Early Prenatal Care - How Can We Get the Numbers Higher?

Early Prenatal Care - How Can We Get the Numbers Higher?

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Friday, January 25, 2013

Making sure pregnant women get care for themselves and their growing babies early in their pregnancies is the kind of cause most everyone can get behind. Yet, data show that the numbers in the Mid-Hudson Valley and elsewhere have proven hard to move. We might expect this to improve considering that national health reform will expand access to health insurance, but studies suggest having health insurance isn't the only factor.

viewpoint-2a.pngThe nation had set a goal for 2010: 90% of pregnant women getting care in the first trimester of pregnancy. In New York and in the Mid-Hudson Valley, we're not close: in 2010, only 75% of mothers in our region
started prenatal care that early, a bit higher than the state rate. And that's down slightly from 78% in 20001. Generally speaking, rates of early access to prenatal care haven't changed much over the past decade, and neither have rates of problems that prenatal care helps prevent, such as low birth weight. Even more troubling, low-income and minority women tend to be less likely to start care early, another stubborn pattern.

viewpoint-2b.pngOver the past decade, New York has expanded health insurance by making more people eligible for Medicaid, but that's only filled in a gap left by employment-based insurance. The share of residents receiving insurance through work dropped from 63% in 2000 to 57% in 2010. The share covered by Medicaid increased by the same margin, from 14% to 20% (not necessarily the same people, of course) - leaving our overall share of residents without insurance stable at about 15%2.

It's easy to imagine that expanding health insurance will lead to more mothers getting early care, and some research backs this up. A study of insurance expansion in the 1990s in California found rates of early prenatal care increased from 73% to 84%3. Yet other research has pointed to different factors, including women's education levels, their attitudes toward their pregnancies, lack of regular health care before their pregnancies, and transportation problems4. Moving this indicator may require multiple approaches at both the national/state and local levels, with communities wrestling with how to reach women who for many different reasons are not inclined to seek early care for themselves.

Learn more about the health status of Mid-Hudson Valley residents and early prenatal care by visiting the Mid-Hudson Valley Community Profiles websites.



1. New York State Department of Health, Vital Statistics. http://www.health.ny.gov/statistics/vital_statistics/
2. U.S. Census Bureau, http://www.census.gov/hhes/www/hlthins/data/historical/HIB_tables.html
3. http://www.cdph.ca.gov/data/surveys/Documents/MO-MIHA-PromotingAccessToPrenatalCare.pdf
4. http://www.guttmacher.org/pubs/journals/3226200.html

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