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Greg R. Alexander, RS, MPH, ScD, Michael D. Kogan, PhD and Sara Nabukera, MD, MPH

Greg R. Alexander and Sara Nabukera are with the School of Public Health, Department of Maternal and Child Health, the University of Alabama at Birmingham. Michael D. Kogan is with the Office of Data and Information Management, Maternal and Child Health Bureau, Health Resources and Services Administration.

Correspondence: Requests for reprints should be sent to Greg R. Alexander, Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, RPHB 320, 1530 3rd Ave South, Birmingham, Alabama 35294–0022 (e-mail: alexandg{at}uab.edu).

Objectives. We examined trends and racial disparities (White, African American) in trimester of prenatal care initiation and adequacy of prenatal care utilization for US women and specific high-risk subgroups, e.g., unmarried, young, or less-educated mothers.

Methods. Data from 1981–1998 US natality files on singleton live births to US resident mothers were examined.

Results. Overall, early and adequate use of care improved for both racial groups, and racial disparities in prenatal care use have been markedly reduced, except for some young mothers.

Conclusions. While improvements are evident, it is doubtful that the Healthy People 2000 objective for prenatal care will soon be attained for African Americans or Whites. Further efforts are needed to understand influences on and to address barriers to prenatal care.

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