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New Report Reveals Concerning Decline in Early Prenatal Care Across the U.S.
A new report from the Centers for Disease Control and Prevention (CDC) paints a concerning picture: more pregnant women in the United States are delaying prenatal care or skipping it entirely. The analysis of birth certificate data, released Thursday, indicates a significant shift from a decade ago, with the percentage of women receiving care in their first trimester steadily decreasing.
As of 2024, only 75.5% of pregnant women in the U.S. received prenatal care during their first trimester, a noticeable drop from 78.3% in 2021. Conversely, care beginning in the second trimester rose from 15.4% in 2021 to 17.3% in 2024.
Even more troubling, the percentage of women receiving very late or no prenatal care increased from 6.3% to 7.3% during the same period. This marks a reversal from the trend observed between 2016 and 2021, when early prenatal care had been on the rise.
While the report does not delve into the specific reasons behind this shift, experts and previous research offer several potential contributing factors. The COVID-19 pandemic may have played a role in delayed care.
Additionally, the overturning of Roe v. Wade in 2022 has been linked to decreased access to OB-GYN services for many women.
A 2024 March of Dimes report also highlighted the prevalence of “maternity care deserts” across the U.S., where over a third of counties lack any specialized maternity care providers or facilities.
Dr. Mya Zapata, an OB-GYN at UCLA Health not involved in the new research, also suggested that a growing distrust of medical institutions or the government could be a factor.
She noted, “We have a large portion of patients in the Los Angeles area whose legal documentation is unclear. They may be hesitant to get care.”
The trend of later or no prenatal care was found to be widespread, affecting women of all ages in their childbearing years and across all racial groups. Thirty-six states and Washington, D.C., saw an increase in women delaying or foregoing prenatal care. Florida, Georgia, Hawaii, New Mexico, and Texas were particularly affected, with more than 1 in 10 pregnant women falling into this category.
However, some states showed improvement in access to prenatal care, primarily in the Midwest and South. These include Arkansas, New Hampshire, South Carolina, Tennessee, West Virginia, and Wisconsin.
The report’s author noted that early, provisional data for 2025 suggests some improvements, but cautioned that these figures are subject to change once finalized this summer.
Dr. Brenna Hughes, interim chair of the obstetrics and gynecology department at Duke University School of Medicine, emphasized the critical importance of early prenatal care.
“There’s a host of reasons why prenatal care is important,” she stated. “The earlier that we can get patients seen, the earlier we can start interventions that can improve these longer-term outcomes.”
Why Early Prenatal Care is Crucial
According to the American College of Obstetricians & Gynecology, consistent doctor visits throughout pregnancy are vital for the well-being of both mother and baby. Early prenatal care, specifically within the first few months of pregnancy, allows medical professionals to identify and address potential risks that could complicate the pregnancy.
For example, untreated urinary tract infections can lead to premature labor and even sepsis. Proper management of diabetes is also essential, as pregnancy hormones can make blood sugar regulation challenging.
Dr. Zapata explained, “In the first trimester, if a person’s blood sugars are already not regulated, what that means is there’s more sugar circulating in their blood all the time, and that is affecting how fetal organs are developing.”
Early doctor visits can also identify patients at risk for preeclampsia, a dangerous condition characterized by dangerously high blood pressure later in pregnancy. For these patients, a low-dose aspirin regimen is recommended to begin as early as 12 weeks’ gestation.
“If you don’t even start your prenatal care until 14 weeks’ gestation, you’ve already lost the opportunity to start that preventive measure early in the pregnancy,” Dr. Hughes highlighted, “at a time when it’s probably most important.”