Nearly a quarter of pregnant women aren’t getting prenatal care in the early stages of pregnancy, according to a new analysis from the U.S. Centers for Disease Control and Prevention.

The share of pregnant women getting prenatal care had been improving: It rose between 2016 and 2021 to a high of more than 78%, but then declined to 75.5% by 2024, wiping out previous gains.

The trend is worrying because getting care early in pregnancy can improve the likelihood of a healthy pregnancy and baby.

The decrease in early prenatal care held true for nearly all race and ethnic groups, but the drops were sharpest for Native Hawaiian and Other Pacific Islanders, Black women and American Indian and Alaska Native women.

By 2024, less than half of Native Hawaiian and Other Pacific Islander mothers received prenatal care in their first trimester — the first three months of pregnancy.

Anne Markus, a professor at George Washington University’s Milken Institute School of Public Health, said that because the statistically significant decline began around 2021, two events could explain some of the decrease: the COVID pandemic, with its associated stay-at-home orders, and the U.S. Supreme Court’s Dobbs decision in 2022 that dismantled the constitutional right to abortion.

“Both disproportionately affected, and continue to affect, communities of color, and the decline in early entry into prenatal care has been disproportionately bigger for racial and ethnic minorities since 2021,” said Markus, whose work focuses on public policy and access to health care. She was not involved in the analysis.

A lack of early prenatal care has also been disproportionately seen in “very young women who are more likely to have a pregnancy that they do not want,” Markus said. “The Dobbs decision and the fear and uncertainty it generated could be particularly relevant in explaining this disproportionate effect observed in the data.”

The share of women getting late care — beginning in the seventh month of pregnancy or later — or no care at all increased in more than half of states from 2021-2024. Utah saw the biggest rise in late or no care, followed by Massachusetts and Rhode Island. The number of Utah women getting late or no prenatal care jumped 54%, up to nearly 6% of women.

More than 1 in 10 women had late or no prenatal care by 2024 in Florida, Georgia, Hawaii, New Mexico and Texas.

“Geographic and financial barriers to accessing care are often behind late entry to recommended care, including prenatal care,” Markus said.

Late or no prenatal care decreased in six states: Arkansas, New Hampshire, South Carolina, Tennessee, West Virginia and Wisconsin.

The CDC compiled the report based on information from birth certificates, and includes information for all births that occurred in the United States.

Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.

Rep. Lisa Subeck (D-Madison) is proposing that Wisconsin require crisis pregnancy centers to get express written permission before releasing a person’s private health information. (Photo by Baylor Spears/Wisconsin Examiner)

Rep. Lisa Subeck (D-Madison) is proposing that Wisconsin require crisis pregnancy centers to get express written permission before releasing a person’s private health information. Those who have given permission would also be able to withdraw their permission at any time under the bill. 

“Many people assume that when they seek care for pregnancy or other reproductive health services that that information is protected, just like any other medical records under HIPAA, and while that is true at your doctor’s office or at the hospital, it’s not always true when you visit other providers,” Subeck said at a press conference Thursday.

Concerns about information being gathered about women’s reproductive health, including by crisis pregnancy centers, have surged in the years since Roe v. Wade was overturned by the U.S. Supreme Court, especially in states where abortion has been criminalized. 

A 2022 TIME Magazine report found that crisis pregnancy centers have been collecting information including sexual and reproductive histories, test results, ultrasound photos, and information shared during consultations, parenting classes, or counseling sessions, from women they interact with through telephone and online chats. They are not required to follow federal health data privacy laws. The report led to U.S. Sen. Elizabeth Warren requesting an examination of the practices by crisis pregnancy centers.

The bill, coauthored by Sen. LaTonya Johnson (D-Milwaukee), would also require centers to disclose in “plain language” that they are not a HIPAA-covered entity for the purpose of federal privacy regulations as well as disclosing any data breach that exposes individual digital health information.

Subeck said the centers can “look and feel an awful lot like a traditional medical clinic,” noting that they might offer ultrasounds, pregnancy tests and claim to have counselors on staff. However, she said “many of these centers are not licensed medical providers, and therefore they are not covered by HIPAA privacy protections.”

Subeck said that changes in reproductive health laws have raised concerns about the misuse of health related information and data. She said the bill would not close unregulated pregnancy centers, limit the services they can provide or limit speech. Rather, she said, it “simply sets some basic privacy expectations and protections for unsuspecting individuals.”

Subeck noted that lawmakers in other states, including Pennsylvania, have introduced similar measures, though none have become law.

Subeck said the violations of the provisions in the bill would be treated as “unfair and deceptive practices” under existing state law.

Laura Hanks, an OB-GYN and legislative chair for American College of Obstetricians and Gynecologists, said at the press conference that the bill shouldn’t be political.

“It’s about privacy, honesty and safe, medically accurate care. Unregulated pregnancy centers often look like clinics, but they aren’t held to the basic medical privacy rules,” Hanks said. “This means they lack regulation, medical oversight or standard confidentiality rules. Too many people are walking in and assuming their health care information is protected when it isn’t. This bill sets commonsense guardrails.”

The headline on this report has been revised for clarity. 

A Planned Parenthood clinic in Salt Lake City on Wednesday, July 31, 2024. (Photo by McKenzie Romero/Utah News Dispatch)

WASHINGTON — A federal judge on Monday closed the lawsuit Planned Parenthood filed last summer after Republicans’ “big, beautiful” law blocked Medicaid patients from visiting its clinics for any health care appointments for one year. 

Planned Parenthood filed notice with the court Friday that it had dismissed “without prejudice all claims against” the Trump administration in the case. Massachusetts District Court Judge Indira Talwani issued an electronic order Monday closing the case “Pursuant to Plaintiffs’ Notice of Voluntary Dismissal without Prejudice.”

The law prevents people on Medicaid from being seen at Planned Parenthood facilities through early July, when the one-year period would expire.

Planned Parenthood Federation of America President and CEO Alexis McGill Johnson wrote in a statement released last week that President Donald Trump “and his allies in Congress have weaponized the federal government to target Planned Parenthood at the expense of patients —  stripping people of the care they rely on. 

“Through every attack, Planned Parenthood has never lost sight of its focus: ensuring patients can get the care they need from the provider they trust. That will never change. Care continues, as does our commitment to fighting for everyone’s freedom to make their own decisions about their bodies, lives, and futures.”

The Department of Justice did not immediately respond to a request for comment from States Newsroom. 

Talwani originally ruled for Planned Parenthood in the case, temporarily blocking the defunding provision from taking effect. But an appeals court later overturned that decision, allowing the Trump administration to legally withhold Medicaid funding from going to Planned Parenthood. 

Talwani was nominated by former President Barack Obama.

The provision in Republicans’ “big, beautiful” law that blocks all Medicaid funding from going to Planned Parenthood was originally slated to last for a decade, but the final version covered one year. 

Federal law for decades has barred spending from covering abortions with limited exceptions for rape, incest, or the woman’s life. 

So the new language prevented Medicaid patients from scheduling appointments at Planned Parenthood for other types of health care, like annual physicals, cancer screenings, or birth control appointments. 

Shireen Ghorbani, president and CEO of Planned Parenthood Association of Utah, which filed the lawsuit along with Planned Parenthood League of Massachusetts and Planned Parenthood Federation of America, wrote in a statement that its health care providers would “continue to see patients and deliver on our mission to provide high-quality care and education to everyone who needs it, no matter where they live or how much money they make.” 

A Planned Parenthood spokesperson, who did not want to comment on the record, said that certain clinics may choose to cover the cost of treating Medicaid patients, even though the clinic will not receive reimbursement from the federal government under the law. 

Angela Vasquez-Giroux, vice president of communications at Planned Parenthood Federation of America, wrote in a statement that the organization’s “health centers initially shielded the overwhelming majority of patients who rely on Medicaid from the harm of this cruel law. Unfortunately, the consequences for patients will worsen considerably over time as health centers close, costs rise, and access to their trusted provider is pushed further out of reach.”