This Performance Measure tracks how well we are doing in getting patients enrolled in prenatal care within the first 12 weeks of their pregnancy which is difficult to achieve. Many women are unaware of their pregnancy until they are already 6 to 8 weeks pregnant, leaving only 4 to 6 weeks in the first trimester to schedule and keep an appointment. Work, transportation issues and other barriers related to various social determinants of health add additional layers to the problem and the COVID pandemic further exacerbated it by causing staff shortages and by increasing patients' health needs. Initial appointment slots are also quite limited making it difficult for women to schedule their first appointment quickly. The pandemic also caused the repeated cancellation and rescheduling of appointments due to staff illness; sometimes, over 100 patients were canceled in a single day.