Osterman, Michelle JK, and Joyce A. Martin. “System Timing and adequacy of prenatal care in the United States, 2016.” (2018).

Link: https://stacks.cdc.gov/view/cdc/55174

Journal Article Summary:

This article is a report published in 2018 on prenatal care utilization in the United States in 2016. I chose this article because of a patient I saw in the emergency department as an OBGYN consult (H&P#2). The 16-year-old patient was currently 18 weeks pregnant, which the mother stated they just found out about, but the patient did not have any prenatal care for this pregnancy. I wanted to learn more about prenatal care in the United States, when patients typically start their prenatal care and how this affects pregnancy outcomes. This article is from within the last five years, is a report from the CDC and provided intriguing information on this topic, which is why I found it appropriate to summarize as my journal article for this rotation.

Prenatal visits were defined as a healthcare professional examining and/or counseling a pregnant patient in regard to her pregnancy and excluded visits for labs or other testing without any counseling. Inadequate care was defined as prenatal care that started after the fourth month of pregnancy and prenatal care that included 50% or less of the recommended number of visits. The data in this review included all births in the United States for 2016. The review found that 77.1% of women, or more than three out of four women, started prenatal care in the first trimester of pregnancy in 2016. 1.6% of women received no prenatal care at all and 4.6% of women began their prenatal care in the third trimester. Older women, those in their 30s, were more likely to start prenatal care in their first trimester in comparison to other age groups. Women under 20 were least likely to receive prenatal care in their first trimester (61.2%). Those receiving late or no care was highest in teenage women with 25.7% under 15 and 11% age 15-19. Other findings included that first trimester prenatal care was more common in those with their first (79%), second (80.1%), and third (75.8%) births in comparison to those with a fourth or more birth (66.2%). Additionally, those with a bachelor’s degree or higher (87.6%) had first trimester prenatal care compared with those who had less than a high school education which was 62.7%. When comparing first trimester prenatal care to the adequacy of prenatal care, 88.1% received at least adequate prenatal care. However, those who started prenatal care in the second trimester, 46.1% received at least adequate care and 46.7% received inadequate care. This provides insight into the differences in women receiving care and how that care is affected when it is started in a later trimester.

The article provided intriguing and in-depth information on prenatal care statistics and its comparison to the level of adequacy in care for pregnant women. Consolidating, reviewing and understanding this data on a yearly basis, if possible, would aid in comprehending what factors play a role in prenatal care and what education needs to be provided so women obtain the best care available.