Early, high-quality prenatal care is critical to reducing risks for complications of pregnancy or birth and improving birth outcomes. As in other health care settings, there are significant racial and ethnic disparities in prenatal care access and use. Research has identified socioeconomic status as the largest factor driving disparities, which has its roots in historical discrimination, segregation and lack of equitable access to resources.

In Lancaster County, rates of early prenatal care were 72% for African American births, 79% for Hispanic births, 85% for Asian births and 65% for white births in 2018. Lancaster rates were higher than the state rates for all populations, with the exception of whites, which is 13 percentage points lower than the state rate. Since 2007, the rates among African Americans and Hispanics increased 15 and 18 points respectively. The rates among Asians and whites are the same as they were in 2007.

Cumberland County had the highest prenatal care rate for Hispanic births (89%) and Lebanon County had the highest prenatal care rate for Black mothers at 100%. The rates for white and Asian mothers were highest in Berks County (83% and 100% respectively).

Researchers have uncovered a number of factors contributing to generally lower rates of early prenatal care among mothers of color. These include: socioeconomic characteristics like education and family income; maternal health and characteristics of pregnancies (such as maternal age and number of previous pregnancies); types of insurance coverage - whether women are covered by Medicaid, private insurance, or have no coverage; and the location of prenatal care facilities - in physicians' offices and public health clinics. One study found socioeconomic differences was responsible for roughly half the gap -- pregnant women with lower incomes and levels of formal education often do not have the resources necessary to obtain care early and often - but that public programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children increased access to care.

The rate excludes the number of live births for which the date of entry into prenatal care is unknown. In addition to considering when prenatal care began, it is also important to understand the quality and continuity of care received throughout the pregnancy.