Exploring the social determinants of racial/ethnic disparities in prenatal care utilization and maternal outcome

Semin Perinatol. 2017 Aug;41(5):308-317. doi: 10.1053/j.semperi.2017.04.008. Epub 2017 Jul 29.


Rates of maternal morbidity and mortality are rising in the United States. Non-Hispanic Black women are at highest risk for these outcomes compared to those of other race/ethnicities. Black women are also more likely to be late to prenatal care or be inadequate users of prenatal care. Prenatal care can engage those at risk and potentially influence perinatal outcomes but further research on the link between prenatal care and maternal outcomes is needed. The objective of this article is to review literature illuminating the relationship between prenatal care utilization, social determinants of health, and racial disparities in maternal outcome. We present a theoretical framework connecting the complex factors that may link race, social context, prenatal care utilization, and maternal morbidity/mortality. Prenatal care innovations showing potential to engage with the social determinants of maternal health and address disparities and priorities for future research are reviewed.

Keywords: Prenatal care; Racial disparity; Racism; Social determinants.

Publication types

  • Review

MeSH terms

  • Continental Population Groups
  • Ethnic Groups
  • Female
  • Healthcare Disparities / ethnology*
  • Humans
  • Maternal Health / ethnology*
  • Maternal Mortality
  • Pregnancy
  • Prenatal Care* / methods
  • Prenatal Care* / statistics & numerical data
  • Socioeconomic Factors
  • United States