Posted on December 2, 2002 at 1:53 p.m.
BIRMINGHAM, AL — Although black women still do not receive prenatal care at the same rate as white women, that gap is narrowing, according to a recent study by researchers at the University of Alabama at Birmingham (UAB). “Prenatal care rates have improved significantly over the last two decades for both racial groups, but more so for blacks,” said Greg R. Alexander, Ph.D., professor of maternal and child health with the School of Public Health at UAB. Details of the study are published in the December 2002 issue of the American Journal of Public Health.
“The fact that more women in this country are receiving early and regular prenatal care is very good news,” said Alexander. “Prenatal care is focused on identifying and reducing potential health risks to mom and baby. The earlier in pregnancy that a woman begins receiving care, the more likely it is to be effective.”
The expansion of Medicaid in the mid-1980s to provide coverage for prenatal care services is the most likely reason for the improvement, according to researchers. “Also, older moms are more likely to seek prenatal care, so rates have risen in part because of the aging population of women and first-time moms,” says Alexander.
The study, funded by the U.S. Department of Health and Human Services, analyzed more than 60 million single live birth records obtained from the National Center for Health Statistics. From these records, researchers determined the month that care began and the number of prenatal visits to assess whether women received early and adequate care based on standard recommendations.
Over the course of the study, from 1981 to 1998, the percentage of women who adequately used prenatal care increased from 33.6 percent to 50.2 percent for whites and from 26.9 percent to 44 percent for blacks. These trends represent a nearly 50 percent improvement for whites and a nearly 64 percent improvement for blacks.
The percentage of women who initiated prenatal care early in their pregnancy (the first three months) increased from 80.1 percent to 84.8 percent for whites and from 61.1 percent to 72.8 percent for blacks. While this is a marked improvement, researchers caution that it is doubtful that either whites or blacks will reach the 90-percent objective outlined in Healthy People 2010, the desired national health standards set by the U.S. Department of Health and Human Services.
The study also revealed substantial changes in prenatal care rates among young, high-risk mothers. “While overall, racial differences in prenatal care rates have declined, the gap has widened among teen moms,” says Alexander. “Black teens are less likely than white teens to seek prenatal care. Clearly, more work must be done to enroll young black women who are expecting in prenatal care services.”
Findings support the need for ongoing and new initiatives to address shortfalls and racial differences in women receiving prenatal care. “Universal health care coverage for all pregnant women, ongoing education of providers about cultural factors that affect the use of prenatal care and comprehensive preconception programs for women need to be explored further if we’re going to reach our national goal.”