Improving Prenatal Care Usage in the District
As a preventative measure that lowers the risk of preterm birth and low birth weight, prenatal care is vitally important for the health of pregnant women, new mothers and their infants.
Thorough and early prenatal services allow health care providers to screen for potential health risks and developmental issues and advise expectant mothers on proper nutrition, exercise, and behaviors that may jeopardize their unborn child’s health while pregnant. Children whose mothers receive late or no prenatal care are at a greater risk for serious health problems: they are three times more likely to be born underweight and five times more likely to die. Children born preterm or with low birth weight have an increased risk of developmental delays and cognitive impairment that can last into adulthood. Health costs for a baby born prematurely or underweight average $49,000 for the first year compared to $4,551 for a healthy birth.
In the District, only 66% of children born in 2013 had adequate prenatal care beginning in the first trimester. For mothers of color, the numbers are even lower: only 55% of births to black mothers, and 64% of births to Hispanic mothers, had the benefit of prenatal care beginning in the first trimester. This lack of access to prenatal care has produced troubling, if not unexpected results: 13% of children born to black mothers were preterm, compared to 8% for whites, and black children are twice as likely to have low birth weight as white children. Even more unsettling, the death rate for infants born to black mothers is almost 6 times higher than for white children. While preterm birth, infant mortality, and low birth rate may reflect other issues than just a lack of prenatal care — such as environmental toxins, parental neglect or a lack of access to health insurance or adequate nutrition — prenatal care is a proven intervention that can significantly impact a child’s development long after birth.
In the District, the Department of Health (DOH) oversees the city’s prenatal care initiatives. In light of the data on the use of prenatal care by women of color, we must think about the barriers that women face accessing care. As we begin to address these questions, we can determine how DOH can be better supported to ensure that their outreach programs are effectively targeting the populations most at-risk of not receiving timely prenatal care, and that adequate prenatal care providers are in place in the communities where they live.