Originally created 05/12/00

Prenatal care improves, but racial and ethnic disparities persist



ATLANTA -- White women are twice as likely as black and Hispanic ones to see a doctor in the first few months of pregnancy, a disparity that leads to more health problems for minority mothers and infants, the government reported Thursday.

The Centers for Disease Control and Prevention said more women are seeking early prenatal care, but a review of 13 states indicates Hispanic and black women wait longer for checkups, if they go to the doctor at all.

In 1997, the percentage of babies born to mothers whose first medical exam was more than three months into their pregnancy was 27.7 percent for black women, 26.3 for Hispanic women and 12.1 percent for white women, the CDC said.

In Washington, Surgeon General David Satcher called for research into why the gap persists. He pointed out that black women are nearly four times as likely to die of pregnancy-related causes as white women.

"Studies estimate that at least half of these deaths are preventable based on current medical knowledge," Satcher said.

Women who don't see a doctor until after the first three months of pregnancy risk complications such as premature delivery and low birth-weight babies, CDC epidemiologist Suzanne Zane said.

Diabetes, high blood pressure, infections, clotting and bleeding need to be caught early to avoid health problems that can kill, she said.

A CDC analysis of U.S. births indicated the number of women who delayed prenatal care or did not seek care declined from 25 percent in 1989 to 18 percent in 1997.

The improvement may be partly due to an expansion of Medicaid in the mid-1980s that made it possible for more women to pay a doctor.

Of the women who did not see a doctor early on, the most frequent explanation was that they did not know they were pregnant. Inability to pay and lack of health insurance were also significant factors.