Prenatal or antepartum care is care given to pregnant women by an obstetrician or midwife and increases the likelihood of a safe and healthy delivery. Components of prenatal care recommended by the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) include determination of gestational age, fetal ultrasound imaging, routine laboratory testing, immunizations, genetic screening, psychosocial risk screening and patient education. According to the National Institute of Health, engaging in prenatal care early and consistently in pregnancy is an essential preventative factor in reducing adverse pregnancy outcomes such as low birth weight.  By addressing chronic diseases such as diabetes and hypertension associated with preterm birth, prenatal care has been found to reduce adverse birth outcomes. Assessment of prenatal care utilization is considered a critical step in improving prenatal care access and birth outcomes.   2022 NC SHIP, pg. 104.

Racial discrimination is a significant risk factor for adverse birth outcomes. To best understand the mechanisms by which racial discrimination impacts birth outcomes, and to inform the development of effective interventions that eliminate its harmful effects on health, longitudinal research that incorporates comprehensive measures of racial discrimination is needed. Healthcare providers must fully acknowledge and address the psychosocial factors that impact health outcomes in minority racial/ethnic women. 2022 NC SHIP, pg. 106

• Allow certified nurse midwives to practice under their full authority
• Encourage group prenatal care, childbirth education, and doula services are covered services by Medicaid
• Expand Medicaid eligibility
• Expand safe and reliable public transit options
• Provide education for local health & human services agencies on the importance of prenatal care.
• Public and provider awareness/education about ability to receive prenatal care services before receiving Medicaid card
• Strengthen workforce diversity and cultural humility in the delivery of prenatal care services
• Support quality improvement efforts to address provider bias
• Take advantage of the Children’s Health Insurance Program option to provide coverage for comprehensive prenatal care to undocumented immigrant women
• Use community health workers to provide outreach and education to women of childbearing age in underserved communities

NC State Center for Health Statistics, Vital Statistics

• Number of pregnancy care providers in the community
• Number of High-risk pregnancy care providers in the community
• Employer policies related to pregnancy care
• Number of community health care workers providing outreach and education
• Availability of public transportation to get to prenatal appointments