Prenatalcare is a health care provided to a woman throughout the course of pregnancy,which includes early and regular visits with a health care provider that areimportant for the health of both the mother and the fetus 1. In theyear 2016, 77.2% 2 of women began their prenatal care in the firsttrimester which was 74.1% in the year 20123. 6.
2% 2women began prenatal care in the third trimester or did not receive anyprenatal care in the year 2016 which was 6% in the year 2012 3. Thegoal of prenatal care is to maximize health outcomes for a pregnant woman andher fetus. Prenatal care is important as research has shown that woman who donot receive prenatal care are three times more likely to deliver a low birthweight infant and babies are five times more likely to die as compared to thoseborn to woman who received prenatal care 4. Prenatal appointmentsprovide an opportunity to the health care provider to identify high-riskpatients and alleviate the risk for negative birth outcome 5. Lateor no prenatal care increases the rate of preterm and low birth weight infants 6.
Preterm birth is the main cause behind a newborn death 5. Apartfrom that health care provider can provide guidance about important healthissues, such as diet and nutrition, immunization, weight gain and abstainingfrom alcohol and drugs 7. Main focus of prenatal care is to educatepregnant women, inform them of risk factors and discuss their concerns 8. Assoon as a woman suspect that she might be pregnant, she should schedule a visitwith her health care provider 9.
Early and regular prenatal visitshelp to monitor woman’s health and growth of the fetus. Prenatalvisit Schedule 1: Before 28 weeks Monthly Weeks 28-36 Every 2 weeks Week 36-birth weekly First visit will be longer and the health careprovider will do the following:1) Collect urine sample to confirm pregnancy 2)Ask about past history including diseases, surgeries, or prior pregnancies,family history and genetic history 3) Do complete physical examinationincluding blood pressure, weight, height, pelvic examination and pap smear 4)Will ask about last menstrual period to calculate the due date 5) Take bloodand urine samples for lab work 6) Testfor hepatitis B, rubella, HIV and syphilis.7) Answer questions related topregnancy 1. Later visits will be shorter in duration and willinclude checking blood pressure, weight gain, abdominal examination to checkfetal growth by measuring fundal height, fetal heart rate and ultrasound exam 1.Health care provider will also do some special tests like checking forgestational diabetes, screening for chromosomal and neural tube defects andother conditions depending upon the age, family history or ethnicity 10. The reasons behind the lack or inadequateprenatal care are complex and varying 11.
Women with low educationlevel may not be able to obtain a well-paying job with time off for a healthcare visit and also, they might be living in a neighborhood with poor assess topublic transportation 12. Women with 12 or more year of educationare more likely to begin prenatal care early than with less than 12 years ofeducation 13. As maternal age increases, the percentage of womenwho receive early prenatal care also increases 13. In 2014, 25% ofteens under the age 15 years received late or no prenatal care which decreasedto 10% for teens between the age 15-19 years, the percentage further drops to4.5% for women in their thirties 7. Multiparous women are atgreater risk of receiving less prenatal care as compared to primiparous women 14.Substance abusing women, particularly cocaine or opiate are less likely toobtain prenatal care 15.
Women who were on private insurance planwere more likely to receive timely care (88%), followed by those who receivedMedicaid (83.3%) 3. Uninsured women were less likely to receivetimely care or no care 3. Timing of prenatal care also varied byrace and ethnicity. African American and Hispanic women were less likely toreceive adequate prenatal care than white mothers 16.