HC 3.2.C

INADEQUATE PRENATAL CARE

Receiving early and consistent prenatal care increases the likelihood of a healthy birth outcome. Adequate prenatal care is determined by both the early receipt of prenatal care (within the first trimester) and the receipt of an appropriate number of prenatal care visits for each stage of a pregnancy. Women whose prenatal care fails to meet these standards are at a greater risk for pregnancy complications and negative birth outcomes. After fluctuating for the latter half of the 1980s, the percentage of mothers receiving inadequate prenatal care has decreased since 1990.

Differences by Race. While the percentages of both black and white women receiving inadequate prenatal care have declined since 1990, the percentage of black women receiving inadequate care has consistently been more than twice as high as the percentage of white women receiving inadequate care. This gap has existed since at least 1984 (see Table HC 3.2.C). For example, in 1994, 12.0 percent of black women received inadequate prenatal care, compared to 4.9 percent of white women.
 

Table HC 3.2.C  Percentage Receiving Inadequate Prenatal Care (Based on the Kessner Indexa), by Race for Selected Years: 1984-1994b
		1984		1986		1988	1990	1991		1992		1993	1994
		———		———		———	———	———		———		———	———
Racec
	White	6.2		6.3		6.1	6.8	6.4		5.7		5.3	4.9
	Black	15.1		15.3		15.5	16.4	15.5		14.5		13.1	12
Notes: aThe Kessner Index provides a measure for the adequacy of prenatal care by assessing the timeliness and frequency with which prenatal care is received according to the gestational age of the baby. Using the Kessner Index standards, prenatal care is determined to be adequate, intermediate or inadequate. Adequate prenatal care must begin within the first trimester of pregnancy and follow a prescribed number of minimum prenatal visits by gestational period. Inadequate care encompasses all women who started care after the sixth month of pregnancy (3rd trimester) and all women who had a low frequency of prenatal visits that followed the pattern described in the following chart:
Gestation (Weeks)									Number of Prenatal Visits
—————————									—————————
17 - 21			and								0
22 - 29			and								1 or less
30 - 31			and								2 or less
32 - 33			and								3 or less
34 or More			and								4 or less
bBased on 49 states for 1984-1988 and all 50 states of the United States, 1989-1994. Births with period of gestation, number of prenatal visits or month pregnancy care began not stated were excluded from tabulation.   cIn 1990, 1991, 1992, 1993 and 1994 race is of mother; for 1984, 1986 and 1988, race is of child.   Source: Division of Vital Statistics, National Center for Health Statistics. Unpublished tabulations.