The state has ranked last in recent years when it comes to women obtaining adequate care, defined as initiating care in the first four months of pregnancy and making it to an appropriate number of doctors appointments.
A large number of women in Hawaii aren’t receiving important prenatal care, putting them and their babies at increased risk of health complications. Indeed, the state has ranked in recent years when it comes to women obtaining adequate care, defined as initiating care in the first four months of pregnancy and making it to an appropriate number of doctors appointments.
Just 62% of women in Hawaii, according to recently released government data, compared with a national rate of about 75%.
The rates were the worst on Oahu and Hawaii island, where only 60% of women met the adequacy benchmark when averaged over the years 2019-2021, and the best on Kauai, where 86% of women received adequate care. On Maui, 80% of women met this standard, though the island is now facing a crisis in prenatal care as its only private practice that delivers babies phases out its obstetrics services.
Among the more troubling data points: About 1 in 9 infants in Hawaii was born to a mother who either didn’t begin receiving pregnancy care until her third trimester or received no prenatal care at all, according to the survey, which was analyzed by the March of Dimes, a national nonprofit that works to end preventable health risks for mothers and babies.
That rate, which has hovered at this level since 2018, is nearly twice the national average.
Ideally, prenatal care should begin within the first three months of pregnancy, according to health officials.
The state Department of Health’s Family Health Services Division has collected the data annually for decades through surveys that become part of the Pregnancy Risk Assessment Monitoring System, a project of the U.S. Centers for Disease Control and Prevention.
A review of the data over the past two decades indicates that Hawaii has been trending in the wrong direction. For example, in 2001 82% of women were beginning prenatal care in the first trimester, a rate that steadily declined to 71% in 2021.
Dr. Ann Chang, an OB-GYN at Kapiolani and Pali Momi medical centers, said she wasn’t surprised by the numbers.
“My partners and I take care of a lot of women who have barriers to accessing health care,” she said.
Chang said that women may lack health insurance or not have a good understanding of how to navigate the health care system. Sometimes they may not be able to obtain an appointment or even know in the early months that they are pregnant.