What does this measure?
The number of births to women who initiated prenatal care during the first trimester of pregnancy (before 13 weeks gestation), expressed as a percentage of all live births within each racial and ethnic group.
Why is this important?
Early, high-quality prenatal care is critical to reducing risks for complications of pregnancy or birth and improving birth outcomes. As in other health care settings, there are significant racial and ethnic disparities in prenatal care access and use. Research has identified socioeconomic status as the largest factor driving disparities, which has its roots in historical discrimination, segregation and lack of equitable access to resources.
How is the region doing?
In 2018 in the MetroWest region, rates of early prenatal care were 74% for African American births, 82% for Hispanic births, 86% for Asian births and 88% for white births. These rates were all between 2 and 5 percentage points higher than the state rates for 2018, which showed similar racial and ethnic disparities. Since 2012, there were no changes or slight improvements in the rates for all groups in MetroWest.
Norfolk County had a substantially higher prenatal care rate for Hispanic births (96%) than Middlesex or Worcester (both at 80%). Compared to the region as a whole, the prenatal care rate for Black mothers was slightly higher in Norfolk (80%). The rates for white and Asian mothers were highest in Norfolk (92% and 89% respectively). Data for this indicator was not available for individual communities in the region.
Why do these disparities exist?
Researchers have uncovered a number of factors contributing to generally lower rates of early prenatal care among mothers of color. These include: socioeconomic characteristics like education and family income; maternal health and characteristics of pregnancies (such as maternal age and number of previous pregnancies); types of insurance coverage - whether women are covered by Medicaid, private insurance, or have no coverage; and the location of prenatal care facilities - in physicians' offices and public health clinics. One study found socioeconomic differences was responsible for roughly half the gap -- pregnant women with lower incomes and levels of formal education often do not have the resources necessary to obtain care early and often - but that public programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children increased access to care.
Notes about the data
The rate excludes the number of live births for which the date of entry into prenatal care is unknown. In addition to considering when prenatal care began, it is also important to understand the quality and continuity of care received throughout the pregnancy.
| Asian or Pacific Islander | Black or African American | Hispanic or Latino | White | |
|---|---|---|---|---|
| United States | 78% | 65% | 71% | 78% |
| Massachusetts | 84% | 71% | 76% | 84% |
| Region | 86% | 74% | 82% | 88% |
| Middlesex | 85% | 71% | 80% | 87% |
| Norfolk | 89% | 80% | 96% | 92% |
| Worcester | 88% | 75% | 80% | 85% |
Notes: Percent of live births for which mothers received prenatal care beginning in the first trimester of pregnancy. Data may not be available for every group.
| Asian or Pacific Islander | Black or African American | Hispanic or Latino | White | |
|---|---|---|---|---|
| United States | 220,677 | 411,160 | 628,189 | 2,206,118 |
| Massachusetts | 5,567 | 7,078 | 10,520 | 44,120 |
| Region | 4,107 | 2,455 | 3,437 | 20,642 |
| Middlesex | 2,532 | 1,139 | 1,814 | 10,394 |
| Norfolk | 1,040 | 571 | 420 | 4,613 |
| Worcester | 535 | 745 | 1,203 | 5,635 |
Notes: Number of births for which mothers received prenatal care beginning in the first trimester of pregnancy. Data may not be available for every group.
| INDICATORS | TREND |
|---|---|
| Early Prenatal Care by Mother's Race/Ethnicity | Not Applicable |
| Infant Mortality by Mother's Race/Ethnicity | Not Applicable |
| Children Living in Poverty | Increasing |
| Children Living in Poverty, by Race/Ethnicity | Not Applicable |
| Single-Parent Families | Increasing |
| Single-Parent Families by Race/Ethnicity | Not Applicable |
| Disengaged Youth | Decreasing |
| Reports of Domestic Violence | Maintaining |
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