​Prenatal and Postpartum Care—Timeliness of Prenatal Care

Measure Definition

The Prenatal and Postpartum Care—Timeliness of Prenatal Care measure calculates the percentage of women who delivered a live birth who received a prenatal care visit as a member of the plan in the first trimester or within 42 days of enrollment in the plan.


Effective prenatal care aids in the identification of high-risk pregnancies and provides educational opportunities to prevent subsequent poor birth outcomes. Timely and frequent prenatal care visits allow health problems to be detected early. A lack of timely prenatal care may indicate weak therapeutic alliances, lack of peer support, hesitation regarding health plans, and residential instability throughout the gestational period. Studies reveal that women in the U.S. who are at risk for inadequate prenatal care are more likely to be non-Caucasian, not a high school graduate, enrolled in Medicaid, unmarried, a smoker, a drug user, and under 20 years of age. Socioeconomic status is a determinant of health outcomes, including poor birth outcomes. Socioeconomic factors that present barriers to consistent care are common in the Medicaid populations. Due to this lack of care, poor birth outcomes are particularly high among these populations. Studies revealed that receiving timely prenatal care is associated with the timing of Medicaid coverage. In 2008, only 82 percent of Medicaid members received timely prenatal care, compared to approximately 92 percent for members in commercial plans.

In contrast to women who received prenatal care, women who did not receive prenatal care were three to four times more likely to die from complications of pregnancy and were three times more likely to have an infant death. When comparing the infant mortality rate for women who had timely prenatal care and those that did not, the infant mortality rate was five times greater.

In a 2006 report, more than $26 billion in health care costs in 2005 were attributed to preterm births. Further, 6,500 babies per week are born, on average, with a low birth weight. Low birth weights may be prevented by continuous prenatal care.

To see how Managed Care reported on Prenatal and Postpartum Care—Timeliness of Prenatal Care, click here.​

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Last modified date: 11/1/2019 11:20 AM