More pregnant women are delaying prenatal care until the later stages of pregnancy or going without it altogether, according to a new report from the Centers for Disease Control and Prevention.
The CDC’s analysis of birth certificate data, published Thursday, found that as of 2024, 75.5% of pregnant women in the U.S. received care during their first trimesters. In 2021, 78.3% received early prenatal care.
Prenatal care beginning in the second trimester rose from 15.4% in 2021 to 17.3% in 2024. And the percentage of women who got very late or no prenatal care increased from 6.3% to 7.3% during the same period.
It's a marked shift from a decade ago when the percentage of women with prenatal care increased overall from 2016 until 2021, the report found.
The report doesn’t address reasons for the changes.
It's possible the pandemic played a role in delayed care. It has also been documented that a growing number of women were unable to access OB-GYN care after the U.S. Supreme Court overturned Roe v. Wade in 2022. And a 2024 March of Dimes report found that over a third of U.S. counties qualify as “maternity care deserts,” meaning they don’t have a single doctor, nurse, midwife or medical center specializing in maternity care.
Dr. Mya Zapata, an OB-GYN at UCLA Health who wasn’t involved with the new research, said she wondered whether distrust of the medical establishment or the government has played a role.
"We have a large portion of patients in the Los Angeles area whose legal documentation is unclear," Zapata said. "They may be hesitant to get care."
But the trend in later or no prenatal care was found across the board in the new report, among all women at any age in their childbirth years and all races.
Thirty-six states and Washington, D.C., had increases in women either delaying their first OB-GYN visits or going without prenatal care. In Florida, Georgia, Hawaii, New Mexico and Texas, more than 1 in 10 pregnant women fit those criteria.
Six states where access to prenatal care improved were mostly in Midwestern and Southern states: Arkansas, New Hampshire, South Carolina, Tennessee, West Virginia and Wisconsin.
The report's author said that early, provisional data from 2025 suggests some improvements in prenatal care access but warned that could change once the data is finalized his summer.
Dr. Brenna Hughes, interim chair of the obstetrics and gynecology department at Duke University School of Medicine, who wasn’t involved in the new research: “There’s a host of reasons why prenatal care is important. The earlier that we can get patients seen, the earlier we can start interventions that can improve these longer-term outcomes.”
Why is early prenatal care important?
Visits to the doctor are critical throughout pregnancy, according to the American College of Obstetricians & Gynecology, for the health of both mom and baby.
Early prenatal care in particular — that is, seeing a doctor within the first few months of pregnancy — allows doctors to assess patients for risks that might complicate pregnancies.
Urinary tract infections, for example, can lead to premature labor and even sepsis if they’re left untreated.
And making certain a woman is treated appropriately for diabetes is essential, Zapata said, because pregnancy hormones make it much more difficult to regulate blood sugar.
“In the first trimester, if a person’s blood sugars are already not regulated, what that means is there’s more sugar circulating in their blood all the time, and that is affecting how fetal organs are developing,” she said.
