Early prenatal care, considered best for moms and babies, is on the
decline in the US
[February 19, 2026]
By LAURA UNGAR
Early prenatal care improves the chances of having a healthy pregnancy
and baby. But a new federal report shows it’s been on the decline.
The share of U.S. births to women who began prenatal care in the first
trimester dropped from 78.3% in 2021 to 75.5% in 2024, according to data
released by the Centers for Disease Control and Prevention on Thursday.
Meanwhile, starting care later in pregnancy or getting no care at all
has been on the rise. Prenatal care beginning in the second trimester
rose from 15.4% to 17.3%, and starting care in the third trimester or
getting no care went from 6.3% to 7.3%.
“We know that early engagement in prenatal care is linked to better
overall health outcomes,” said Dr. Clayton Alfonso, an OB-GYN at Duke
University in North Carolina. When patients delay medical care during
pregnancy, “we’ve missed that window to optimize both fetal and maternal
care.”
While the trend identified in the report held for nearly all racial and
ethnic groups, the decrease in early prenatal care was higher for moms
in minority groups. For example, first-trimester care dropped from 69.7%
in 2021 to 65.1% in 2024 for Black mothers. Getting late or no prenatal
care raises the risk of maternal mortality, which is much higher among
Black mothers.
Michelle Osterman, lead author of the report, said the overall findings
represent a shift. Between 2016 and 2021, the timing of when U.S. women
started prenatal care had been improving.
The earlier prenatal visits begin, doctors said, the earlier problems
can be caught. Visits give doctors a chance to share health guidance,
and can include blood pressure checks, screenings, blood tests, physical
exams and ultrasound scans.
The report doesn't provide reasons why prenatal care is starting later.
But the proliferation of maternity care deserts across the nation is a
growing concern, said Dr. Grace Ferguson, an OB-GYN in Pittsburgh.
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A doctor performs an ultrasound scan on a pregnant woman at a
hospital in Chicago on Aug. 7, 2018. (AP Photo/Teresa Crawford,
File)
 Many hospitals have shut down labor
and delivery units “and the prenatal care providers that work at
those hospitals also have probably moved,” said Ferguson, who was
not involved with the report.
A 2024 March of Dimes report found that more than 35% of U.S.
counties are maternity care deserts, meaning there’s no birthing
facility or obstetric provider. Women living in these areas receive
less prenatal care, the report showed.
Ferguson, who provides abortions as part of her OB-GYN care, said
post-Roe v. Wade abortion restrictions may play a part because some
obstetricians are choosing not to practice in states with more
restrictive laws.
Alfonso, who was not involved in the CDC report, said he also
suspects that access issues for patients are pushing prenatal care
later, particularly in rural areas. Patients may have to travel
farther to get to appointments and may struggle to find a practice
that accepts their insurance, particularly if they have Medicaid.
Doctors fear that things could get worse.
“If this trend continues,” Alfonso said, “I worry about kind of what
that would mean for morbidity and mortality for our moms.”
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