelines for Perinatal care: American Academy of Pediatrics and American College of Obstetricians and Gynecologists. Washington, DC: Library of Congress, 2017.
Federal Interagency Forum on Child and Family Statistics
