Prenatal third trimester or did not receive any

                         Prenatal
care is a health care provided to a woman throughout the course of pregnancy,
which includes early and regular visits with a health care provider that are
important for the health of both the mother and the fetus 1. In the
year 2016, 77.2% 2 of women began their prenatal care in the first
trimester which was 74.1% in the year 20123. 6.2% 2
women began prenatal care in the third trimester or did not receive any
prenatal care in the year 2016 which was 6% in the year 2012 3. The
goal of prenatal care is to maximize health outcomes for a pregnant woman and
her fetus. Prenatal care is important as research has shown that woman who do
not receive prenatal care are three times more likely to deliver a low birth
weight infant and babies are five times more likely to die as compared to those
born to woman who received prenatal care 4. Prenatal appointments
provide an opportunity to the health care provider to identify high-risk
patients and alleviate the risk for negative birth outcome 5. Late
or no prenatal care increases the rate of preterm and low birth weight infants 6.

Preterm birth is the main cause behind a newborn death 5. Apart
from that health care provider can provide guidance about important health
issues, such as diet and nutrition, immunization, weight gain and abstaining
from alcohol and drugs 7.  Main focus of prenatal care is to educate
pregnant women, inform them of risk factors and discuss their concerns 8.

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                    As
soon as a woman suspect that she might be pregnant, she should schedule a visit
with her health care provider 9. Early and regular prenatal visits
help to monitor woman’s health and growth of the fetus.

Prenatal
visit Schedule 1:

Before
28 weeks

Monthly

Weeks
28-36

Every
2 weeks

Week
36-birth

weekly

             

                       
  First visit will be longer and the health care
provider will do the following:1) Collect urine sample to confirm pregnancy 2)
Ask about past history including diseases, surgeries, or prior pregnancies,
family history and genetic history 3) Do complete physical examination
including blood pressure, weight, height, pelvic examination and pap smear 4)
Will ask about last menstrual period to calculate the due date 5) Take blood
and urine samples for lab work  6) Test
for hepatitis B, rubella, HIV and syphilis.7) Answer questions related to
pregnancy 1. Later visits will be shorter in duration and will
include checking blood pressure, weight gain, abdominal examination to check
fetal growth by measuring fundal height, fetal heart rate and ultrasound exam 1.

Health care provider will also do some special tests like checking for
gestational diabetes, screening for chromosomal and neural tube defects and
other conditions depending upon the age, family history or ethnicity 10.

                            The reasons behind the lack or inadequate
prenatal care are complex and varying 11. Women with low education
level may not be able to obtain a well-paying job with time off for a health
care visit and also, they might be living in a neighborhood with poor assess to
public transportation 12. Women with 12 or more year of education
are more likely to begin prenatal care early than with less than 12 years of
education 13. As maternal age increases, the percentage of women
who receive early prenatal care also increases 13. In 2014, 25% of
teens under the age 15 years received late or no prenatal care which decreased
to 10% for teens between the age 15-19 years, the percentage further drops to
4.5% for women in their thirties 7. Multiparous women are at
greater risk of receiving less prenatal care as compared to primiparous women 14.

Substance abusing women, particularly cocaine or opiate are less likely to
obtain prenatal care 15. Women who were on private insurance plan
were more likely to receive timely care (88%), followed by those who received
Medicaid (83.3%) 3. Uninsured women were less likely to receive
timely care or no care 3. Timing of prenatal care also varied by
race and ethnicity. African American and Hispanic women were less likely to
receive adequate prenatal care than white mothers 16.

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