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 2021, rates of prenatal care in Lancaster County were highest among Asian and Hispanic births (both 76%) followed closely by African American births (75%), and white births (62%). Lancaster rates were higher than the state rates for all populations, with the exception of whites, which was 15 percentage points lower than the state rate. Since 2016, the rates among Hispanics and whites decreased 1 and 5 points respectively. The rate among Asians and African Americans rose 4 and 2 points, since in 2016.

Lancaster County had the lowest prenatal care among whites compared to surrounding counties and the third lowest rate among Hispanic births above Lebanon (73%) and Chester (71%). Lancaster's rate among African Americans was similar to Berks (76%) and above Dauphin (73%), Chester (71%) and Cumberland (66%).

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.