Data highlight

Oklahoma ranks 31 (of 51) for adequate prenatal care. Vermont leads the nation with 89.2% of pregnant women in the state starting and maintaining prenatal care during the recommended timeframe. In comparison, New Mexico is worst in the nation with only  70.7% of its pregnant women receiving adequate prenatal care.1“Distribution of Prenatal Care Adequacy Categories: Oklahoma, 2022,” PeriStats, March of Dimes. marchoftimes.org. Accessed January 2024.

Definition

Receiving adequate prenatal care means having access to comprehensive and timely medical services, screenings, and support that help ensure the health and well-being of both the pregnant person and the developing fetus throughout pregnancy.

It involves a series of healthcare services designed to monitor the pregnancy, identify and address potential complications, and provide guidance for a healthy pregnancy and childbirth.

Adequate prenatal care is considered care that begins within the first four months of pregnancy and continues based on the infant’s gestational age.

Why we care

Adequate access to prenatal care is vital to the health and well-being of the mother and baby during pregnancy. Regular visits allow moms to address health concerns throughout the pregnancy and gives providers the opportunity to screen for possible complications. 

A key marker of fetal development is weight, as it is an important part of physical and cognitive development for the baby. The infant death rate is five times higher if the mother did not seek prenatal care.2“Prenatal Care,” Office on Women’s Health, Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services. February 22, 2021. 

Pregnancy-related ailments like gestational diabetes (diabetes developed during pregnancy), preeclampsia (high blood pressure), and mental health disorders are rare but can harm both mother and child during and after birth. Adequate prenatal care drastically increases the chance they will be detected and addressed.3“What Is Prenatal Care and Why Is It Important?” Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health at the U.S. Department of Health and Human Services, nichd.nih.gov. January 31, 2017.

Specialized healthcare programs for low-income pregnant Oklahomans have existed for years, but the 2021 expansion of Medicaid (called SoonerCare in Oklahoma) and further extensions to cover more pregnancy-related services for longer (up to one year postpartum) has dramatically increased the scope of care available to mothers. (see Women Enrolled in Medicaid/SoonerCare).

Undocumented women do not qualify for SoonerCare. Instead, a program called Soon-to-be-Sooners is available and is specifically designed to cover healthcare costs strictly related to the health of the fetus.

Considerations

The COVID-19 pandemic and major changes to Oklahoma’s Medicaid program over the last five years have all affected the data in major ways. Impacts are still being disentangled and analyzed.

Much of the data in this article was collected during the pandemic. Adequate prenatal care is dependent on physician access and requires leaving the home. However, the Federal emergency declaration paused Medicaid (called SoonerCare in Oklahoma) recipients nationwide from rolling off, meaning many Americans maintained coverage despite no longer meeting qualifications. 

SoonerCare expansion and the extension of coverage for postpartum women occurred one and two years after the declaration, respectively (see Women Enrolled in Medicaid/SoonerCare). While the pandemic may have depressed physician access leading to lower rates of adequate prenatal care, it is also possible the changes to Medicaid rules did the opposite. 

It also needs to be noted that many Americans lost their jobs during this time and often their health insurance. While many then qualified for Medicaid, they may not have applied. 

What we can do

This issue brief was written by Metriarch staff as part of our Data Lookbook. Contributions and peer review were provided by Barbara O’Brien with the Oklahoma Perinatal Quality Improvement Collaborative (OPQIC)

Suggested citation
 Metriarch. “Access to Quality Care,” Data Lookbook (2024). URL: metriarchok.org/adequate-prenatal-care.

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