Skagit County Trends Newsletter

SHARE OF WOMEN RECEIVING FIRST TRIMESTER PRENATAL CARE BELOW STATE -

Going to the doctor for a routine check-up is an important aspect of personal health at any age. But for women who have an intention to become pregnant, routine medical attention and planning is critical. Healthy development in the very early stages of pregnancy has life-long health implications as the baby continues to grow and develop through childhood and eventually adulthood.

Prenatal health care is important not only for the baby, but for the mother as well. According to the University of Stanford, Stanford Children's Health, "The first prenatal visit is the most thorough. A complete medical history is taken, a physical exam is done, and certain tests and procedures are performed to assess the initial health of the mother and her unborn baby."

Early prenatal medical appointments create opportunities to provide education on basic health, such as proper nutrition, important vitamins, and exercise, as well as tools to refrain from tobacco, alcohol, and other substances. They also create openings to tell a professional about unsafe living conditions, including reporting on situations of domestic violence.

Questions about lifestyle, family medical history, medications, and past pregnancies will certainly be discussed. Additionally, a variety of tests, such as urine, blood, and genetics testing might be conducted to check for common diseases, infectious diseases, and inherited diseases, and blood incompatibility between the mother and the fetus. An estimated due date will also be set to track progress.

According to the U.S. Centers for Disease Control and Prevention in 1999, "The leading causes of infant death were congenital anomalies and low birthweight - two conditions that can be [considerably] impacted by prenatal care."

Taking a look at the Total and Share of Women Giving Birth Who Received Prenatal Care in the First Trimester indicator, we see a slightly favorable trend. For Skagit County women who gave birth and received prenatal care in the first trimester (1,085 in 2015 compared to 1,015 in 2000), the share was 75.2% in 2015 compared to 72.7% in 2000.

Typically throughout the years covered by this trend, Skagit County had a lower share of mothers who gave birth

and received prenatal care in the first trimester than the state, except for 2012. In that year, 76.8% of expecting mothers in the county versus 75.8% in the state received prenatal care. 2012 also produced the highest share for Skagit County for any year offered in the series.

Jennifer Sass-Walton, Family Health Manager with Skagit County Public Health, says there are "variety of reasons" expecting mothers under the age of 18 might be reluctant to tell people they are pregnant, some of which include not realizing "they are pregnant, fear of disclosure, lack of understanding of the importance of prenatal care, lack of experience with the health care system, lack of personal control over their health care, etc."

Women of all ages who use drugs or have substance use disorder also might avoid seeking prenatal care. Sass-Walton explains these mothers might not receive prenatal care "due to shame, fear of child protective services involvement, lack of control over their lives, past and current trauma, homelessness, [or due to a] lack of resources". Other reasons might include mothers with mental or cognitive issues that "may limit their ability to access health care and/or insurance" and the waiting period between applying and approval for Apple Health.

Although anecdotal because there isn't very much data available for prenatal care in the first trimester for our immigrant and undocumented populations, Sass-Walton said within these populations, prenatal care "may not be part of their cultural experience/expectations…[and] undocumented moms may have less ability to get to care, less options for care providers who can deliver services that are a good fit for culture/language, [and] perhaps some fear due to our current climate of increased immigration enforcement."

Sass-Walton concludes that "In an ideal world, all pregnancies would occur to healthy parents who are prepared to be parents materially [and] socially…Although health care, itself, is not the biggest contributor to health status, it is very important during pregnancy to provide anticipatory guidance, early identification and management of chronic health conditions and connection to other community supports."

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