Access to early prenatal care is a cornerstone of healthy pregnancies. Getting care within the first trimester (the first 12 weeks) allows providers to assess maternal and fetal health, identify risk factors, initiate needed care, and help set the stage for optimal outcomes. Yet in the United States, a sizeable proportion of expectant mothers do not receive prenatal care early — and the gap is growing.
What the data show
According to the Centers for Disease Control and Prevention (CDC), in 2023 only 76.1% of women who gave birth began prenatal care in the first trimester, down from 77.0% in 2022 and 78.3% in 2021. CDC+1
That means roughly one in four pregnant women are not receiving first trimester prenatal care — whether because they start later (in the second or third trimester) or receive no prenatal care at all.
The March of Dimes data confirm this figure: in 2023, 76.1% of live births were to women receiving early (first-trimester) care, 16.9% to women beginning in the second trimester, and 7.0% to women receiving late or no care. March of Dimes
Why it matters
Beginning prenatal care early is linked to improved maternal and child outcomes — including lower rates of preterm birth, low birthweight, and other complications. When care is delayed, opportunities to identify high-risk conditions (such as hypertension, diabetes, or infections) or to provide early interventions are missed.
For example, late or absent prenatal care is more common in populations already facing higher risk — young mothers, women of color, women living in rural or underserved areas, and those without insurance. These disparities can widen health inequities.
Disparities in early prenatal care access
The data reveal disparities by race/ethnicity and age. For example:
- Among women who gave birth in 2023: first-trimester prenatal care ranged from as low as 66.3% for Black women to 82.4% for White women. CDC
- Younger mothers (under age 20) had lower first-trimester care rates (57.6% in 2023) compared to women age 30 and older (75.8%). CDC
- Geographic disparities exist as well, with rural areas and “maternity care deserts” (areas with limited maternity services) presenting larger obstacles.
What are some of the barriers?
Research identifies a complex mix of factors contributing to delayed or absent prenatal care. A recent scoping review pointed to multilevel barriers including:
- Lack of insurance or delayed coverage
- Transportation challenges or long travel distances
- Unintended pregnancy or late pregnancy recognition
- Clinic or provider shortages, especially in rural areas
- Immigration status, language or cultural barriers
- Structural and systemic inequities such as poverty and neighborhood disadvantage PubMed
What can be done — a call to action
For a healthcare institution like ATLMed, this data underscores the importance of targeted efforts to promote early prenatal care access across our community. Some proactive strategies include:
- Community outreach and education — Inform prospective and expectant mothers about the importance of early prenatal care, what it includes, and how to access it.
- Reduce access barriers — Help women navigate insurance/Medicaid, provide transportation assistance, expand tele-prenatal options, and coordinate with community clinics.
- Partner with provider networks — Ensure that obstetric and midwifery services are available, particularly in underserved neighborhoods and rural areas, and promote “early entry” pathways into care.
- Integrate care and wraparound support — Offer screening for social determinants of health (housing, food security, transportation) and link to resources that support women beyond just the clinical visit.
- Monitor and track metrics — Use institution and community data to identify groups with especially low early-care initiation rates and target interventions accordingly.
Why early prenatal care should remain a priority
Early prenatal care is not just a clinical best-practice—it is a matter of equity, prevention, and healthier futures for mothers and children. When more women begin care in the first trimester, we reduce risk, support healthier pregnancies, and strengthen entire communities.
By shining a spotlight on the approximately one in four women who are missing first trimester prenatal care, ATLMed reaffirms its commitment to improving maternal and infant health in the Atlanta region—and to working toward a future where every pregnant woman receives the care she needs, when she needs it.
