Landscape of Pregnancy Care in US Community Health Centers

Abstract

Purpose: Community health centers (CHCs) provide critical health care access for people who experience high risks during and after pregnancy, however it is unclear to what extent they provide prenatal care. This study seeks to describe clinic and patient characteristics associated with longitudinal prenatal care delivery in CHC settings.

Methods: This retrospective cohort study utilized electronic health record (EHR) data from the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) between 2018 to 2019 to describe prenatal care provision among CHCs (n = 408), and pregnant CHC patients (n = 28,578) and compared characteristics of patients who received longitudinal prenatal care at CHCs versus those who did not.

Results: 41% of CHCs provided longitudinal prenatal care; these CHCs were more likely to be larger, have multidisciplinary teams, and serve higher proportions of nonwhite or non-English speaking patients. Patients who received longitudinal prenatal care at CHCs were racially and ethnically diverse and many had comorbidities. Patients who received longitudinal prenatal care at CHCs (compared with pregnant patients who did not) were more likely to be white or Latinx and more likely to have non-English language preference.

Conclusions: Many CHCs in this national network provide prenatal care and serve pregnant patients at high risk of pregnancy-related complications, including people of color, those with low income, and those with comorbidities. CHCs provide critical access to care for vulnerable populations and will be an important partner in work addressing inequities in maternal morbidity and mortality.

Keywords: Data Set; Family Medicine; Health Services Accessibility; Newborns; Obstetrics; Postpartum; Pregnancy; Prenatal; Retrospective Studies; Vulnerable Populations.