More California mothers are skipping prenatal care
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Fewer pregnant Americans are getting prenatal care in the first weeks of pregnancy — or at all — reversing years of progress, new CDC data shows.
Why it matters: Skipping first-trimester care raises the risk of preventable complications for mothers and babies.
The big picture: First-trimester prenatal care rose from 77.1% of U.S. births in 2016 to 78.3% in 2021 — then slid to 75.5% in 2024, per a CDC report.
- Late or no care increased in at least 36 states and D.C. in that same period — rising nationally from 6.3% to 7.3%.
- The shift spanned every age group and nearly all racial and ethnic groups.
Zoom in: In California, late or no prenatal care increased in that time period from 3.2% to 3.7%.
- That's a significant increase, per the CDC.
Yes, but: It's still one of the lowest percentages in the country, meaning California mothers are going to those appointments more than most.
What we're hearing: If caught early, conditions like diabetes and high blood pressure can often be managed to lower risks for mothers and babies — sometimes with "easy interventions" like starting aspirin, says Alex Peahl, OB-GYN and ACOG Fellow.
- As more patients enter pregnancy with chronic conditions, early treatment becomes even more critical.
- These are therapies "we know make a big difference in patients' lives," she says, "but they're most effective if they're started in that first trimester."
Between the lines: The report doesn't identify causes, but growing maternity care deserts and insurance coverage gaps are a concern for patients and providers.
- Rural hospitals have closed, practices have scaled back obstetric services, and there are Medicaid patients who struggle to get appointments covered.
- In some cases, Peahl says, patients need proof of pregnancy to enroll in Medicaid but can't obtain that proof without an appointment, creating a catch-22.
The intrigue: Most new mothers in California are missing postpartum checkups.
- UC San Diego Health doctors created a "fourth trimester" program to improve access to postpartum care and boost follow-up visit rates.
What we're watching: Whether health systems respond to access pressures by adopting any of ACOG's new tailored prenatal care guidance — co-authored by Peahl — such as streamlining prenatal care for low-risk patients into only eight to nine visits.