EARLY PRENATAL CARE

Description Of Indicator

This indicator tracks the number and percent of infants born to women whose prenatal care began during the first trimester (the first three months) of pregnancy.

Why is this important?

Early (i.e. first trimester) and regular prenatal healthcare improves the potential for a healthy pregnancy, delivery and baby. Ideally, this care should begin even before pregnancy with a preconception care visit to a health care provider. Prenatal care provides screening and management of a woman’s risk factors and health conditions to reduce pregnancy complications, as well as education and counseling on healthy behaviors during and after pregnancy.1

Of particular concern is late (third trimester) or no prenatal care which has been associated with increased risk of maternal death in all women (especially in minorities), increased rates of preterm delivery, low birth weight, and congenital malformations.2 In addition to prenatal care, certain genetic, behavioral, social, environmental, and other factors can adversely affect the ability to have a healthy, full-term baby.

Findings

• Orange County’s 2015 rate of women receiving early prenatal care was 85.2% – greater than both California (84.6%)3 and the United States’ (77.0%).4

• In Orange County, the percent of women receiving early prenatal care has decreased 3.2% since 2007, dropping from 88.0% in 2007 to 85.2% in 2015. However, this decrease is correlated with an increase of self-pay deliveries.5

– Self-pay deliveries are those paid through cash payment rather than health insurance and are often associated with foreign visitors that travel to the U.S. to give birth. These women generally arrive in the U.S. late in their pregnancy and leave shortly after giving birth; therefore, these births typically have no recorded prenatal care. In 2015, there were 2,581 self-pay deliveries in Orange County, an increase from 859 in 2007. Nearly 83% of self-pay deliveries in 2015 were among Asian women.

– When self-pay deliveries are excluded, the percent of women who received early prenatal care in Orange County in 2015 increases from 85.2% to 87.4%. While this still results in a lower rate than 2007 (88.1%), it reflects a more stable pattern.

• With self-pay deliveries excluded, 91.7% of White women received early prenatal care followed by Asian (87.3%), Hispanic (85.1%) and Black (81.8%) women. The most significant decreases in early prenatal rates are among Asian and Black women, which both have a nearly 4% decrease since 2007.

Percent of Women who Received Early

Note: California implemented a change in methodology for the collection of prenatal care information beginning in 2007, which likely resulted in reduced reports of early prenatal care after 2006.

Department of Health, Vital Statistics Query System.

Note: If comparing to state and national data, beginning in 2006, individuals whose race/ ethnicity is not stated or is unknown have been grouped with Non-Hispanic Whites for CA and USA statistics. As a result, Hispanic rates are potentially underestimated.

Orange County Health Care Agency, Family Health Division