Prenatal care in the United States, 1980-94.

OBJECTIVES: This report examines trends in timing of prenatal care in the United States from 1980 to 1994. Demographic characteristics examined include age, race, Hispanic origin, marital status, place of birth of mother, educational attainment of mother, and live-birth order. Social characteristics discussed include barriers to care and pregnancy wantedness. METHODS: The source of data for trends and demographic analysis is the certificate of live birth filed for each child born in the United States. Data for social characteristics are from the 1988 National Maternal and Infant Health Survey (NMIHS). Data from the NMIHS are based on 9,953 responses. RESULTS: Very few groups of women have yet to achieve the goal of 90 percent initiating prenatal care in the first trimester as set by Healthy People 2000. In 1994, 80 percent of all mothers initiated care in the first trimester. Cuban mothers were the only mothers to reach the objective of 90 percent with Japanese mothers close behind at 89 percent. Mothers with the lowest percent initiating early prenatal care were non-Hispanic black (68 percent), Puerto Rican (67 percent), and American Indian mother (65 percent). Mothers who have problems getting prenatal care due to financial, scheduling, transportation, or other problems have lower rates of initiating early care. Mothers who wanted to be pregnant when they did were more inclined to initiate early care than mothers who did not want to become pregnant or whose pregnancies were mistimed. CONCLUSIONS: Prenatal care use in the United States did not improve in the 1980's but has been improving since 1990. Variations in use by demographic characteristics persist. There are wide gaps between mothers with easier access to prenatal care and those who encounter barriers to care. Mothers who want to become pregnant also tend to seek help in understanding their pregnancy and its risks earlier than those who did not intend to get pregnant or cared to become pregnant at another time.

Surveillance for pregnancy and birth rates among teenagers, by state--United States, 1980 and 1990.

PROBLEM/CONDITION: In the United States in 1990, there were an estimated 1 million pregnancies and 521,826 births among women ages 15-19 years. Rates of teenage pregnancy and birth rates by state in 1990 exceeded those in most developed countries. An estimated 95% of teenage pregnancies are unintended (i.e., they occur sooner than desired or are not wanted at any time). REPORTING PERIOD COVERED: This report summarizes and reviews surveillance data for pregnancies, abortions, and births among women ages 15-19, 15-17, and 18-19 years reported by CDC for 1980 and 1990. DESCRIPTION OF SYSTEM: Data for births and abortions were reported to state health departments and other health agencies and sent to CDC. The data from each state included the total number of births and abortions by age and race/ethnicity. RESULTS: Data in this report indicate that pregnancy rates by state among U.S. teenagers ages 15-19 years have changed little since 1980. Moreover, many states have reported increases in birth rates that are probably related to concurrent decreases in abortion rates. Pregnancy rates range from 25 to 75 per 1,000 for 15- to 17-year-olds and from 92 to 165 per 1,000 for 18- to 19-year-olds. INTERPRETATION: States with low rates of teenage pregnancy or birth may have developed and used prevention strategies directed at the needs of both younger and older teenagers; these programs may serve as models for other states where birth rates have remained high or have increased since 1980. ACTIONS TAKEN: CDC will continue to conduct surveillance of and analyze data for pregnancies, abortions, and births among teenagers to monitor progress toward national goals and to assist in targeting program efforts for reducing teenage pregnancy.

Compiling provisional and final birth statistics.

PIP: An explanation is provided for the differences between the provisional and final U.S. birth statistics produced by the National Center for Health Statistics (NCHS). Some consideration is also given to recent U.S. fertility trends and to Hispanic and Asian fertility.^ieng